Diffusion-Weighted Imaging and Post-contrast Enhancement in Differentiating Optic Neuritis and Non-arteritic Anterior Optic Neuropathy

Ore-Ofe O Adesina; J Scott McNally; Karen L Salzman; Bradley J Katz; Judith E A Warner; Molly McFadden; Kathleen B Digre

doi:10.1080/01658107.2017.1356856

Diffusion-Weighted Imaging and Post-contrast Enhancement in Differentiating Optic Neuritis and Non-arteritic Anterior Optic Neuropathy

Neuroophthalmology. 2017 Aug 18;42(2):90-98. doi: 10.1080/01658107.2017.1356856. eCollection 2018 Apr.

Authors

Ore-Ofe O Adesina^{1

2

3

4}, J Scott McNally⁵, Karen L Salzman⁵, Bradley J Katz^{1

6}, Judith E A Warner^{1

6}, Molly McFadden⁷, Kathleen B Digre^{1

6}

Affiliations

¹ Moran Eye Center, Department of Ophthalmology and Visual Sciences, The University of Utah, Salt Lake City, Utah, USA.
² Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
³ Robert Cizik Eye Clinic, Houston, Texas, USA.
⁴ Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
⁵ Department of Radiology, The University of Utah, Salt Lake City, Utah, USA.
⁶ Department of Neurology, The University of Utah, Salt Lake City, Utah, USA.
⁷ Division of Epidemiology, The University of Utah, Salt Lake City, Utah, USA.

Abstract

Non-arteritic anterior ischaemic optic neuropathy (NAION) and optic neuritis (ON) may be difficult to distinguish early in their disease courses. Our goal was to determine if specific magnetic resonance imaging characteristics differentiate acute NAION from ON. Neuroradiologists, masked to diagnosis, reviewed the diffusion-weighted imaging (DWI) and post-contrast enhancement (PCE) characteristics of the optic nerve in 140 eyes. PCE and DWI signals of the optic disc alone did not discriminate between NAION and ON. After taking age and sex into consideration, only DWI and PCE of the intraorbital segment of the optic nerve differentiated the two, with ON having the increased likelihood of these findings. Isolated PCE without DWI signal at the optic disc, however, was 100% specific for NAION. This may be the most specific way to radiographically differentiate between NAION and ON in the acute setting.

Keywords: Diffusion-weighted imaging; magnetic resonanceimaging; non-arteriticanterior ischaemic optic neuropathy; optic neuritis; post-contrast enhancement.

Abstract

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