Utility of standard diffusion-weighted magnetic resonance imaging for the identification of ischemic optic neuropathy in giant cell arteritis

Danyel, Leon Alexander; Miszczuk, Milena; Pietrock, C.; Büge, B. T.; Villringer, Kersten; Böhner, Georg; Siebert, Eberhard

doi:10.1038/s41598-022-20916-y

Cited by 7 publications

(4 citation statements)

References 55 publications

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“…In 2021, Kaur et al performed an experiment to monitor ocular pressure changes during prone spine surgery and found that ocular pressure was significantly elevated at the end of the case when compared to baseline pressures [64]. Danyel et al described the use of diffusion-weighted MRI to diagnose ION in patients with giant cell arteritis [65].…”

Section: -Presentmentioning

confidence: 99%

“…The presentation of PION will be consistent with optic neuropathy, but with an unremarkable fundoscopic exam [36]. While PION is often a diagnosis of exclusion, recent reports have argued for the use of diffusion weighted imaging (DWI) to diagnose the acute phase of PION [55,61,65]. DWI has been applied to AION and shows promise in detecting ischemic changes [81].…”

Section: Assessment and Diagnosismentioning

confidence: 99%

“…DWI has been applied to AION and shows promise in detecting ischemic changes [81]. In the giant cell arteritis population, sensitivity and specificity for DWI in detecting aggregated AION and PION is 87% and 99%, respectively [65]. Fundoscopic exam for CRAO shows a pale and edematous retina coupled with a cherry red macula and the narrowing of arterioles [34,82,83].…”

Section: Assessment and Diagnosismentioning

confidence: 99%

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Perioperative Blindness in Spine Surgery: A Scoping Literature Review

Sperber,

Owolo,

Zachem

et al. 2024

JCM

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Perioperative vision loss (POVL) is a devastating surgical complication that impacts both the recovery from surgery and quality of life, most commonly occurring after spine surgery. With rates of spine surgery dramatically increasing, the prevalence of POVL will increase proportionately. This scoping review aims to aggregate the literature pertinent to POVL in spine surgery and consolidate recommendations and preventative measures to reduce the risk of POVL. There are several causes of POVL, and the main contribution following spine surgery is ischemic optic neuropathy (ION). Vision loss often manifests immediately following surgery and is irreversible and severe. Diffusion weighted imaging has recently surfaced as a diagnostic tool to identify ION. There are no effective treatments; therefore, risk stratification for counseling and prevention are vital. Patients undergoing prone surgery of long duration and/or with significant expected blood loss are at greatest risk. Future research is necessary to develop effective treatments.

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Section: -Presentmentioning

confidence: 99%

Section: Assessment and Diagnosismentioning

confidence: 99%

Section: Assessment and Diagnosismentioning

confidence: 99%

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Perioperative Blindness in Spine Surgery: A Scoping Literature Review

Sperber,

Owolo,

Zachem

et al. 2024

JCM

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“…In 2019, Matsuoka et al reported, to our knowledge, the first case with an abnormal DWI signal of the temporal arteries (TAs) [10]. Recently, a few additional cases of DWI in GCA were published [11][12][13]. DWI is based on the measurement of random Brownian motion of water molecules.…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted magnetic resonance imaging for the diagnosis of giant cell arteritis – a comparison with T1-weighted black-blood imaging

Seitz

Bucher

Bütikofer

et al. 2023

Preprint

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Objectives: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) of the superficial cranial arteries in the diagnosis of giant cell arteritis (GCA). Methods: Retrospectively, 156 patients with clinically suspected GCA were included. A new 4-point ordinal DWI rating scale was developed. A post-contrast, fat-suppressed, T1-weighted "black-blood" sequence (T1-BB) was rated for comparison. Ten arterial segments were assessed: common superficial temporal arteries, temporal and parietal branches, occipital and posterior auricular arteries bilaterally. The expert clinical diagnosis after ≥ 6 months of follow-up was the diagnostic reference standard. Diagnostic accuracy was evaluated for different rating methods. Results: The study cohort consisted of 87 patients with and 69 without GCA. For DWI, the area under the curve was 0.90. For a cut-off of ≥ 2 consecutive pathological slices, DWI showed a sensitivity of 75.9%, a specificity of 94.2% and a positive likelihood ratio of 13.09. With a cut-off of ≥ 3 consecutive pathological slices, sensitivity was 70.1%, specificity was 98.6%, and the positive likelihood ratio was 48.38. For the T1-BB, values were 88.5%, 88.4% and 7.63, respectively. The inter-rater analysis for DWI with a cut-off of ≥ 2 pathological slices showed a kappa of 1.00 on the patient level and 0.85 on the arterial segment level. For the T1-BB the kappa was 0.78 and 0.79, respectively. Conclusion: DWI of the superficial cranial arteries demonstrates a good diagnostic accuracy and reliability for the diagnosis of GCA. DWI is widely available and can be used immediately in clinical practice for patients with suspected GCA.

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Optic nerve sheath measurement to monitor disease activity in giant cell arteritis: a pilot study

Ross,

Ducharme-Bénard,

Hussein

et al. 2024

Clin Rheumatol

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Introduction/Objectives Optic nerve sheath (ONS) enhancement using magnetic resonance imaging of the orbits was observed in patients with giant cell arteritis (GCA). We previously showed that ONS diameter (ONSD) by bedside ultrasound is increased in patient with active GCA. This study aims to assess whether ONSD decreases with clinical remission in patients with GCA. Methods A prospective cohort study was conducted from June 2022 to January 2023. Patients who had an optic nerve ultrasound at GCA diagnosis as part of a previous crosssectional study were eligible. Optic nerve ultrasound was performed by the same investigator at diagnosis and month 3. ONSD (includes the optic nerve and its sheath) and optic nerve diameter (OND) were measured. Descriptive statistics for baseline characteristics and paired sample t-test were performed to assess the mean difference in OND and ONSD between diagnosis and month 3. Results Nine patients with GCA were included. The median age at disease onset was 79 years (interquartile range (IQR) of 79–82 years), and 7 patients were males. All patients were in clinical remission at month 3 on prednisone (median dose of 15 mg/day, IQR of 10–25 mg). The mean ONSD was lower at month 3 (3.76 mm) compared to baseline (5.98 mm), with a paired mean difference of 2.22 mm (95% CI 1.41–3.03 mm, p < 0.001). As anticipated, OND measurements did not vary between diagnosis and month 3. Conclusion ONSD on ultrasound improves after 3 months of therapy in patients with GCA. A longer prospective study is required to determine if ONSD is useful to assess disease activity in GCA. Key Points • ONS ultrasound can identify patients with active GCA.• The ONSD on ultrasound is dynamic and improved after 3 months of GCA therapy.• ONS ultrasound may be useful to monitor disease activity in GCA.

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Utility of standard diffusion-weighted magnetic resonance imaging for the identification of ischemic optic neuropathy in giant cell arteritis

Cited by 7 publications

References 55 publications

Perioperative Blindness in Spine Surgery: A Scoping Literature Review

Perioperative Blindness in Spine Surgery: A Scoping Literature Review

Diffusion-weighted magnetic resonance imaging for the diagnosis of giant cell arteritis – a comparison with T1-weighted black-blood imaging

Optic nerve sheath measurement to monitor disease activity in giant cell arteritis: a pilot study

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