PT  - JOURNAL ARTICLE
AU  - Smith, S.A.
AU  - Williams, Z.R.
AU  - Ratchford, J.N.
AU  - Newsome, S.D.
AU  - Farrell, S.K.
AU  - Farrell, J.A.D.
AU  - Gifford, A.
AU  - Miller, N.R.
AU  - van Zijl, P.C.M.
AU  - Calabresi, P.A.
AU  - Reich, D.S.
TI  - Diffusion Tensor Imaging of the Optic Nerve in Multiple Sclerosis: Association with Retinal Damage and Visual Disability
AID  - 10.3174/ajnr.A2574
DP  - 2011 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1662--1668
VI  - 32
IP  - 9
4099  - http://www.ajnr.org/content/32/9/1662.short
4100  - http://www.ajnr.org/content/32/9/1662.full
SO  - Am. J. Neuroradiol.2011 Oct 01; 32
AB  - BACKGROUND AND PURPOSE: There is a well-known relationship between MS and damage to the optic nerve, but advanced, quantitative MR imaging methods have not been applied to large cohorts. Our objective was to determine whether a short imaging protocol (<10 minutes), implemented with standard hardware, could detect abnormal water diffusion in the optic nerves of patients with MS. MATERIALS AND METHODS: We examined water diffusion in human optic nerves via DTI in the largest MS cohort reported to date (104 individuals, including 38 optic nerves previously affected by optic neuritis). We also assessed whether such abnormalities are associated with loss of visual acuity (both high and low contrast) and damage to the retinal nerve fiber layer (assessed via optical coherence tomography). RESULTS: The most abnormal diffusion was found in the optic nerves of patients with SPMS, especially in optic nerves previously affected by optic neuritis (19% drop in FA). DTI abnormalities correlated with both retinal nerve fiber layer thinning (correlation coefficient, 0.41) and loss of visual acuity, particularly at high contrast and in nerves previously affected by optic neuritis (correlation coefficient, 0.54). However, diffusion abnormalities were overall less pronounced than retinal nerve fiber layer thinning. CONCLUSIONS: DTI is sensitive to optic nerve damage in patients with MS, but a short imaging sequence added to standard clinical protocols may not be the most reliable indicator of optic nerve damage. CIconfidence intervalDTIdiffusion tensor imagingEDSSExpanded Disability Status ScaleEPIecho-planar imagingFAfractional anisotropyHVhealthy volunteerICCintra- and interclass correlation coefficientMDmean diffusivityMSmultiple sclerosisMSSSMS severity scoreOCToptical coherence tomographyODright eye/optic nerveONoptic neuritisOSleft eye/optic nervePPMSprimary-progressive MSPRNFLperipapillary retinal nerve fiber layerRRMSrelapsing-remitting MSROIregion of interestSEspin-echoSENSEsensitivity encodingSPMSsecondary-progressive MST2WIT2-weighted imagingTMVtotal macular volumeVEPvisual-evoked potentialλ‖parallel diffusivityλ⊥perpendicular diffusivity