Prognostic value of magnetic resonance imaging in monosymptomatic optic neuritis

Ophthalmology. 1996 Nov;103(11):1768-73. doi: 10.1016/s0161-6420(96)30429-6.


Purpose: Magnetic resonance imaging is able to depict lesions in the optic nerve in the acute stage of monosymptomatic optic neuritis. Most patients have lesions located intraorbitally, intracanalicularly, and/or intracranially. The goal of this study is to determine whether these lesions resolve after visual recovery, change in length or localization, or could be correlated to the visual function.

Methods: Between 1987 and 1992, the authors examined 22 patients with acute optic neuritis using magnetic resonance imaging short-time inversion recovery sequences. Additionally, the authors determined visual acuity, visual field, color vision, contrast sensitivity, and visual-evoked responses. All patients were re-examined between 1993 and 1994 in the same manner. Visual recovery in the re-examination was divided into three groups: group 1 with complete visual recovery (visual acuity better than 20/25); group 2 with incomplete recovery (visual acuity better than 20/25 but defect in at least one of the other tests: visual field, color vision, and contrast sensitivity); and group 3 with partial recovery (visual acuity remained less than 20/25, defect in all the other tests).

Results: All group 1 patients initially had lesions less than 17.5 mm, group 2 patients had lesions greater than 17.5 mm (44%) and/or lesions located intracanalicularly (66%), and most of group 3 patients initially had lesions greater than 17.5 mm (79%).

Conclusion: Eyes with lesions less than 17.5 mm in the optic nerve in acute optic neuritis have a good prognosis for visual recovery. Lesions greater than 17.5 mm or lesions involving the intracanalicular portion of the optic nerve lead to incomplete or partial visual recovery.

MeSH terms

  • Acute Disease
  • Adult
  • Color Perception / physiology
  • Contrast Sensitivity / physiology
  • Evoked Potentials, Visual / physiology
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Optic Nerve / pathology*
  • Optic Nerve / physiopathology
  • Optic Neuritis / diagnosis*
  • Optic Neuritis / physiopathology
  • Prognosis
  • Visual Acuity / physiology
  • Visual Fields / physiology