Related Experiment Video
Updated: Aug 29, 2025
Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
Published on: April 14, 2014
MRI pattern in acute optic neuritis: Comparing multiple sclerosis, NMO and MOGAD
Maximiliano Darakdjian1, Hernan Chaves1, Jairo Hernandez1
1FLENI, Buenos Aires, Argentina.
Background:
Several MRI findings of optic neuritis (ON) have been described and correlated with specific underlying etiologies. Specifically, optic nerve enhancement is considered an accurate biomarker of acute ON.
Objective:
To identify differences in MRI patterns of optic nerve enhancement in certain demyelinating etiologies presenting with acute ON.
Methods:
Retrospective analysis of enhancement patterns on fat-suppressed T1-weighted images from patients presenting clinical and radiological acute ON, treated at our institution between January 2014 and June 2022. Location and extension of enhancing optic nerve segments, as well as presence of perineural enhancement were evaluated in three predetermined demyelinating conditions. Fisher's exact test and chi2 were calculated.
Results:
Fifty-six subjects met eligibility criteria. Mean age was 31 years (range 6-79) and 70% were females. Thirty-four (61%) patients were diagnosed with multiple sclerosis (MS), 8 (14%) with neuromyelitis optica (NMO), and 14 (25%) with anti-myelin oligodendrocyte glycoprotein disease (MOGAD). Bilateral involvement was more frequent in MOGAD, compared to MS and NMO (43 vs 3% and 12.5% respectively, p = 0.002). MS patients showed shorter optic nerve involvement, whereas MOGAD showed more extensive lesions (p = 0.006). Site of involvement was intraorbital in 63% MS, 89% NMO, 90% MOGAD (p = 0.051) and canalicular in 43% MS, 33% NMO and 75% MOGAD (p = 0.039). Intracranial or chiasmatic involvement and presence of perineural enhancement were not statistically different between entities.
Conclusion:
In the setting of acute ON, patients presenting MOGAD were more likely to show bilateral, longitudinally extended and anterior (intraorbital and canalicular) optic nerve involvement compared to patients with MS or NMO.
Insights
Magnetic Resonance Imaging (MRI) patterns in acute optic neuritis (ON) differ by cause. Anti-myelin oligodendrocyte glycoprotein disease (MOGAD) shows more extensive, bilateral optic nerve involvement than multiple sclerosis (MS) or neuromyelitis optica (NMO).
Area of Science:
- Neuroimaging
- Ophthalmology
- Neurology
Background:
- Optic neuritis (ON) MRI findings correlate with specific etiologies.
- Optic nerve enhancement on MRI is a key biomarker for acute ON.
Purpose of the Study:
- To differentiate MRI enhancement patterns in acute ON across various demyelinating diseases.
- Identify unique MRI signatures for multiple sclerosis (MS), neuromyelitis optica (NMO), and anti-myelin oligodendrocyte glycoprotein disease (MOGAD).
Main Methods:
- Retrospective analysis of MRI fat-suppressed T1-weighted images in 56 patients with acute ON.
- Evaluated location, extension, and perineural enhancement of optic nerve lesions.
- Statistical comparison using Fisher's exact test and chi-squared test.
Main Results:
- MOGAD cases (25%) more frequently showed bilateral ON (43%) compared to MS (3%) and NMO (12.5%).
- MS patients had shorter optic nerve lesions, while MOGAD patients exhibited more extensive lesions.
- Anterior involvement (intraorbital/canalicular) was common in MOGAD (75%) and NMO (89%) but less so in MS (63%).
Conclusions:
- MOGAD presents with distinct MRI features in acute ON, including bilateral and longitudinally extensive optic nerve involvement.
- These findings aid in differentiating MOGAD from MS and NMO based on MRI patterns.
- MRI analysis of optic nerve enhancement patterns is crucial for etiological diagnosis in acute ON.
Related Concept Videos
01:24Magnetic Resonance Imaging
01:27Imaging Studies IV: Magnetic Resonance Imaging