Neuroimaging in Pediatric Optic Neuritis: A Narrative Review

Abstract

Context: Pediatric optic neuritis can occur in isolation or association with neuroinflammatory disorders. We reviewed the abnormal orbital and cranial magnetic resonance imaging in literature diagnosed as pediatric optic neuritis, which was primarily presented with visual problems. Evidence Acquisition: A PubMed literature search was accomplished using the following key terms: “Neuroimaging", “Pediatric", “Optic Neuritis", “Multiple Sclerosis", and “Magnetic Resonance Imaging". Results: Poorly demarcated changes in white and or gray matter, well-demarcated white matter changes, confluent lesions in white matter, and small nonspecific lesions or nothing in some areas of the brain are the most common patterns of children with optic neuritis. The thin, fat suppression imaging technique can reveal optic nerve lesions. Contrast-enhanced sequences, especially by short tau inversion recovery, allow differentiation of particular high-signal intensity foci in the optic nerve and newly formed active lesions from inactive lesions. Conclusions: Brain imaging should be performed in all patients, if possible, during the two weeks after the initial diagnosis. The cranial neuroimaging can predict multiple sclerosis development in pediatric patients with demyelinating brain lesions.