Comparison of Initial MRI Characteristics of the Optic Nerve and Brain in Patients with Optic Neuritis with Different Diagnoses in One-Year Follow-Up

Haji Ahmadi, Somayeh; Zolfaghari, Shahrbanoo; Ferdosi, Felora; Dehghani, Alireza; Shaygannejad, Vahid; Shayganfar, Azin

doi:10.48305/jims.v43.i848.2025

Comparison of Initial MRI Characteristics of the Optic Nerve and Brain in Patients with Optic Neuritis with Different Diagnoses in One-Year Follow-Up

Document Type : Original Article (s)

Authors

Somayeh Haji Ahmadi ¹

Shahrbanoo Zolfaghari ²

Felora Ferdosi ³

Alireza Dehghani ⁴

Vahid Shaygannejad ⁵

Azin Shayganfar ¹

¹ Department of Radiology, School of Medicine Al-Zahra Hospital Isfahan University of Medical Sciences

² Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

³ Department of Radiology, School of Medicine, Isfahan University of Medical Sciences

⁴ Department of Ophthalmology, School of Medicine Eye Research Center Feiz Hospital Isfahan University of Medical Sciences

⁵ Department of Neurology, School of Medicine Neurosciences Research Center Kashani Hospital Isfahan University of Medical Sciences

10.48305/jims.v43.i848.2025

Abstract

Background: This study investigates and compares the initial MRI characteristics of the optic nerve and brain in patients with optic neuritis across different diagnoses during a one-year follow-up.
Methods: In this cross-sectional study, 30 patients with acute optic neuritis from 2022 to 2024 were examined. Visual acuity was assessed using a Snellen chart, and relative afferent pupillary defect and color vision testing were conducted within 48 hours. The DWI sequence was analyzed for the apparent diffusion coefficient (ADC) of optic nerve lesions. Patients were monitored for one year post-attack, with clinical examinations, paraclinical tests (AQP4 and MOG antibody evaluation), and follow-up MRI performed.
Findings: Right optic nerve involvement was observed in 63% of cases, with less than half the nerve length affected in 63% of those cases. MRI findings of the brain revealed that 18.5% were normal, 7.4% were unclear, 59.3% had spatial dissemination lesions, and 14.8% had lesions disseminated in both space and time. One-year follow-up imaging showed that 63% of patients were diagnosed with multiple sclerosis (MS), 33.3% with clinically isolated syndrome (CIS), and 3.7% with neuromyelitis optica (NMO).
Conclusion: While the correlation between the initial MRI pattern and visual recovery remains unclear, the presence and number of brain lesions during the initial manifestations of optic neuritis may help predict the development of MS.

Keywords

MRI

optic nerve

optic neuritis

multiple sclerosis

Subjects