Diagnosis of Traumatic Optic Neuropathy

Bodanapally, Uttam K.; Shanmuganathan, Kathirkamanathan; Geraymovych, Elena; Mirvis, Stuart E.; Choi, Andrew; McMillan, A.; Zhuo, Jiachen; Shin, Robert K.

doi:10.1097/wno.0b013e3182842553

Cited by 25 publications

(8 citation statements)

References 12 publications

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“…Also, RD decreased, and interestingly AD decreased, being the most affected metric ( 115 ). Bodanapally et al [2013] ( 115 ) did notice that their results were in disagreement with Yang et al [2011] ( 114 ), leading them to suggest an alternative putative cellular pathology [see also ( 47 , 116 )]. Li and colleagues [2014] ( 117 ) further investigated this issue and looked more closely at the time-since-onset.…”

Section: Resultsmentioning

confidence: 99%

“…In the optic nerve, Yang and colleagues [2011] ( 114 ) find a lower FA and higher MD in the affected compared to the unaffected optic nerve. Although not in the same section of the optic nerve, Bodanapally and colleagues [2013] ( 115 ) found that TON patients have a lower MD in the posterior section of the orbital optic nerve compared to both controls and TBI patients, with no FA difference. Also, RD decreased, and interestingly AD decreased, being the most affected metric ( 115 ).…”

Section: Resultsmentioning

confidence: 99%

“…Although not in the same section of the optic nerve, Bodanapally and colleagues [2013] ( 115 ) found that TON patients have a lower MD in the posterior section of the orbital optic nerve compared to both controls and TBI patients, with no FA difference. Also, RD decreased, and interestingly AD decreased, being the most affected metric ( 115 ). Bodanapally et al [2013] ( 115 ) did notice that their results were in disagreement with Yang et al [2011] ( 114 ), leading them to suggest an alternative putative cellular pathology [see also ( 47 , 116 )].…”

Section: Resultsmentioning

confidence: 99%

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Diffusion tensor imaging of optic neuropathies: a narrative review

Cooper,

Tchernykh,

Shmuel

et al. 2024

Quant Imaging Med Surg

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Background and Objective Diffusion tensor imaging (DTI) has been implemented in a breadth of scientific investigations of optic neuropathies, though it has yet to be fully adopted for diagnosis or prognosis. This is potentially due to a lack of standardization and weak replication of results. The aim of this investigation was to review DTI results from studies specific to three distinct optic neuropathies in order to probe its current clinical utility. Methods We reviewed the DTI literature specific to primary open-angle glaucoma (POAG), optic neuritis (ON), and traumatic optic neuropathy (TON) by systematically searching the PubMed database on March 1 st , 2023. Four distinct DTI metrics are considered: fractional anisotropy (FA), along with mean diffusivity (MD, axial diffusivity (AD), and radial diffusivity (RD). Results from within-group, between-group, and correlational studies were thoroughly assessed. Key Content and Findings POAG studies most consistently report a decrease in FA, especially in the optic radiations, followed in prevalence by an increase in RD and then MD, whilst AD yields conflicting results between studies. It is notable that there is not an equal distribution of investigated DTI metrics, with FA utilized the most, followed by MD, RD, and AD. Studies of ON are similar in that the most consistent findings are specific to FA, RD, and MD. These results are specific to the optic nerve and radiation since only one study measured the intermediary regions. More studies are needed to assess the effect that ON has on the tracts of the visual system. Finally, only three studies assessing DTI of TON have been performed to date, displaying low to moderate replicability of results. To improve the level of agreement between studies assessing each optic neuropathy, an increased level of standardization is recommended. Conclusions Both POAG and ON studies have yielded some prevalent DTI findings, both for contrast and correlation-based assessments. Although the clinical need is high for TON, considering the limitations of the current diagnostic tools, too few studies exist to make confident conclusions. Future use of standardized and longitudinal DTI, along with the foreseen methodological and technical improvements, is warranted to effectively study optic neuropathies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Diffusion tensor imaging of optic neuropathies: a narrative review

