Which imaging modalities are used in the diagnosis of optic neuritis?

Updated: Apr 02, 2019
  • Author: Pil (Peter) S Kang, MD; Chief Editor: James G Smirniotopoulos, MD  more...
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The diagnosis of optic neuritis is usually made on clinical grounds, supplemented by ophthalmologic examination findings. However, in atypical cases (eg, prolonged or severe pain, lack of visual recovery, atypical visual-field loss, evidence of orbital inflammation and/or inflammation), MRI is used to further characterize and to exclude other disease processes. [2]

Computed tomography (CT) scanning has a very limited role in the setting of optic neuritis. Size differences in the optic nerve can be appreciated, but this is neither sensitive nor specific. Contrast-enhanced CT scanning of the orbits may be able to help exclude other orbital pathology, albeit in a limited way relative to MRI, because of the inherently superior soft-tissue contrast resolution yielded with MRI. Certainly, CT scanning of the brain, regardless of whether intravenous contrast material is administered or not, does not yield prognostic and treatment-altering information as does MRI of the brain. [12]

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