Orbital MRI versus fundus photography in the diagnosis of optic nerve hypoplasia and prediction of vision.
Kruglyakova Jacqueline, Garcia-Filion Pamela, Nelson Marvin, Borchert Mark
AI Summary
Orbital MRI moderately diagnoses optic nerve hypoplasia and predicts vision, but fundus photography remains superior for definitive diagnosis and prognosticating visual outcomes.
Abstract
Introduction
In patients with optic nerve hypoplasia (ONH), the visualisation of the optic disc can be challenging and the definitive diagnosis difficult to ascertain without fundus photography. The use of MRI for diagnosis has been reported as a diagnostic alternative with conflicting results. We retrospectively analysed a disease registry to determine the reliability of orbital MRI measurements of the optic nerve diameter to diagnose ONH, and the correlation with vision outcomes.
Materials and methods
From a cohort of 140 patients with ONH (13% unilateral) that had reached age 5 years, we identified 43 subjects who had orbital MRI in addition to fundus photography performed prior to 2 years of age. We compared measurements of the optic nerve diameter from orbital MRI scans to the standard relative optic disc size (disc diameter/disc-macula (DD/DM) distance) by fundus photography. All patients had visual acuity tested at age 5 years. Spearman's correlation coefficient was used to determine the correlation of orbital MRI measurements and fundus photography with the diagnosis of ONH, and with vision outcomes.
Results
Relative disc size (DD/DM)<0.35 showed 100% sensitivity and 100% specificity for the diagnostic confirmation of ONH. The optic nerve diameter measurements by orbital MRI displayed a moderate correlation (r s =0.471; p<0.001) with DD/DM and moderate sensitivity for the diagnosis of ONH. Final visual acuity correlated well with DD/DM measurements by fundus photography (r s =-0.869; p<0.001) and moderately with optic nerve diameter by orbital MRI (r s =-0.635; p<0.001).
Discussion: Orbital optic nerve diameter from MRI scans has moderate reliability in diagnosing ONH and predicting vision outcomes. Fundus photography for measurements of the optic nerve size should remain the reference for diagnostic confirmation of ONH. These data further support the prognostic value of fundus photography for eventual vision outcomes in this population.
MeSH Terms
Shields Classification
Key Concepts6
Relative optic disc size (disc diameter/disc-macula (DD/DM) distance) measured by fundus photography, with a value <0.35, showed 100% sensitivity and 100% specificity for the diagnostic confirmation of optic nerve hypoplasia (ONH) in a cohort of 43 subjects.
Optic nerve diameter measurements by orbital MRI displayed a moderate correlation (r_s =0.471; p<0.001) with relative optic disc size (DD/DM) measured by fundus photography and moderate sensitivity for the diagnosis of optic nerve hypoplasia (ONH) in a cohort of 43 subjects.
Final visual acuity at age 5 years correlated well with relative optic disc size (DD/DM) measurements by fundus photography (r_s =-0.869; p<0.001) in a cohort of 43 subjects with optic nerve hypoplasia.
Final visual acuity at age 5 years correlated moderately with optic nerve diameter by orbital MRI (r_s =-0.635; p<0.001) in a cohort of 43 subjects with optic nerve hypoplasia.
Fundus photography for measurements of the optic nerve size should remain the reference for diagnostic confirmation of optic nerve hypoplasia (ONH), as orbital optic nerve diameter from MRI scans has moderate reliability in diagnosing ONH and predicting vision outcomes.
In patients with optic nerve hypoplasia (ONH), the visualization of the optic disc can be challenging and the definitive diagnosis difficult to ascertain without fundus photography.
Related Articles5
Overhead Mounted Optical Coherence Tomography in Childhood Glaucoma Evaluation.
Cross-Sectional StudyDirect Smartphone Disc Video Documentation for Pediatric Glaucomas During Evaluation Under Anesthesia.
Pilot ProjectsMacular and retinal nerve fiber layer analysis of normal and glaucomatous eyes in children using optical coherence tomography.
Cross-Sectional StudyCorrelation between optical coherence tomography and glaucomatous optic nerve head damage in children.
Case-Control StudyThe Rates of Retinal Nerve Fiber Layer Change in Children With Optic Disc Drusen.
Cohort StudyIs this article assigned to the wrong chapter(s)? Let us know.