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Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
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MRI pattern in acute optic neuritis: Comparing multiple sclerosis, NMO and MOGAD.

Maximiliano Darakdjian1, Hernan Chaves1, Jairo Hernandez1

  • 1FLENI, Buenos Aires, Argentina.

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|September 5, 2022
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Summary

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).

Keywords:
MRIanti-myelin oligodendrocyte glycoproteinmultiple sclerosisneuromyelitis opticaoptic neuritis

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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.