Vasculitis & polymyalgia rheumatica
Orbital MRI for diagnosing giant cell arteritis in cases of anterior ischaemic optic neuropathy
Authors' conclusion
These results suggest that orbital MRI may help clinicians rapidly differentiate between A-AION and NA-AION to provide the most appropriate treatment.
Study context
- Population
- Patients >50 years with recent-onset anterior ischaemic optic neuropathy (AION), enrolled June 2021–October 2024, single centre18 analysed
- Participants
- 18 patients
- Comparison
- Orbital MRI findings in arteritic vs non-arteritic AION
- Arteritic AION (A-AION)n = nine
- NA-AIONn = ninereference
- Outcome
- Orbital MRI features differentiating A-AION from NA-AION
Methodological detailsprospective, single-centre, radiologists blinded to clinical diagnosis
- Prospective
- Single-centre
- Radiologists blinded to clinical diagnosis
Performance
As reported in the abstract
Diagnostic accuracy of retrobulbar fat enhancement on orbital MRI (the most discriminative feature) for A-AION vs NA-AION
| Test or model | Sensitivity | Specificity |
|---|---|---|
| Retrobulbar fat enhancement | 100% (95% CI 72 to 100) | 89% (95% CI 52 to 100) |
Retrobulbar fat enhancement
Sensitivity100% (95% CI 72 to 100)
Specificity89% (95% CI 52 to 100)
Further findings
Contrast enhancement on orbital MRI, A-AION vs NA-AION
- Ophthalmic artery enhancement, A-AION vs NA-AION
- 72.7% vs 22.2%; p=0.07
- Perineural fat enhancement, A-AION vs NA-AION
- 90.9% vs 22.2%; p=0.005
- Retrobulbar fat enhancement, A-AION vs NA-AION
- 100% vs 11.1%; p<0.001
Bilateral orbital enhancement in unaffected contralateral eyes of A-AION patients
- Identified in more than half of the unaffected contralateral eyes
Original publication
Orbital MRI for diagnosing giant cell arteritis in cases of anterior ischaemic optic neuropathy. RMD Open. Published 23 February 2026. doi:10.
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