MR of vasculitis-induced optic neuropathy

Area of Science:

• Neuroimaging
• Ophthalmology
• Rheumatology

Background:

• Optic neuropathy can be caused by vasculitis, a condition affecting blood vessels.
• Systemic autoimmune diseases like lupus and rheumatoid arthritis are common causes.
• Radiation therapy can also lead to vasculitic optic neuropathy.

Purpose of the Study:

• To characterize the magnetic resonance (MR) imaging findings in patients with optic neuropathy secondary to vasculitis.
• To correlate MR imaging features with the underlying cause of vasculitis.

Main Methods:

• Retrospective review of nine patients diagnosed with optic neuropathy and vasculitis.
• MR imaging of the orbits and anterior visual pathways, with and without contrast (gadopentetate dimeglumine) and fat suppression.
• MR imaging of the brain was performed in five patients.

Main Results:

• Six of nine patients showed optic nerve and/or chiasm enhancement and enlargement on contrast-enhanced MR imaging.
• Enhancement of the optic nerve segments occurred with or without enlargement.
• Brain MR imaging revealed abnormalities in three patients, including periventricular hyperintensities and a lacunar infarct.

Conclusions:

• MR imaging with gadolinium contrast and fat suppression can detect blood-brain barrier disruption in the optic nerve.
• These findings are indicative of acute optic neuropathy in the context of vasculitis.
• This imaging technique is recommended for diagnosing acute optic neuropathy when vasculitis is suspected.