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Imaging the optic nerve in multiple sclerosis

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

S J Hickman

NMR Research Unit, Department of Neuroinflammation, Institute of Neurology, University College London, Queen Square, London, UK

L Bö

Department of Pathology, MS Center for Research and Treatment, VU University Medical Center, Amsterdam, The Netherlands, and National Competence Center for MS, Department of Neurology, Haukeland University Hospital, Bergen, Norway

F Agosta

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

D H Miller

NMR Research Unit, Department of Neuroinflammation, Institute of Neurology, University College London, Queen Square, London, UK

G Comi

Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy

M Filippi

Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy, filippi.massimo{at}hsr.it

Although multiple sclerosis (MS) frequently involves the optic nerves, imaging this structure is not yet performed routinely in clinical practice. The recent improvement of magnetic resonance (MR) technology and the development of new MR strategies, capable of providing an, in vivo, overall assessment of MS pathology has allowed objective metrics to be obtained for monitoring disease evolution, essentially in the brain. However, despite this progress, the correlation between brain MR metrics of the disease and clinical disability are still disappointing. An objective and accurate estimate of the presence and extent of optic nerve involvement might help to overcome this clinical/MRI paradox. This review summarizes the main results obtained from the application of conventional and modern MR-based techniques for the evaluation of optic nerve damage in MS.

Key Words: disability • magnetic resonance imaging • multiple sclerosis • optic nerve • pathology

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