Highlights
- •Distinguishing between causes of optic neuritis is of paramount importance.
- •Optic nerve enhancement distinguishes neuromyelitis optica from multiple sclerosis.
- •Enhancement greater than 40 mm can be called longitudinally extensive optic neuritis.
Abstract
Background
Neuomyelitis optica, sarcoid, and multiple sclerosis can all cause optic neuritis.
Further means of distinguishing the causes of optic neuritis among these etiologies
would be valuable for the clinician.
Methods
This is a retrospective, cohort study from a single university based hospital and
neuro-ophthalmology clinic. Blinded interpretation of orbit MRIs was performed on
patients with acute optic neuritis from multiple sclerosis (n = 25), sarcoid (n = 5) and neuromyelitis optica spectrum disorder (n = 6).
Results
A length of >40 mm anterior visual pathway enhancement distinguished neuromyelitis optica spectrum
disorder from multiple sclerosis (p = 0.0376). No statistically significant differences were found for presence of pain
or papillitis, however there was a trend for bilateral involvement and chiasmal involvement
in neuromyelitis optica spectrum disorder compared to multiple sclerosis.
Conclusions
In acute optic neuritis, enhancing anterior visual pathway lesion length >40 mm helps differentiate neuromyelitis optica spectrum disorder from multiple sclerosis.
This degree of involvement can be considered longitudinally extensive optic neuritis.
Further characterization is necessary as this degree of enhancement occurs in other
clinical syndromes besides neuromyelitis optica.
Keywords
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Article info
Publication history
Published online: July 28, 2014
Accepted:
July 21,
2014
Received in revised form:
July 20,
2014
Received:
May 17,
2014
Identification
Copyright
© 2014 Elsevier B.V. Published by Elsevier Inc. All rights reserved.