Dataset Information

Diffusion tensor imaging of the optic nerve in multiple sclerosis: association with retinal damage and visual disability.

ABSTRACT: There is a well-known relationship between MS and damage to the optic nerve, but advanced, quantitative MR imaging methods have not been applied to large cohorts. Our objective was to determine whether a short imaging protocol (< 10 minutes), implemented with standard hardware, could detect abnormal water diffusion in the optic nerves of patients with MS.We examined water diffusion in human optic nerves via DTI in the largest MS cohort reported to date (104 individuals, including 38 optic nerves previously affected by optic neuritis). We also assessed whether such abnormalities are associated with loss of visual acuity (both high and low contrast) and damage to the retinal nerve fiber layer (assessed via optical coherence tomography).The most abnormal diffusion was found in the optic nerves of patients with SPMS, especially in optic nerves previously affected by optic neuritis (19% drop in FA). DTI abnormalities correlated with both retinal nerve fiber layer thinning (correlation coefficient, 0.41) and loss of visual acuity, particularly at high contrast and in nerves previously affected by optic neuritis (correlation coefficient, 0.54). However, diffusion abnormalities were overall less pronounced than retinal nerve fiber layer thinning.DTI is sensitive to optic nerve damage in patients with MS, but a short imaging sequence added to standard clinical protocols may not be the most reliable indicator of optic nerve damage.

SUBMITTER: Smith SA

PROVIDER: S-EPMC3190034 | biostudies-literature | 2011 Oct

REPOSITORIES: biostudies-literature

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Diffusion tensor imaging of the optic nerve in multiple sclerosis: association with retinal damage and visual disability.

Smith S A SA Williams Z R ZR Ratchford J N JN Newsome S D SD Farrell S K SK Farrell J A D JA Gifford A A Miller N R NR van Zijl P C M PC Calabresi P A PA Reich D S DS

AJNR. American journal of neuroradiology 20110728 9

<h4>Background and purpose</h4>There is a well-known relationship between MS and damage to the optic nerve, but advanced, quantitative MR imaging methods have not been applied to large cohorts. Our objective was to determine whether a short imaging protocol (< 10 minutes), implemented with standard hardware, could detect abnormal water diffusion in the optic nerves of patients with MS.<h4>Materials and methods</h4>We examined water diffusion in human optic nerves via DTI in the largest MS cohort ...[more]

PMID: 21799043

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Project description:BackgroundIntracranial tumors involving the temporo-occipital lobe often compress or destroy the optic radiation (OpR), resulting in decreased visual function. The aim of this study is to explore the value of diffusion tensor imaging (DTI) tractography integrated with neuronavigation to prevent visual damage when resecting tumors involving the OpR and find potential factors affecting patients' visual function and quality of life (QOL).MethodsOur study is a cross-sectional study that included 28 patients with intracranial tumors in close morphological relationship with the OpR recruited between January 2020 and February 2022. The surgical incision and approach were preoperatively designed and adjusted according to the DTI tractography results and visual function scores. All patients underwent examinations of visual acuity (VA) and visual field index (VFI) and completed visual function and QOL scales at admission and 2 months after discharge. Logistic regression and linear regression analysis were conducted to evaluate clinical factors potentially affecting pre/postoperative OpR morphology, VA, VFI, visual function, and QOL.ResultsLesion size was the main factor found to affect visual function (β = -0.74, 95%CI: -1.12~-0.36, P = 0.05), VA (left: β = -0.11, 95%CI: -0.14~-0.08, P < 0.001; right: β = -0.15, 95%CI: -0.17~-0.13, P < 0.001), and VFI (left: β = -0.11, 95%CI: -0.14~-0.08, P < 0.001; right: β = -0.14, 95%CI: -0.16~-0.12, P < 0.001). Lesion size, edema, and involvement of the lateral ventricle temporal horn were factors affecting OpR morphology and QOL. The 28 patients showed significantly improved VA, VFI, visual function, and QOL results (P < 0.05) 2 months after discharge.ConclusionsCombining DTI of OpR mapping and microscopic-based neuronavigation aided precise mapping and thus preservation of visual function in patients undergoing tumor resection. Potential clinical factors affecting patients' visual function and QOL scores were identified which are useful for assessing a patient's condition and predicting prognosis.

Project description:OBJECTIVES: Leber's hereditary optic neuropathy (LHON) is a mitochondrial disease leading to bilateral loss of central vision and severe optic nerve atrophy. A subtype of LHON presents additional clinical and MRI aspects indistinguishable from those of multiple sclerosis (MS) (LHON-MS). In patients with LHON or LHON-MS, an assessment was made of (a) the severity of optic nerve damage, using MRI and magnetisation transfer imaging (MTI), and (b) the presence and extent of macroscopic and microscopic pathology in the brain and cervical cord, using MRI and MT ratio (MTR) and mean diffusivity (D) histogram analysis. METHODS: Ten patients with LHON, four with LHON-MS, and 20 age and sex matched healthy controls were studied. For the optic nerve and the brain, dual-echo turbo spin echo (TSE), T1 weighted spin echo, and MT images were obtained. For the brain, fast fluid attenuated inversion recovery (fast FLAIR) and diffusion weighted images were also obtained. For the cervical cord, fast short tau inversion recovery (STIR) and MT images were obtained. The volume and the average MTR value of both the optic nerves were measured. MTR and histograms of the normal appearing brain tissue (NABT) and MTR histograms of the whole cervical cord tissue were created. RESULTS: The mean values of optic nerve volumes and MTR were significantly lower in patients with LHON than in healthy controls. Mean NABT-MTR histogram peak height was significantly lower in patients with LHON than in controls, whereas no significant difference was found for any of the cervical cord MTR histogram derived measures. Average diffusivity (D) was higher in patients with LHON than in controls. Optic nerve volume and MTR value and mean NABT-MTR were lower in patients with LHON-MS than in those with LHON. CONCLUSIONS: The severity of optic nerve pathology in LHON is measurable in vivo using MRI and MTI. MTR and histogram analysis suggests that microscopic brain damage occurs in LHON and that it is more severe in the MS-like form of the disease.

Dataset Information

Diffusion tensor imaging of the optic nerve in multiple sclerosis: association with retinal damage and visual disability.

Publications

Diffusion tensor imaging of the optic nerve in multiple sclerosis: association with retinal damage and visual disability.

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