Optic nerve sheath enhancement on orbital MRI in giant cell arteritis

被引：0
作者：
Ephrem, Rebka K. [1 ]
Mohan, Suyash [2 ]
Rebello, Ryan [3 ]
Liang, Rui [1 ]
Kurtz, Robert [2 ]
Song, Jae W. [2 ]
Tamhankar, Madhura A. [4 ,5 ,6 ]
Rhee, Rennie L. [7 ]
机构：
[1] Univ Penn, Philadelphia, PA USA
[2] Univ Penn, Dept Radiol, Philadelphia, PA USA
[3] St Josephs Healthcare Hamilton, Dept Diagnost Imaging, Hamilton, ON, Canada
[4] Univ Penn, Dept Neuroophthalmol, Philadelphia, PA USA
[5] Univ Penn, Dept Ophthalmol, Philadelphia, PA USA
[6] Univ Penn, Dept Neurol, Philadelphia, PA USA
[7] Univ Penn, Med Rheumatol, Philadelphia, PA 19104 USA
来源：
BRITISH JOURNAL OF OPHTHALMOLOGY | 2024年
关键词：
Imaging; Optic Nerve; Orbit; Inflammation; NEUROPATHY; INVOLVEMENT;
D O I：
10.1136/bjo-2024-326608
中图分类号：
R77 [眼科学];
学科分类号：
100212 ;
摘要：
Background Differentiating arteritic anterior ischaemic optic neuropathy (A-AION) due to giant cell arteritis (GCA) from non-arteritic anterior ischaemic optic neuropathy (NA-AION) may pose a diagnostic challenge. Our study aimed to assess the use of standard orbital MRI in distinguishing ocular manifestations of GCA from NA-AION.Methods This study included 25 consecutive patients (11 GCA, 14 NA-AION) who underwent contrast-enhanced orbital MRIs within 3 months of symptom onset. Two radiologists blinded to clinical data independently evaluated MRIs for the enhancement of the optic nerve sheath (ONS) and other orbital structures.Results On orbital MRI, ONS enhancement of at least one eye was more common in patients with GCA than NA-AION (64% vs 14%, p=0.02). ONS enhancement on MRI was seen in patients with typical ophthalmologic exam findings of A-AION as well as in GCA patients with other features of ocular ischaemia (eg, retinal artery occlusion). Among patients with GCA, ONS enhancement was bilateral in six of seven cases even when visual symptoms and signs were unilateral.Conclusion Patients with ocular GCA are more likely to have ONS enhancement on MRI compared with NA-AION. ONS enhancement was observed in (i) A-AION and other forms of ocular ischaemia, demonstrating the potential value of MRI in multiple orbital pathologies in GCA, and (ii) both the affected and unaffected eye, suggesting MRI may detect early subclinical ocular disease in GCA. These results highlight the potential value of adding orbital MRI to the diagnostic workup of ocular GCA.
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页数：6
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