Diagnostic value of magnetic resonance imaging and planimetric measurement of optic disc size in confirming optic nerve hypoplasia.
OBJECTIVE
This study set out to evaluate magnetic resonance imaging (MRI) and measurement of optic disc size as diagnostic tools for confirming the diagnosis of optic nerve hypoplasia (ONH) in children with impaired growth.


METHODS
MRI was performed to study the size of the intracranial visual pathways, and image analysis measurements of fundus photographs were performed to determine the size of the optic disc. Results from these investigations were compared with those using the gold standard for diagnosis of ONH, which was the clinical eye examination (visual function, ophthalmoscopic signs, or both). Forty children (median age, 9 years; range, 3 to 19 years) with impaired growth were included in the study.


RESULTS
The prevalence of ONH among the children was 15%. MRI classification of the visual pathways had a higher positive predictive value than image analysis measurement of the optic disc size (1.0 vs 0.6).


CONCLUSIONS
MRI is a good tool for confirming the diagnosis of ONH and may thus facilitate early detection. On the other hand, a small optic disc per se is not a definite indicator of ONH but should encourage further investigation with MRI, especially if there is a clinical suspicion of ONH.
Hellström
A
A
Department of Clinical Neurosciences, International Paediatric Growth Research Centre, Sahlgrenska University Hospital, Göteborg, Sweden.
Wiklund
L M
LM
Svensson
E
E
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005124:Eye Abnormalities / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009898:Optic Disk / Q000473:pathology*; D009900:Optic Nerve / Q000002:abnormalities*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014792:Visual Acuity