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Multiple Sclerosis
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Continuing optic nerve atrophy following optic neuritis: a serial MRI study

S J Hickman

NMR Research Unit, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK

C MH Brierley

Cambridge Centre for Brain Repair, Forvie Site, Robinson Way, Cambridge CB2 2PY, UK

P A Brex

NMR Research Unit, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK

D G MacManus

NMR Research Unit, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK

N J Scolding

Institute of Clinical Neurosciences, Frenchay Hospital, Bristol BS16 1LE, UK

D AS Compston

Cambridge Centre for Brain Repair, Forvie Site, Robinson Way, Cambridge CB2 2PY, UK

D H Miller

NMR Research Unit, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK, d.miller{at}ion.ucl.ac.uk

To investigate optic neuritis as a model for atrophy in multiple sclerosis (MS) lesions we performed serial magnetic resonance imaging (MRI) on 10 patients with a history of optic neuritis using a fat saturated short-echo fast fluid-attenuated inversion recovery (sTE fFLAIR) sequence. The first study was performed a median of 19.5 months after the onset of optic neuritis and the second 1 year later. Using a computer-assisted contouring technique, a blinded observer calculated the mean area of the intra-orbital optic nerves. The mean area of affected optic nerves decreased over 1 year by 0.9 mm2 from 11.1 to 10.2 mm2 (p=0.01). Poor visual acuity and decreased visual-evoked potential (VEP) amplitude were associated with atrophy. These findings suggest that atrophy is a feature of focal demyelinating lesions, it may evolve over several years, and may have functional significance. Optic neuritis provides a model to study the effect of inflammatory demyelination through the ability to accurately measure visual function and to visualize and measure the optic nerves using magnetic resonance imaging.

Key Words: magnetic resonance imaging/methods • multiple sclerosis/complications • multiple sclerosis/pathology • multiple sclerosis/physiopathology • optic atrophy/aetiology • optic atrophy/pathology • optic nerve/pathology • optic neuritis/complications

Multiple Sclerosis, Vol. 8, No. 4, 339-342 (2002)
DOI: 10.1191/1352458502ms809oa
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