Hongyu Wu1, Ban Luo2, Gang Yuan3, Qiuxia Wang1, Ping Liu4, Yali Zhao1, Linhan Zhai1, Yanqiang Ma5, Wenzhi Lv6, Jing Zhang7. 1. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. 2. Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. 3. Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. 4. Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China. 5. Ultrasound Medical Center, Lanzhou University Sencond Hospital, Lanzhou University, Lanzhou, 730030, Gansu, China. 6. Department of Artificial Intelligence, Julei Technology Company, Wuhan, 430030, Hubei, China. 7. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. hbclleo@163.com.
Abstract
OBJECTIVES: To evaluate the optic nerve and CSF in the optic nerve sheath as imaging markers of dysthyroid optic neuropathy (DON). METHODS: In this single-centre retrospective study, orbital images of 30 consecutive participants (54 orbits) with DON, 30 patients (60 orbits) with thyroid-associated ophthalmopathy (TAO) without DON, and 19 healthy controls (HCs; 38 orbits) were analysed. The diameter and cross-sectional area of the optic nerve and its sheath, water fraction of the optic nerve, and volume of the fluid in the optic nerve sheath were measured and compared. The associations between MR parameters and clinical measures were assessed using correlation analysis. RESULTS: The diameter and water fraction of the optic nerve (3 mm and 6 mm behind the eyeball), optic nerve subarachnoid space (ONSS) (3 mm and 6 mm behind the eyeball), and subarachnoid fluid volume in the optic nerve sheath were significantly greater in the DON group than in the TAO group (p < 0.01) or HC group (p < 0.01). ROC analysis showed that ONSS 3 mm behind the eyeball (ONSS3) was a robust predictor of DON (AUC = 0.957, sensitivity = 0.907, specificity = 0.9). Water fraction of the optic nerve 3 mm behind the eyeball (water fraction3) had the best specificity (0.967). Water fraction3, fluid volume in the optic nerve sheath, and optic nerve diameter (3 mm behind the eyeball) were correlated with clinical measures (i.e. clinical activity score, mean defect, and pattern standard deviation). CONCLUSIONS: Increased water fraction of the optic nerve and ONSS3 are promising and easily accessible radiological markers for diagnosing DON. KEY POINTS: • The water fraction of the optic nerve and optic nerve subarachnoid space (ONSS) are greater in patients with dysthyroid optic neuropathy (DON) than in patients with thyroid-associated ophthalmopathy (TAO) without DON. • The optic nerve and the cerebrospinal fluid in the optic nerve sheath measures are associated with visual dysfunction. • The water fraction of the optic nerve and ONSS may be promising imaging markers for diagnosing DON.
OBJECTIVES: To evaluate the optic nerve and CSF in the optic nerve sheath as imaging markers of dysthyroid optic neuropathy (DON). METHODS: In this single-centre retrospective study, orbital images of 30 consecutive participants (54 orbits) with DON, 30 patients (60 orbits) with thyroid-associated ophthalmopathy (TAO) without DON, and 19 healthy controls (HCs; 38 orbits) were analysed. The diameter and cross-sectional area of the optic nerve and its sheath, water fraction of the optic nerve, and volume of the fluid in the optic nerve sheath were measured and compared. The associations between MR parameters and clinical measures were assessed using correlation analysis. RESULTS: The diameter and water fraction of the optic nerve (3 mm and 6 mm behind the eyeball), optic nerve subarachnoid space (ONSS) (3 mm and 6 mm behind the eyeball), and subarachnoid fluid volume in the optic nerve sheath were significantly greater in the DON group than in the TAO group (p < 0.01) or HC group (p < 0.01). ROC analysis showed that ONSS 3 mm behind the eyeball (ONSS3) was a robust predictor of DON (AUC = 0.957, sensitivity = 0.907, specificity = 0.9). Water fraction of the optic nerve 3 mm behind the eyeball (water fraction3) had the best specificity (0.967). Water fraction3, fluid volume in the optic nerve sheath, and optic nerve diameter (3 mm behind the eyeball) were correlated with clinical measures (i.e. clinical activity score, mean defect, and pattern standard deviation). CONCLUSIONS: Increased water fraction of the optic nerve and ONSS3 are promising and easily accessible radiological markers for diagnosing DON. KEY POINTS: • The water fraction of the optic nerve and optic nerve subarachnoid space (ONSS) are greater in patients with dysthyroid optic neuropathy (DON) than in patients with thyroid-associated ophthalmopathy (TAO) without DON. • The optic nerve and the cerebrospinal fluid in the optic nerve sheath measures are associated with visual dysfunction. • The water fraction of the optic nerve and ONSS may be promising imaging markers for diagnosing DON.
Entities:
Keywords:
Cerebrospinal fluid in the optic nerve sheath; Dysthyroid optic neuropathy; Magnetic resonance imaging; Optic nerve; Quantitative water-fat sequence