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Analysis of the initial orbital MRI in aquaporin-4 antibody-positive optic neuritis (AQP4-ON): lesion location and lesion length can be predictive of visual prognosis

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Abstract

Purpose

Despite mounting evidence indicating that aquaporin-4 antibody-positive optic neuritis (AQP4-ON) presents a less favorable prognosis than other types of optic neuritis, there exists substantial heterogeneity in the prognostic outcomes within the AQP4-ON cohort. Considering the persistent debate over the role of MRI in assessing the prognosis of optic neuritis, we aim to investigate the correlation between the MRI appearance and long-term visual prognosis in AQP4-ON patients.

Methods

We retrospectively reviewed the ophthalmological and imaging data of AQP4-ON patients admitted to our Neuro-ophthalmology Department from January 2015 to March 2018, with consecutive follow-up visits for a minimum of 3 years.

Results

A total of 51 AQP4-ON patients (59 eyes) meeting the criteria were enrolled in this research. After assessing the initial orbital MR images of each patient at the first onset, we observed the involvement of the canalicular segment (p < 0.001), intracranial segment (p = 0.004), optic chiasm (p = 0.009), and the presence of LEON (p = 0.002) were significantly different between recovery group and impairment group. For quantitative measurement, the length of the lesions is significantly higher in the impairment group (20.1 ± 9.3 mm) than in the recovery group (12.5 ± 5.3 mm) (p = 0.001).

Conclusion

AQP4-ON patients with involvement of canalicular, intracranial segment and optic chiasm of the optic nerve, and the longer range of lesions threaten worse vision prognoses. Timely MR examination during the initial acute phase can not only exclude the intracranial or orbital mass lesions but also indicate visual prognosis in the long term.

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Data availability

The data that support the findings of this study are available on request from the corresponding author upon reasonable request.

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Funding

This work is supported by the Youth Fund of Shanghai Health Commission in China, 20224Y0318.

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Authors and Affiliations

  1. Shanghai Institution of Medical Imaging, Shanghai, 200032, China

    Hanyu Shaw, Wei Chen & Luxi Wang

  2. Department of Radiology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China

    Hanyu Shaw, Meng Qi, Yalan Deng, Wei Chen, Yiyin Zhang, Luxi Wang, Naier Lin & Yan Sha

  3. Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China

    Chaoyi Feng & Guohong Tian

Authors
  1. Hanyu Shaw
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  2. Chaoyi Feng
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Contributions

Hanyu Shaw: conceptualization (lead); methodology; writing—original draft.

Chaoyi Feng: resources; data curation.

Meng Qi: formal analysis.

Yalan Deng: visualization.

Wei Chen: revise English writing.

Yiyin Zhang: software; validation.

Luxi Wang: software; investigation.

Naier Lin: funding acquisition.

Guohong Tian: conceptualization (support); supervision.

Yan Sha: writing—review and editing.

The first draft of the manuscript was written by Hanyu Shaw and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Guohong Tian or Yan Sha.

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Competing interests

The authors declare no competing interests.

Ethical approval

All experiments were performed in accordance with the relevant guidelines and regulations and were approved by the ethics committee of the Eye Ear Nose and Throat Hospital.

Informed consent

Informed consent from the subjects was waived by the above-mentioned ethic committee.

Human and animal rights

The study is a retrospective clinical data analysis and therefor does not involve human or animal research.

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Shaw, H., Feng, C., Qi, M. et al. Analysis of the initial orbital MRI in aquaporin-4 antibody-positive optic neuritis (AQP4-ON): lesion location and lesion length can be predictive of visual prognosis. Neuroradiology (2024). https://doi.org/10.1007/s00234-024-03306-1

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