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Establishing Optic Nerve Diameter Threshold Sensitive and Specific for Optic Atrophy Diagnosis

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Abstract

Purpose

To determine a potential threshold optic nerve diameter (OND) that could reliably differentiate healthy nerves from those affected by optic atrophy (OA) and to determine correlations of OND in OA with retinal nerve fiber layer (RNFL) thickness, visual acuity (VA), and visual field mean deviation (VFMD).

Methods

This was a retrospective case control study. Magnetic resonance (MR) images were reviewed from individuals with OA aged 18 years or older with vision loss for more than 6 months and an OA diagnosis established by a neuro-ophthalmologist. Individuals without OA who underwent MR imaging of the orbit for other purposes were also collected. OND was measured on coronal T2-weighted images in the midorbital section, 1cm posterior to the optic disc. Measurements of mean RNFL thickness, VA and VFMD were also collected.

Results

In this study 47 OA subjects (63% women, 78 eyes) and 75 normal subjects (42.7% women, 127 eyes) were assessed. Healthy ONDs (mean 2.73 ± 0.24 mm) were significantly greater than OA nerve diameters (mean 1.94 ± 0.32 mm; P < 0.001). A threshold OND of ≤2.3 mm had a sensitivity of 0.92 and a specificity of 0.93 in predicting OA. Mean RNFL (r = 0.05, p = 0.68), VA (r = 0.17, p = 0.14), and VFMD (r = 0.18, p = 0.16) were not significantly associated with OND.

Conclusion

ONDs are significantly reduced in patients with OA compared with healthy nerves. A threshold OND of ≤2.3 mm is highly sensitive and specific for a diagnosis of OA. OND was not significantly correlated with RNFL thickness, VA, or VFMD.

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Funding

The research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1-TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Departments of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA

    Michael L. Prairie, Collin M. McClelland & Michael S. Lee

  2. Department of Neuroradiology, University of Minnesota, Minneapolis, MN, USA

    Mehmet Gencturk & Mark Folkertsma

  3. Department of Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA

    Nicholas A. Marka & Ziou Jiang

Authors
  1. Michael L. Prairie
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  2. Mehmet Gencturk
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  3. Collin M. McClelland
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  4. Nicholas A. Marka
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  5. Ziou Jiang
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  6. Mark Folkertsma
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  7. Michael S. Lee
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Correspondence to Michael S. Lee.

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Conflict of interest

M.L. Prairie, M. Gencturk, C.M. McClelland, N.A. Marka, Z. Jiang, M. Folkertsma and M.S. Lee declare that they have no competing interests.

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For this article no studies with animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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Prairie, M.L., Gencturk, M., McClelland, C.M. et al. Establishing Optic Nerve Diameter Threshold Sensitive and Specific for Optic Atrophy Diagnosis. Clin Neuroradiol (2024). https://doi.org/10.1007/s00062-023-01369-w

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  • DOI: https://doi.org/10.1007/s00062-023-01369-w

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