Neuroimaging Techniques in Optic Neuritis and Multiple Sclerosis

Neuroimaging has become indispensable in the diagnosis and monitoring of optic neuritis and multiple sclerosis (MS), two disorders characterised by inflammatory demyelination and neuronal injury within the visual pathways. Conventional MRI sequences provide macroscopic views of focal lesions and global atrophy, yet fail to reveal subtle microstructural changes. Diffusion‐weighted techniques such as diffusion tensor imaging (DTI) quantify directional water diffusion, offering insights into white matter integrity via metrics including fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (AD). Recent tractography approaches enable in vivo reconstruction of the optic nerves and radiations, illuminating patterns of Wallerian degeneration and transneuronal neurodegeneration following acute demyelinating events. Optical coherence tomography (OCT) complements central assessments by measuring retinal nerve fibre layer thickness as a surrogate for axonal loss. Combined electrophysiological measures, particularly visual evoked potentials (VEP), afford functional correlates of conduction velocity and myelination status. Together, these modalities chart the dynamic processes of demyelination, remyelination and neurodegeneration across both anterior and posterior visual pathways. Emerging quantitative MRI techniques, including myelin water imaging and magnetisation transfer ratio, promise enhanced specificity for myelin content, while high‐field systems improve spatial resolution of cortical and subcortical visual structures. Integrative analyses of structural, diffusion and functional data have begun to refine prognostic models and therapeutic monitoring, aligning with the wider shift towards personalised management of MS and optic neuritis on a global scale.

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Neuroimaging Techniques in Optic Neuritis and Multiple Sclerosis publication trend

The graph below shows the total number of articles in neuroimaging techniques in optic neuritis and multiple sclerosis across all publications each year (not limited to Nature Index journals).

Technical terms

Diffusion tensor imaging (DTI): An MRI technique that models water diffusion directionalities to infer white matter microstructure.

Fractional anisotropy (FA): A scalar DTI metric ranging from 0 to 1 indicating the degree of directional water diffusion.

Radial diffusivity (RD): A DTI metric reflecting diffusion perpendicular to fibre tracts, often associated with myelin integrity.

Axial diffusivity (AD): A DTI metric reflecting diffusion parallel to fibre tracts, sensitive to axonal integrity.

Optical coherence tomography (OCT): A non-invasive imaging modality that measures retinal layer thickness with micrometre resolution.

Visual evoked potential (VEP): An electrophysiological measure of cortical responses to visual stimuli, indicating conduction speed along the visual pathway.

References

1. Decoding Diffusivity in Multiple Sclerosis: Analysis of Optic Radiation Lesional and Non-Lesional White Matter. PLOS ONE (2015).
2. Optic Nerve Diffusion Tensor Imaging after Acute Optic Neuritis Predicts Axonal and Visual Outcomes. PLOS ONE (2013).
3. Diffusion tensor imaging for multilevel assessment of the visual pathway: possibilities for personalized outcome prediction in autoimmune disorders of the central nervous system. EPMA Journal (2017).
4. Vision and Vision-Related Measures in Progressive Multiple Sclerosis. Frontiers in Neurology (2019).