Background/Aims The aim of this study was to identify specific MRI characteristics of anterior ischaemic optic neuropathy (AION) and optic neuritis (ON) that would aid in the differentiation between these two diagnoses.
Methods We retrospectively analysed a consecutive case series including all patients with an MRI study of brain and orbit and the clinical diagnosis of either ON or AION. We examined the scans for restricted diffusion of the optic nerve, optic sheath diameter, enhancement and location of enhancement of the optic nerve and distribution of the white matter lesions.
Results Fifty patients met the inclusion criteria. We found an accuracy of 0.98 for the discrimination between AION and ON based solely on parameters extracted from MRI data. Dominance analysis to determine the most influential parameters showed that the enhancement pattern of the optic nerve and distribution of the white matter lesions had the biggest impact on the classification and led to a discrimination accuracy of 0.9 when used alone.
Conclusion In patients with an inconclusive clinical diagnosis, optic nerve enhancement pattern and distribution of white matter lesions can aid in the diagnosis and differentiation between AION and ON. Diffusion-weighted imaging did not add significant information to the diagnosis or help to differentiate between the two conditions.
- diagnostic tests/investigation
- optic nerve
Data availability statement
All data relevant to the study are included in the article or uploaded as supplemental information.
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VDP and DB contributed equally.
Contributors VDP: collected the data, performed imaging and data analysis, co-wrote the manuscript draft. DB: collected the data, performed statistical analysis, co-wrote the manuscript draft. RH: collected clinical data. RV: contributed imaging data and analysis. AW: contributed imaging data. MA: conceived and designed the analysis and corrected the final manuscript. FW: conceived and designed the analysis, supervised the study, reviewed and corrected the final manuscript. Responsible for the ethical statement.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.