OPTICON: Magnetic resonance tomography of optic neuritis using DTI imaging for differential diagnosis in patients with neuroinflammatory diseases

Study Description:
Acute optic nerve inflammation (optic neuritis) is one of the most common symptoms of both multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). Optic nerve damage usually leads to a rapid loss of visual function in the affected eye. One crucial factor in determining what course the disease will take, as well as what therapy the patient will receive, is whether the inflammation can be clearly diagnosed as MS or NMOSD at an early stage in its development.

In current clinical practice, even comprehensive diagnostics -- including serological blood tests for detecting antibodies, lumbar puncture and conventional MRI imaging – cannot adequately distinguish between MS and NMOSD with a high degree of accuracy. As a result, misdiagnosis is common in diseases that involve optic nerve inflammation. This is especially true in early stages of the disease when specific therapies are needed. Absence of such therapies due to misdiagnoses can result in serious consequences for patients and have a marked negative impact on the course of the disease, sometimes leading to significant impairments in the patient’s overall quality of life.

In order to better differentiate between MS and NMOSD in the future, in the OPTICON-Study, we would like to use magnetic resonance imaging (MRI) with diffusion tensor imaging (DTI) to provide a closer examination (often referred to as a ‘differential diagnosis’) of optic nerve damage.

DTI imaging provides more accurate measurements of optic nerve damage, especially damage caused by inflammation which goes unseen in routine MRI methods of measurement. If DTI imaging can detect differences in the location and extent of optic nerve damage due to inflammation, this method could significantly improve the chances of an accurate, early differential diagnosis that distinguishes between MS and NMOSD.

Principal Investigator: Prof. Dr. med. Friedemann Paul (Head of Neuroimmunology, NCRC)