title: Baseline magnetic resonance imaging of the optic nerve provides limited predictive information on short-term recovery after acute optic neuritis.
abstract: BACKGROUND
  In acute optic neuritis, magnetic resonance imaging (MRI) may help to confirm the diagnosis as well as to exclude alternative diagnoses. Yet, little is known on the value of optic nerve imaging for predicting clinical symptoms or therapeutic outcome.
  
  
  OBJECTIVE
  To evaluate the benefit of optic nerve MRI for predicting response to appropriate therapy and recovery of visual acuity.
  
  
  METHODS
  Clinical data as well as visual evoked potentials (VEP) and MRI results of 104 patients, who were treated at the Department of Neurology with clinically definite optic neuritis between December 2010 and September 2012 were retrospectively reviewed including a follow up within 14 days.
  
  
  RESULTS
  Both length of the Gd enhancing lesion (r = -0.38; p = 0.001) and the T2 lesion (r = -0.25; p = 0.03) of the optic nerve in acute optic neuritis showed a medium correlation with visual acuity after treatment. Although visual acuity pre-treatment was little but nonsignificantly lower if Gd enhancement of the optic nerve was detected via orbital MRI, improvement of visual acuity after adequate therapy was significantly better (0.40 vs. 0.24; p = 0.04). Intraorbitally located Gd enhancing lesions were associated with worse visual improvement compared to canalicular, intracranial and chiasmal lesions (0.35 vs. 0.54; p = 0.02).
  
  
  CONCLUSIONS
  Orbital MRI is a broadly available, valuable tool for predicting the improvement of visual function. While the accurate individual prediction of long-term outcomes after appropriate therapy still remains difficult, lesion length of Gd enhancement and T2 lesion contribute to its prediction and a better short-term visual outcome may be associated with detection and localization of Gd enhancement along the optic nerve.
authors: Department of Neurology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: Sebastian
authors: S
authors: Berg
authors: Department of Neuroradiology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: Iris
authors: I
authors: Kaschka
authors: Department of Neurology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: Kathrin S
authors: KS
authors: Utz
authors: Department of Neurology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: Konstantin
authors: K
authors: Huhn
authors: Department of Neurology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: Alexandra
authors: A
authors: Lämmer
authors: Department of Ophthalmology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: Robert
authors: R
authors: Lämmer
authors: Department of Neurology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: Anne
authors: A
authors: Waschbisch
authors: Department of Neuroradiology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: Stephan
authors: S
authors: Kloska
authors: Department of Neurology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: De-Hyung
authors: DH
authors: Lee
authors: Department of Neuroradiology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: Arnd
authors: A
authors: Doerfler
authors: Department of Neurology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
authors: Ralf A
authors: RA
authors: Linker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005123:Eye / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology; D009900:Optic Nerve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009902:Optic Neuritis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011859:Radiography; D014786:Vision Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014785:Vision, Ocular / Q000502:physiology
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