Cooper,

Tchernykh,

Shmuel

et al. 2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

“…Further, axonal swelling in cytotoxic edema and reduction in the extracellular space that occur secondary to cell swelling also restrict water diffusion. 6,7) Thus, AD, RD, and mean diffusivity can be comprehensively determined based on these effects. Regarding the signal change over time, Mac Donald et al 8) reported that AD significantly decreases in the period between 6 h and 4 days after trauma and that it is “pseudo-normalized,” whereas RD increases in 1–4 weeks after the trauma, depending on the degree of injury.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of MRI Slices Parallel to the Optic Chiasma in a Case with Traumatic Optic Nerve Avulsion after a Bear Attack

Tamase

Tachibana

Iizuka

2019

Neurol. Med. Chir.(Tokyo)

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Optic nerve avulsion is an exceedingly rare condition. Here, we describe a case of optic nerve avulsion in a 74-year-old man with temporal hemianopia in the contralateral eye after a bear attack. Magnetic resonance imaging (MRI) revealed separation of the optic nerve distal to the optic chiasma, whereas the high signal in diffusion-weighted imaging suggested nerve injury from the left side of the optic chiasma to the left optic tract. MRI slices parallel to the optic chiasma were obtained and used for evaluating the site of optic nerve avulsion and nerve injury, which were responsible for temporal hemianopia in the contralateral eye.

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“…Direct traumatic optic neuropathy (TON) results from anatomical disruption of the optic nerve, whereas indirect TON originates from optic nerve stretch during a head injury. The latter can also occur due to secondary injury to the retinal ganglion cell axons ( 6 , 7 ). Preclinical studies have showed that repeated mild TBI results in loss of the retinal nerve fiber layer and the inner plexiform layer ( 8–10 ).…”

Section: Introductionmentioning

confidence: 99%

Diffusion basis spectrum imaging detects subclinical traumatic optic neuropathy in a closed-head impact mouse model of traumatic brain injury

Yang,

Lavadi,

Sauerbeck

et al. 2023

Front. Neurol.

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IntroductionTraumatic optic neuropathy (TON) is the optic nerve injury secondary to brain trauma leading to visual impairment and vision loss. Current clinical visual function assessments often fail to detect TON due to slow disease progression and clinically silent lesions resulting in potentially delayed or missed treatment in patients with traumatic brain injury (TBI).MethodsDiffusion basis spectrum imaging (DBSI) is a novel imaging modality that can potentially fill this diagnostic gap. Twenty-two, 16-week-old, male mice were equally divided into a sham or TBI (induced by moderate Closed-Head Impact Model of Engineered Rotational Acceleration device) group. Briefly, mice were anesthetized with isoflurane (5% for 2.5 min followed by 2.5% maintenance during injury induction), had a helmet placed over the head, and were placed in a holder prior to a 2.1-joule impact. Serial visual acuity (VA) assessments, using the Virtual Optometry System, and DBSI scans were performed in both groups of mice. Immunohistochemistry (IHC) and histological analysis of optic nerves was also performed after in vivo MRI.ResultsVA of the TBI mice showed unilateral or bilateral impairment. DBSI of the optic nerves exhibited bilateral involvement. IHC results of the optic nerves revealed axonal loss, myelin injury, axonal injury, and increased cellularity in the optic nerves of the TBI mice. Increased DBSI axon volume, decreased DBSI λ||, and elevated DBSI restricted fraction correlated with decreased SMI-312, decreased SMI-31, and increased DAPI density, respectively, suggesting that DBSI can detect coexisting pathologies in the optic nerves of TBI mice.ConclusionDBSI provides an imaging modality capable of detecting subclinical changes of indirect TON in TBI mice.

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Diagnosis of Traumatic Optic Neuropathy

Abstract: Decreased AD and mean diffusivity in the posterior segment of the optic nerve may serve as a biomarker of axonal damage in patients with TON and merits further investigation as a predictor of initial visual acuity and potential visual recovery.

Cited by 25 publications

References 12 publications

Diffusion tensor imaging of optic neuropathies: a narrative review

Diffusion tensor imaging of optic neuropathies: a narrative review

Usefulness of MRI Slices Parallel to the Optic Chiasma in a Case with Traumatic Optic Nerve Avulsion after a Bear Attack

Diffusion basis spectrum imaging detects subclinical traumatic optic neuropathy in a closed-head impact mouse model of traumatic brain injury

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