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Objectives: This study was designed to evaluate the performance of high-resolution magnetic resonance imaging (HR-MRI) in detecting giant cell arteritis (GCA), evaluate superficial extracranial artery and other MRI abnormalities, and compare three-dimensional (3D) and two-dimensional (2D) techniques. Methods: PubMed, Web of Science, and Cochrane Library were screened up to March 7, 2021, and further selection was performed according to the eligibility criteria. Quality Assessment of Diagnostic Accuracy Studies-2 was used for quality assessment, and heterogeneity assessment and statistical calculations were also performed. Results: In total, 1851 records were retrieved from online databases, and 15 studies were finally included. Regarding the performance of HR-MRI, the superficial extracranial artery had 75% sensitivity and 89% specificity, respectively, with an area under the receiver operating characteristic curve (AUC) of 0.91. Positive and negative post-test possibilities were 86% and 20%, respectively, with clinical diagnosis as reference. When referenced with temporal artery biopsy, the sensitivity was 91%, specificity was 78%, AUC was 0.92, and positive and negative post-test possibilities were 78% and 10%, respectively. 3D HR-MRI and 2D HR-MRI had 70% and 72% sensitivity, respectively, and 91% and 84% specificity, respectively. Conclusions: HR-MRI is a valuable imaging modality for GCA diagnosis. It provided high accuracy in the diagnosis of GCA and played a potential role in identifying GCA-related ischemic optic neuropathy. 3D HR-MRI had better specificity than 2D HR-MRI. Key Points: HR-MRI helps clinicians to diagnose GCA. Superficial extracranial arteries and other MRI abnormalities can be assessed with HR-MRI. HR-MRI can help in assessing GCA-related optic neuropathy. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of timing from visual symptoms' onset to diffusion-weighted (DW) 3 T MRI completion to detect ischemic changes of the optic disc and optic nerve in AION patients. Methods: This IRB-approved retrospective single-center study included 3 T MRI data from 126 patients with AION and 111 controls with optic neuritis treated between January 2015 and May 2020. Two radiologists blinded to all data individually analyzed imaging. A senior neuroradiologist resolved any discrepancies by consensus. The primary judgment criterion was the restricted diffusion of the optic disc and/or the optic nerve assessed subjectively on the ADC maps. ADC values were also measured. Spearman rank correlations were used to examine the relationships between timing from visual symptoms' onset to MRI completion and both the restricted diffusion and the ADC values. Results: One hundred twenty-six patients (47/126 [37.3%] women and 79/126 [62.7%] men, mean age 69.1 ± 13.7 years) with AION were included. Restricted diffusion of the optic disc in AION eyes was more frequent in the early MRI group than in the late MRI group: 35/49 (71.4%) eyes versus 3/83 (3.6%) eyes, p < 0.001. ADC values of the pathological optic discs and optic nerves were lower in the early MRI group than in the late MRI group: 0.61 [0.52–0.94] × 10−3 mm2/s versus 1.28 [1.01–1.44] × 10−3 mm2/s, p < 0.001, and 0.74 [0.61–0.88] × 10−3 mm2/s versus 0.89 [0.72–1.10] × 10−3 mm2/s, p < 0.001, respectively. Conclusions: DWI MRI showed good diagnostic performance to detect AION when performed early after the onset of visual symptoms. Key Points: • Restricted diffusion of the optic disc in eyes affected by AION was significantly more likely to be observed in patients who had undergone MRI within 5 days after onset of visual symptoms. • ADC values of the pathological optic discs and optic nerves were significantly lower in patients who had undergone MRI within 5 days after onset of visual symptoms of AION: 0.61 × 10−3mm2/s versus 1.28 × 10−3mm2/s, p < 0.001, and 0.74 × 10−3mm2/s versus 0.89 × 10−3mm2/s, p < 0.001, respectively. • The optimal threshold for timing from visual symptoms' onset to MRI completion to detect restricted diffusion of the optic disc and/or optic nerve was 5 days, with an AUC of 0.88 (CI95%: 0.82–0.94). [ABSTRACT FROM AUTHOR]

Competing Interests: The authors report no conflicts of interest.

Background/Aim. Anterior ischemic optic neuropathy (AION) represent a segmental infarction of the optic nerve head which is supplied by the posterior ciliary arteries. There are two types of AION: non-arteritic (NAAION and arteritic (A-AION), due to giant cell arteritis (GCA). The aim of this study was to investigate the clinical features and ultrasound characteristics of the orbital vessels and superficial temporal and carotid arteries, in patients with unilateral acute AION in order to help differentiate newly diagnosed NA-AION from AAION. Methods. In this prospective comparative, observational study, 62 consecutive patients with clinical suspicion of unilateral acute AION were examined at admission and in the first two months of evolution, following a protocol including color Doppler imaging (CDI) of the orbital vessels. Results. We found 12 patients with A-AION, all of them with biopsy-confirmed disease, and 50 patients with NA-AION. A-AION patients presented a combination of a history of amaurosis fugax before acute, painless, and severe vision loss in the affected eye, and a diffuse pale optic disc edema. In these patients, CDI of the orbital vessels indicated high resistance index (RI), with severe diminished blood flow velocities in all orbital vessels, in both orbits. In the NAAION patients, none of these clinical symptoms were found and blood velocities and RI in posterior ciliary arteries were preserved. Typical sonographic feature in temporal arteritis as part of GCA was the „dark halo” sign. Conclusions. The ultrasound investigations enable prompt differentiation between NA-AION and A-AION.

The aim of this study was to assess damage to retinal ganglion cells (RGC) and morphology of the optic nerve head (ONH) in patients with primary open angle glaucoma (POAG) and non-arteritic anterior ischemic optic neuropathy (NAION). The study included three groups of patients, as follows: 40 eyes with POAG, 40 eyes with NAION and 40 eyes with refraction anomaly. All patients underwent standard automated perimetry and analysis of ONH topography by using confocal scanning laser ophthalmoscopy (CSLO)-HRT II. Visual field defects such as decreased retinal sensitivity prevailed in the eyes with POAG, whereas in the eyes with NAION they were mostly manifested as concentrically narrowed visual field and quadrant excesses. Topographic ONH alterations, examined by HRT II, showed the same number of sectors to be affected in the eyes with POAG and NAION. A larger number of sectors in the upper part of ONH were affected in the eyes with NAION. Optic disc morphology differed significantly between the eyes with POAG and NAION by a higher rate of neuroretinal rim thinning and higher mean cup depth in the POAG group.