Diffusion Tensor Imaging in Acute Optic Neuropathies

Naismith, Robert T.

doi:10.1001/archneurol.2011.243

Cited by 52 publications

(55 citation statements)

References 35 publications

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“…In this cohort, we observed reduced diffusivity of the ON nerve at the time of the acute inflammatory optic nerve injury, relative to fellow eyes, in agreement with previous studies. [20][21][22] Also consistent with previous studies, 21,22 we observed that diffusivity returned to normal levels with recovery, and there was a near significant association between reduction in diffusivity and visual acuity in ON eyes during the acute phase. Our findings thus confirm the clinical utility of mean diffusivity of the entire optic nerve for the diagnosis and assessment of visual dysfunction caused by ON.…”

Section: Discussionsupporting

confidence: 91%

“…Axial diffusivity (AD) (i.e., diffusion along the nerve) is reduced in the ON eye during the acute phase (less than 1 month) [19][20][21] and appears to be predictive of visual outcome. 21,22 Thus, DTI may represent a structural marker of axonal integrity, which when applied to ON as a putative model, may provide important insights regarding mechanisms of white matter damage and repair in CNS inflammatory disorders.…”

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confidence: 99%

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Skewness of Fractional Anisotropy Detects Decreased White Matter Integrity Resulting From Acute Optic Neuritis

Goodyear

Zayed

Cortese

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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Citation: Goodyear BG, Zayed NMH, Cortese F, Trufyn J, Costello F. Skewness of fractional anisotropy detects decreased white matter integrity resulting from acute optic neuritis. Invest Ophthalmol Vis Sci. 2015;56:7597-7603. DOI:10.1167/ iovs.15-17335 PURPOSE. Diffusion tensor imaging (DTI) has demonstrated optic nerve damage associated with optic neuritis (ON); however, the usefulness of mean fractional anisotropy (FA) specifically is varied in the literature. We wished to determine whether histogram analysis of FA better detects ON damage than mean FA.METHODS. The ON patients (n ¼ 24) underwent DTI within 1 month of symptoms and then 6 months later (n ¼ 21). Twelve control subjects participated in one session. Mean FA and axial (AD), radial (RD), and mean (MD) diffusivities were compared between ON and fellow eyes, control eyes, and sessions. Values were sorted into bins, and coefficients of skewness of FA, AD, RD, and MD were compared between ON and fellow eyes, control eyes, and sessions.RESULTS. Mean AD, RD, and MD of ON eyes were significantly reduced compared with fellow eyes (P < 0.04) within 1 month of symptoms, but did not differ at 6 months. Mean AD and RD of ON eyes were significantly lower than control eyes (P < 0.05). No differences were observed for mean FA. The coefficient of skewness of FA was significantly different between ON eyes and fellow eyes (P ¼ 0.03) and control eyes (P ¼ 0.04) within 1 month of symptoms, but did not differ at 6 months. No differences were observed for AD, RD, and MD.CONCLUSIONS. Skewness of FA can detect white matter damage associated with ON and its recovery, which may further inform us of how DTI can measure white matter injury and repair.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Skewness of Fractional Anisotropy Detects Decreased White Matter Integrity Resulting From Acute Optic Neuritis

Goodyear

Zayed

Cortese

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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“…On the other hand, FA values were reported to be initially normal and then to decrease over time [111,112]. These findings suggest simultaneous demyelination and axonal loss as well as possible reorganization processes to be present in the optic nerve after ON.…”

Section: Optic Nerve Dti In Ms-onmentioning

confidence: 93%

“…Two studies consistently showed initial AD decrease at baseline [112] and after 1 month [111] to predict other visual outcome parameters -i.e. OCT RNFL thinning, full-field VEP latency delay -and visual acuity measures after 6 months [112] as well as OCT RNFL and multifocal VEP changes after 12 months [111]. After an initial decrease, AD values gradually increased back to normal AD values after a median of 18 weeks in MS ON patients.…”

