Assessment of Optic Nerve Impairment in Patients with Neuromyelitis Optica by MR Diffusion Tensor Imaging.

Abstract

BACKGROUND: Diffusion tensor imaging (DTI) has been used for the evaluation of the white matter integrity. In this study, we evaluated optic nerve impairment in patients with neuromyelitis optica (NMO) using DTI. METHODOLOGY/PRINCIPAL FINDINGS: Optic nerve DTI were performed on 28 NMO patients and 38 normal controls. Fractional anisotropy (FA) values were measured in the anterior, middle, and posterior parts of the intraorbital optic nerve segment. For the posterior intraorbital optic nerve, FA values of BI (0.20±0.07), MI (0.24±0.16), and NA (0.25±0.14) decreased significantly compared with that of NC (0.43±0.07) (P<0.05), and ROC analysis demonstrated that the area under the curve (AUC) measurements for BI vs. NC, MI vs. NC, NA vs. NC, and NMO (including BI, MI, and NA) vs. NC were 0.99, 0.93, 0.88, and 0.96, respectively. The corresponding diagnostic sensitivities of ROC analysis were 100%, 80%, 80%, and 91%; and the specificities were 93%, 97%, 91%, and 93%. CONCLUSIONS/SIGNIFICANCE: Decreased FA value in the intraorbital optic nerve, especially in the posterior part of the nerve, was demonstrated as a characteristic MR feature for NMO-related optic nerve impairment.