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Updated: Jun 15, 2026
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Quantification of Optic Nerve Cross Sectional Area on MRI: A Novel Protocol using Fiji Software
Published on: September 4, 2021
MRI demonstrates restricted diffusion in distal optic nerve in atypical optic neuritis
Oriel Spierer1, Liat Ben Sira, Igal Leibovitch
1Ophthalmology Department, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
Summary
A rare case of acute visual loss in a child revealed optic nerve inflammation. Diffusion-weighted imaging identified restricted diffusion, aiding in diagnosis and excluding tumors.
Area of Science:
- Ophthalmology
- Neurology
- Medical Imaging
Background:
- Acute visual loss in children can be caused by various optic neuropathies.
- Inflammatory optic neuropathies present diagnostic challenges, especially in differentiating from neoplastic causes.
- Central retinal artery and vein occlusion (CRAO/CRVO) can occur in pediatric inflammatory optic neuropathies.
Observation:
- A 4-year-old healthy girl presented with acute right-eye visual loss.
- Ophthalmoscopy revealed a swollen optic disc and CRAO/CRVO in the affected eye.
- MRI demonstrated a thickened, enhancing intraorbital optic nerve.
Findings:
- Diffusion-weighted imaging (DWI) showed restricted diffusion in the distal intraorbital optic nerve segment.
- This finding suggests infarction due to vascular compromise secondary to inflammation.
- This is the first reported case of restricted diffusion in inflammatory optic neuropathy.
Implications:
- Restricted diffusion on DWI is a valuable imaging biomarker in inflammatory optic neuropathy.
- This finding helps differentiate inflammatory optic neuropathy from optic nerve tumors.
- Early and accurate diagnosis is crucial for appropriate management and visual recovery in pediatric optic neuropathies.
