Differences in the involved sites among different types of demyelinating optic neuritis in traditional MRI examination: A systematic review and meta-analysis

Yongping Wang; Junxia Fu; Honglu Song; Quangang Xu; Huanfen Zhou; Shihui Wei

doi:10.1016/j.aopr.2021.100019

Differences in the involved sites among different types of demyelinating optic neuritis in traditional MRI examination: A systematic review and meta-analysis

Adv Ophthalmol Pract Res. 2021 Dec 20;1(2):100019. doi: 10.1016/j.aopr.2021.100019. eCollection 2021 Dec.

Authors

Yongping Wang¹, Junxia Fu¹, Honglu Song¹, Quangang Xu¹, Huanfen Zhou¹, Shihui Wei¹

Affiliation

¹ Department of Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China.

Abstract

Background: Magnetic resonance imaging (MRI) plays a significant role in assessing optic neuropathy and providing more detailed information about the lesion of the visual pathway to help differentiate optic neuritis from other visual disorders. This study aims to systematically review the literature and verify if there is a real difference in lesion location among different demyelinating optic neuritis (DON) subtypes.

Methods: A systematic search was conducted including 8 electronic databases and related resources from the establishment of the database to August 25th, 2020. We classified DON into 5 subtypes and divided the visual pathways into five segments mainly comparing the differences in the involved visual pathway sites of different subtypes.

Results: Fifty-five studies were included in the analysis, and the abnormal rate was as high as 92% during the acute phase (within 4 weeks of symptom onset). With respect to lesion location, the orbital segment of the optic nerve was the most frequently involved (87%), whereas optic tract involvement was very rare. Involvement of the orbital segment was more common in myelin oligodendrocyte glycoprotein antibody-related optic neuritis (MOG-ON) (78%) and chronic relapsing inflammatory optic neuropathy (CRION) (81%), while the lesion was found to be located more posteriorly in neuromyelitis optica spectrum disorder-related optic neuritis (NMOSD-ON). With respect to lesion length, approximately 77% of MOG-ON patients had lesions involving more than half of the optic nerve length.

Conclusions: MRI examination is recommended for DON patients in the acute phase. In MOG-ON, anterior involvement is more common and the involved length is mostly more than 1/2 of the optic nerve length, whereas posterior involvement, intracranial segment, optic chiasm, or optic tract, is more common in NMOSD-ON.

Prospero registration number: CRD42020222430 (25-11-2020).

Keywords: A systemic review; Demyelinating optic neuritis; Magnetic resonance imaging; Meta-Analysis.

Publication types

Review