American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Samy, I. McFarlane
Open Access
Journal Browser
American Journal of Medical Case Reports. 2018, 6(4), 58-60
DOI: 10.12691/ajmcr-6-4-1
Open AccessArticle

Evaluation of the Detection Accuracy of Conventional Magnetic Resonance Imaging in Patients Diagnosed with Optic Neuritis

Zahra Janamiri1, and Fariborz Faeghi1

1Department of Radiology Technology, Shohada Tajrish Hospital, School of Allied Medicl Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Pub. Date: April 27, 2018

Cite this paper:
Zahra Janamiri and Fariborz Faeghi. Evaluation of the Detection Accuracy of Conventional Magnetic Resonance Imaging in Patients Diagnosed with Optic Neuritis. American Journal of Medical Case Reports. 2018; 6(4):58-60. doi: 10.12691/ajmcr-6-4-1


Introduction: Inflammation of the optic nerve is one of the most common causes of unilateral and/or bilateral blindness. The most common cause of this phenomenon is demyelinating processes which involve central nervous system and the diagnosis is suspected via clinical finding and confirmed by Magnetic Resonance Imaging (MRI). In this study we plan to investigate whether isolated conventional MRI is a reliable and sufficient diagnosing tool in approach to patients with clinical finings of optic neuritis. Methods: This retrospective study was performed in patients referred to neurology department of a private hospital in Tehran from 2012 to 2014, and underwent brain MRI after clinical diagnosis has been established. Clinical diagnosis of optic neuritis was confirmed by neuro-ophthalmological examination, visual field assessment and visual evoked potential (VEP). We have utilized SPSS program for statistical analysis, along with Student T-test and Chi-Square test. Result: Demographic analysis and data gathering were performed for all of the patients. Ninety patients were enrolled in the study, which 58 cases (64.4%) showed MRI abnormality in their neuro-imaging. In this group, supratentorial and infratentorial lesions were existed in 34 cases (58.6%) and 24 cases (41.3%) respectively. The most common affected sites of supratentorial region were periventricular region (in 17 cases), followed by juxtacortical (in 6 cases), basal ganglia (in 3 cases), corpus callosum (in 3 cases), centrum semiovale (in 2 cases) and in optic nerve in 3 patients. In patients with lesions in their infratentorial region, the most common sites were cerebellum hemispheres (in 11 cases), followed by mesencephalon (in 6 cases), pons (in 4 cases) and medulla oblongata (in 3 cases). Conclusion: We have found that conventional MRI as a single approach is not reliable in detecting enhancing plaques of white matter tracts in 35.6% of our enrolled cases who their diagnosis of optic neuritis were confirmed by visual field assessment and VEP. This issue raises the importance of addition of other enhancing technique to MRI for better localization of enhancement for multi-disciplinary approach.

optic neuritis Magnetic Resonance Imaging neuro-imaging

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Beck, R.W., Smith, C.H., Gal, R.L., Xing, D., Bhatti, M.T., Brodsky, M.C., Buckley, E.G., Chrousos, G.A., Corbett, J., Eggenberger, E., Goodwin, J.A., “Neurologic impairment 10 years after optic neuritis,” Archives of neurology, 61(9). 1386-9. 2004.
[2]  Khanna, S., Sharma, A., Huecker, J., Gordon, M., Naismith, R.T., Van Stavern, G.P., “Magnetic resonance imaging of optic neuritis in patients with neuromyelitis optica versus multiple sclerosis,” Journal of Neuro-ophthalmology, 32(3). 216-20. 2012.
[3]  Flanagan, P., Zele, A.J., “Chromatic and luminance losses with multiple sclerosis and optic neuritis measured using dynamic random luminance contrast noise,” Ophthalmic and Physiological Optics, 24(3). 225-33. 2004.
[4]  Seddighi, A.S., Seddighi, A., Behrouzian, S., Nikouei, A., “Simultaneous Presentation of Cerebellopontine Angle Pleomorphic Xanthoastrocytoma and Malignant Melanoma in a Known Case of Neurofibromatosis 1; Probable Role of BRAF Gene: A Case Report and Review of Literature,” International Journal of Cancer Management, 10(7). 2017.
[5]  Wilhelm, H., Schabet, M., “The diagnosis and treatment of optic neuritis,” Deutsches Ärzteblatt International, 112(37). 616. 2015.
[6]  Wingerchuk, D.M., Lennon, V.A., Pittock, S.J., Lucchinetti, C.F., Weinshenker, B.G., “Revised diagnostic criteria for neuromyelitis optica,” Neurology, 66(10). 1485-9. 2006.
[7]  Frederiksen, J.L., Larsson, H.B., Henriksen, O., Olesen, J., “Magnetic resonance imaging of the brain in patients with acute monosymptomatic optic neuritis,” Acta neurologica scandinavica, 80(6). 512-7. 1989.
[8]  Mealy, M.A., Whetstone, A., Orman, G., Izbudak, I., Calabresi, P.A., Levy, M., “Longitudinally extensive optic neuritis as an MRI biomarker distinguishes neuromyelitis optica from multiple sclerosis,” Journal of the neurological sciences, 355(1). 59-63. 2015.
[9]  Arnold, A.C., “Evolving management of optic neuritis and multiple sclerosis,” American journal of ophthalmology, 139(6). 1101-8. 2005.
[10]  Jacobs, L.D., Beck, R.W., Simon, J.H., Kinkel, R.P., Brownscheidle, C.M., Murray, T.J., Simonian, N.A., Slasor, P.J., Sandrock, A.W., “Intramuscular interferon beta-1a therapy initiated during a first demyelinating event in multiple sclerosis,” New England Journal of Medicine, 343(13). 898-904. 2000.
[11]  Monteiro, M.L., Borges, W.I., Ramos, C.D., Lucato, L.T., Leite, C.C., “Bilateral optic neuritis in wegener granulomatosis,” Journal of Neuro-ophthalmology, 25(1). 25-8. 2005.
[12]  Lennon, V.A., Wingerchuk, D.M., Kryzer, T.J., Pittock, S.J., Lucchinetti, C.F., Fujihara, K., Nakashima, I., Weinshenker, B.G., “A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis,” The Lancet, 364(9451). 2106-12. 2004.
[13]  Pittock, S.J., Weinshenker, B.G., Lucchinetti, C.F., Wingerchuk, D.M., Corboy, J.R., Lennon, V.A., “Neuromyelitis optica brain lesions localized at sites of high aquaporin 4 expression,” Archives of neurology, 63(7). 964-8. 2006.
[14]  Morrow, M.J., Ko, M.W., “Should oral corticosteroids be used to treat demyelinating optic neuritis?,” Journal of Neuro-ophthalmology, 37(4). 444-50. 2017.
[15]  McKinney, A.M., Lohman, B.D., Sarikaya, B., Benson, M., Lee, M.S., Benson, M.T., “Accuracy of routine fat-suppressed FLAIR and diffusion-weighted images in detecting clinically evident acute optic neuritis,” Acta Radiologica, 54(4). 455-61. 2013.