Seeing is Believing: the Optic Nerve from Anatomy to Pathology

Congress:

ECR 2018

Poster Number:

C-0112

Type:

Educational Exhibit

Keywords:

Trauma, Inflammation, Education and training, eLearning, Education, Diagnostic procedure, MR-Diffusion/Perfusion, MR, CT, Head and neck, Eyes, CNS

Authors:

M. Dorigatti Soldatelli, B. da Silveira Arruda, T. M. B. Da Conceição, N. Henz Concatto, D. A. Eifer, L. Gonçalves Campos, F. A. Leiria, J. Adams Perez, J. Ávila Duarte; Porto Alegre/BR

DOI:

10.1594/ecr2018/C-0112

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-0112

Fig. 1: Axial T2WI illustrating the normal optic nerve anatomy and its 4 segments with...

Fig. 2: A cross-section anatomy of the ON adapted from Harnsberger, H. R., & Chapman,...

Fig. 3: A cross-section of the ON demonstrating the ON, subarachnoid space and ON sheat...

Fig. 8: Optic Nerve (ON) Sarcoidosis. Female, 45 yo. Axial T2WI (A), coronal...

Learning objectives

The purpose of our educational exposition is to: Describe the anatomy of the optic nerve (ON) Illustrate the main findings and differential diagnosis of ON pathologies on computed tomography (CT) and on magnetic resonance imaging (MRI). Discuss the main etiologies: congenital, inflammatory/ infectious, neoplastic, vascular and others, based on 10 years of experience of our Neuroradiology service.

Background

Along with clinical and ophthalmoscopic evaluation, imaging, especially magnetic resonance imaging, plays an important role in the thorough evaluation of optic nerve (ON) and the entire visual pathway [1]. The knowledge of this detailed anatomy and its main pathologies is essential for the patient's highly accurate diagnosis. The ON (the second cranial nerve) is an extension of the central nervous system (CNS) axons, thus, it’s myelinated by oligodendrocytes. It originates from the retina, where its first sensory bipolar cell body is located and it is...

Findings and procedure details

Differential diagnosis of ON pathology can be broadly divided into congenital, inflammatory/infectious, neoplastic, vascular and others. In the following section, we will be exploring the main pathologies related to each one of these topics and their main imaging features. 1.CONGENITAL: 1.1 Optic nerve aplasia/hypoplasia ON aplasia is a rare, congenital developmental anomaly, comprising of the absence of ON, central retinal vessels and ganglion cells while the ON hypoplasia is characterized by small optic disc. Both conditions can affect one or both eyes and are generally...

Conclusion

The differential diagnosis for optic nerve pathologies is broad. Clinical information, understanding of the main imaging features, and knowledge in imaging methods and protocols can help radiologists to reach the most accurate diagnosis. After all, a trained radiologist’s eye may improve patient’s chances of seeing and believing.

Personal information

Matheus Dorigatti Soldatelli, MD, Department of Radiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; [email protected] Juliana Ávila Duarte, MD PhD, Department of Radiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; [email protected]

References

Gala F. Magnetic resonance imaging of optic nerve. The Indian Journal of Radiology & Imaging. 2015;25(4):421-438. doi:10.4103/0971-3026.169462. Sheth, S., Branstetter, B. F., & Escott, E. J. (2009). Appearance of Normal Cranial Nerves on Steady-State Free Precession MR Images. RadioGraphics, 29(4), 1045-1055. doi:10.1148/rg.294085743 Khandgave TP, Kulkarni VN, Muzumdar DV, Puthran N. Bilateral Optic Nerve Aplasia: A Rare Isolated Central Nervous System Anomaly. Middle East African Journal of Ophthalmology. 2014;21(3):262-264. doi:10.4103/0974-9233.134690. Haddad NG, Eugster EA. Hypopituitarism and neurodevelopmental abnormalities in relation to central nervous system structural defects...