NEURO-OPHTHALMIC CORRELATES OF OPTIC NERVE PATHOLOGIES: AN MRI-BASED STUDY

Abstract

This MRI-based investigation examined the structural and functional neuro-ophthalmic correlates associated with diverse optic nerve pathologies, aiming to identify measurable biomarkers that enhance diagnostic precision and clinical decision-making. A multi-center prospective design was employed, integrating high-resolution MRI modalities—including T2-weighted imaging, diffusion-weighted imaging, and quantitative neuro-ophthalmic indices—to evaluate patients presenting with ischemic, demyelinating, inflammatory, and compressive optic neuropathies. The findings revealed significant associations between MRI-derived structural changes and functional visual outcomes. Increased T2 hyperintensity correlated strongly with delayed visual evoked potential (VEP) latency, while reduced apparent diffusion coefficient (ADC) values were prominently observed in compressive and ischemic neuropathies. Additionally, lesion topography mapping demonstrated distinct spatial clustering patterns, particularly in the intracanalicular and intracranial optic nerve segments, suggesting segment-specific vulnerability influenced by vascular and anatomical factors. Multidimensional integration of MRI markers into a composite Neuro-Ophthalmic Severity Index (NOSI) provided reliable grading of pathology severity and aligned closely with clinical symptom scores. These results underscore the value of MRI-based structural and functional profiling as a non-invasive, high-precision diagnostic approach, offering clinicians a more comprehensive foundation for early detection, staging, and prognostic predictions in optic nerve disorders. The study highlights the importance of multimodal imaging analytics and supports their routine incorporation into neuro-ophthalmic diagnostic pathways.