The Role of Magnetic Resonance Imaging in Diagnosing Optic Nerve Hypoplasia

Overview

Journal Am J Ophthalmol

Specialty Ophthalmology

Date 2014 Aug 17

PMID 25128595

Citations 13

Authors

Phoebe D Lenhart

Nilesh K Desai

Beau B Bruce

Amy K Hutchinson

Scott R Lambert

Affiliations

Soon will be listed here.

Abstract

Purpose: To establish objective lower limits of normal optic nerve (ON) size in children based on high-resolution orbital magnetic resonance imaging (MRI).

Design: Case-control study of patients with ON hypoplasia vs normal controls.

Methods: A neuroradiologist made 4 measurements of each ON at 2 locations (5 mm posterior to the optic disc and just posterior to the optic canal) in patients with ON hypoplasia and controls aged 0-17 years from an academic eye center and children's hospital. Primary analyses were performed using mixed linear models.

Results: Measurements were made in 26 cases of clinically confirmed ON hypoplasia and 31 controls (median age: ON hypoplasia, 1 year; controls, 5.5 years). Nine of 26 cases (35%) and 19 of 31 controls (61%) underwent high-resolution T2-weighted imaging of the orbits. Mean ON diameter was 1.36 mm (95% CI: 1.19-1.54; P < .001) smaller for clinically hypoplastic ONs than for controls. Optic nerve diameter increased by 0.05 mm per year of age (95% CI: 0.03-0.07; P < .001). A lower bound to the 95% prediction interval for normal optic nerves was (2.24 mm + 0.052 × [age in years]) mm and excluded all but 1 case.

Conclusions: Age was independently associated with normal ON size by MRI and should be taken into consideration when evaluating ON hypoplasia, based on MRI criteria. We have provided a formula to assist clinicians in objectively determining if ON hypoplasia is present.

Citing Articles

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References

Pang Y, Frantz K . Value of the Heidelberg Retinal Tomograph in optic nerve hypoplasia. Optom Vis Sci. 2008; 85(7):508-11. DOI: 10.1097/OPX.0b013e31817c92df. View

Bengtsson B, KRAKAU C . Correction of optic disc measurements on fundus photographs. Graefes Arch Clin Exp Ophthalmol. 1992; 230(1):24-8. DOI: 10.1007/BF00166758. View

Mashima Y, Oshitari K, Imamura Y, Momoshima S, Shiga H, Oguchi Y . High-resolution magnetic resonance imaging of the intraorbital optic nerve and subarachnoid space in patients with papilledema and optic atrophy. Arch Ophthalmol. 1996; 114(10):1197-203. DOI: 10.1001/archopht.1996.01100140397006. View

Tian S, Nishida Y, Isberg B, Lennerstrand G . MRI measurements of normal extraocular muscles and other orbital structures. Graefes Arch Clin Exp Ophthalmol. 2000; 238(5):393-404. DOI: 10.1007/s004170050370. View

Beatty S, Good P, McLaughlin J, ONeill E . Echographic measurements of the retrobulbar optic nerve in normal and glaucomatous eyes. Br J Ophthalmol. 1998; 82(1):43-7. PMC: 1722347. DOI: 10.1136/bjo.82.1.43. View

Hellstrom A, Wiklund L, Svensson E . Diagnostic value of magnetic resonance imaging and planimetric measurement of optic disc size in confirming optic nerve hypoplasia. J AAPOS. 1999; 3(2):104-8. DOI: 10.1016/s1091-8531(99)70079-0. View

Parravano J, Toledo A, Kucharczyk W . Dimensions of the optic nerves, chiasm, and tracts: MR quantitative comparison between patients with optic atrophy and normals. J Comput Assist Tomogr. 1993; 17(5):688-90. DOI: 10.1097/00004728-199309000-00003. View

Moon D, Park T . Optical coherence tomographic findings in optic nerve hypoplasia. Indian J Ophthalmol. 2013; 61(10):596-8. PMC: 3853461. DOI: 10.4103/0301-4738.121088. View

Brodsky M, Glasier C, Pollock S, Angtuago E . Optic nerve hypoplasia. Identification by magnetic resonance imaging. Arch Ophthalmol. 1990; 108(11):1562-7. DOI: 10.1001/archopht.1990.01070130064032. View

10.

Kong L, Fry M, Al-Samarraie M, Gilbert C, Steinkuller P . An update on progress and the changing epidemiology of causes of childhood blindness worldwide. J AAPOS. 2012; 16(6):501-7. DOI: 10.1016/j.jaapos.2012.09.004. View

11.

Karim S, Clark R, Poukens V, Demer J . Demonstration of systematic variation in human intraorbital optic nerve size by quantitative magnetic resonance imaging and histology. Invest Ophthalmol Vis Sci. 2004; 45(4):1047-51. DOI: 10.1167/iovs.03-1246. View

12.

Skalka H . Neural and dural optic nerve measurements with A-scan ultrasonography. South Med J. 1978; 71(4):399-400. DOI: 10.1097/00007611-197804000-00017. View

13.

Gans M, Byrne S, Glaser J . Standardized A-scan echography in optic nerve disease. Arch Ophthalmol. 1987; 105(9):1232-6. DOI: 10.1001/archopht.1987.01060090090035. View

14.

Birkebaek N, Patel L, Wright N, Grigg J, Sinha S, Hall C . Optic nerve size evaluated by magnetic resonance imaging in children with optic nerve hypoplasia, multiple pituitary hormone deficiency, isolated growth hormone deficiency, and idiopathic short stature. J Pediatr. 2004; 145(4):536-41. DOI: 10.1016/j.jpeds.2004.06.041. View

15.

Votruba M, Leary S, Losseff N, Bhattacharya S, Moore A, Miller D . MRI of the intraorbital optic nerve in patients with autosomal dominant optic atrophy. Neuroradiology. 2000; 42(3):180-3. DOI: 10.1007/s002340050041. View

16.

Yanni S, Wang J, Cheng C, Locke K, Wen Y, Birch D . Normative reference ranges for the retinal nerve fiber layer, macula, and retinal layer thicknesses in children. Am J Ophthalmol. 2012; 155(2):354-360.e1. PMC: 3545013. DOI: 10.1016/j.ajo.2012.08.010. View

17.

Beuchat L, Safran A . Optic nerve hypoplasia: papillary diameter and clinical correlation. J Clin Neuroophthalmol. 1985; 5(4):249-53. View

18.

Romano P . Simple photogrammetric diagnosis of optic nerve hypoplasia. Arch Ophthalmol. 1989; 107(6):824-6. DOI: 10.1001/archopht.1989.01070010846026. View

19.

Ali B, Logani S, Kozlov K, Arnold A, Bateman B . Progression of retinal nerve fiber myelination in childhood. Am J Ophthalmol. 1994; 118(4):515-7. DOI: 10.1016/s0002-9394(14)75805-2. View

20.

Lam B, Glasier C, Feuer W . Subarachnoid fluid of the optic nerve in normal adults. Ophthalmology. 1997; 104(10):1629-33. DOI: 10.1016/s0161-6420(97)30085-2. View