Section: Optic Nerve Dti In Ms-onmentioning

confidence: 97%

Diffusion tensor imaging for multilevel assessment of the visual pathway: possibilities for personalized outcome prediction in autoimmune disorders of the central nervous system

et al. 2017

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The afferent visual pathway represents the most frequently affected white matter pathway in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). Diffusion tensor imaging (DTI) can reveal microstructural or non-overt brain tissue damage and quantify pathological processes. DTI facilitates the reconstruction of major white matter fiber tracts allowing for the assessment of structure-function and damage-dysfunction relationships. In this review, we outline DTI studies investigating the afferent visual pathway in idiopathic optic neuritis (ON), NMOSD, and MS. Since MS damage patterns are believed to depend on multiple factors, i.e., ON (anterior visual pathway damage), inflammatory lesions (posterior visual pathway damage), and global diffuse inflammatory and neurodegenerative processes, comprehensive knowledge on different contributing factors using DTI in vivo may advance our understanding of MS disease pathology. Combination of DTI measures and visual outcome parameters yields the potential to improve routine clinical diagnostic procedures and may further the accuracy of individual prognosis with regard to visual function and personalized disease outcome. However, due to the inherent limitations of DTI acquisition and post-processing techniques and the so far heterogeneous and equivocal data of previous studies, evaluation of the true potential of DTI as a possible biomarker for afferent visual pathway dysfunction is still substantially limited. Further research efforts with larger longitudinal studies and standardized DTI acquisition and post-processing validation criteria are needed to overcome current DTI limitations. DTI evaluation at different levels of the visual pathway has the potential to provide markers for individual damage evaluation in the future. As an imaging biomarker, DTI may support individual outcome prediction during personalized treatment algorithms in MS and other neuroinflammatory diseases, hereby leveraging the concept of predictive, preventive, and personalized medicine in the field of clinical neuroimmunology.

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“…Diffusion tensor imaging (Figure 3), having relative specificity for pathology affecting axonal and myelin integrity, may also be useful in assessing response to neuro-protective and remyelinating agents [194]. Diffusion tensor imaging may also play a future role in predicting visual outcomes in acute DON; a recent study evaluating 25 patients within 31 days of acute optic neuritis found that decreased axial diffusivity was associated with a worse 6-month visual outcome and correlated with VEP and RNFL measures of axon and myelin injury [195]. The ability to better characterize axonal loss and predict visual outcomes in DON has the potential to better inform acute management decisions and the determination of which patients would benefit from early initiation of therapies aimed at preventing the development of MS and MS-associated disability.…”

Section: Future Perspectivementioning

confidence: 99%

The Neuro-Ophthalmology of Multiple Sclerosis

2012

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Multiple sclerosis (MS) is a disease marked by focal demyelinating inflammatory plaques throughout the CNS. Neuro-ophthalmologic sequelae are common in MS and may arise from the disease itself or from treatment of the disease. Both afferent and efferent functions may be affected. Despite much progress, our understanding of the pathophysiology of MS, and the efficacy of our available treatments, remain inadequate. Here, we review the chief neuro-ophthalmologic abnormalities associated with MS and discuss the emerging diagnostic and therapeutic advances that are likely to further our understanding of MS and its treatment.

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Diffusion Tensor Imaging in Acute Optic Neuropathies

Abstract: Objective: To evaluate directional diffusivities within the optic nerve in a first event of acute optic neuritis to determine whether decreased axial diffusivity (AD) would predict 6-month visual outcome and optic nerve integrity measures.

Cited by 52 publications

References 35 publications

Skewness of Fractional Anisotropy Detects Decreased White Matter Integrity Resulting From Acute Optic Neuritis

Skewness of Fractional Anisotropy Detects Decreased White Matter Integrity Resulting From Acute Optic Neuritis

Diffusion tensor imaging for multilevel assessment of the visual pathway: possibilities for personalized outcome prediction in autoimmune disorders of the central nervous system

The Neuro-Ophthalmology of Multiple Sclerosis

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