Abstract
BackgroundDiffusion tensor imaging (DTI) has been used for the evaluation of the white matter integrity. In this study, we evaluated optic nerve impairment in patients with neuromyelitis optica (NMO) using DTI.Methodology/Principal FindingsOptic nerve DTI were performed on 28 NMO patients and 38 normal controls. Fractional anisotropy (FA) values were measured in the anterior, middle, and posterior parts of the intraorbital optic nerve segment. For the posterior intraorbital optic nerve, FA values of BI (0.20±0.07), MI (0.24±0.16), and NA (0.25±0.14) decreased significantly compared with that of NC (0.43±0.07) (P<0.05), and ROC analysis demonstrated that the area under the curve (AUC) measurements for BI vs. NC, MI vs. NC, NA vs. NC, and NMO (including BI, MI, and NA) vs. NC were 0.99, 0.93, 0.88, and 0.96, respectively. The corresponding diagnostic sensitivities of ROC analysis were 100%, 80%, 80%, and 91%; and the specificities were 93%, 97%, 91%, and 93%.Conclusions/SignificanceDecreased FA value in the intraorbital optic nerve, especially in the posterior part of the nerve, was demonstrated as a characteristic MR feature for NMO-related optic nerve impairment.
Highlights
Neuromyelitis optica (NMO), known as Devic's disease, is a primary inflammatory demyelination disease of the central nervous system that is characterized by the simultaneous or successive presentation of optic neuritis and myelitis [1]
The mean Fractional anisotropy (FA) values of whole intraorbital optic nerve (ION) were 0.27±0.08 in biocular impairment (BI), 0.29±0.08 in monocular impairment (MI), 0.35±0.13 in NA, and 0.39±0.07 in normal controls (NC)
Diffusion tensor imaging (DTI) is a functional MR imaging technique for studying the diffusion characteristics of water molecules, and it has been widely applied to the quantitative evaluation of white matter changes in various brain disorders [19,20,21], white matter pathways [22], cortical spinal tract [23], and cognitive [24] and spinal disorders [25,26]
Summary
Neuromyelitis optica (NMO), known as Devic's disease, is a primary inflammatory demyelination disease of the central nervous system that is characterized by the simultaneous or successive presentation of optic neuritis and myelitis [1]. Visual evaluations of NMO patients mainly include routine ophthalmological examination, visual evoked potential (VEP) recording [5], and magnetic resonance imaging (MRI). Routine ophthalmologic examination (e.g., fundoscopy) can only reveal abnormalities of the fundus oculi and optic nerve head [6]. VEP can reflect the electrophysiological changes to the functional integrity of the visual system [5], but it cannot accurately pinpoint the location of the optic nerve abnormality. Diffusion tensor imaging (DTI) has been used for the evaluation of the white matter integrity. We evaluated optic nerve impairment in patients with neuromyelitis optica (NMO) using DTI.
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