New Insights into the Pathogenesis of Cryptococcal Induced Visual Loss Using Diffusion-Weighted Imaging of the Optic Nerve

作者：Moodley Anand^*; Rae William; Bhigjee Ahmed; Loubser Noleen; Michowicz Andrew

来源：Neuro-Ophthalmology, 2012, 36(5): 186-192.

DOI：10.3109/01658107.2012.715716

• Apparent diffusion coefficient
• Compartment syndrome
• Cryptococcal meningitis
• Fractional anisotropy
• Optic nerve diffusion

Despite a successful antiretroviral drug rollout in South Africa, cryptococcal induced visual loss continues to be a major complication of cryptococcal meningitis. Preventive measures are lacking due to poor understanding of its pathogenesis. Optic nerve diffusion has shown some promise in investigating inflammatory and axonal changes of the optic nerve in vivo. The lack of post-contrast enhancement on T1 magnetic resonance imaging (MRI) and signal changes on T2 MRI with slightly increased apparent diffusion coefficient and reduced fractional anisotropy on diffusion imaging suggest that pressure-related effects are the dominant mechanism over inflammation and that there is early untested evidence of a compartment syndrome rather than papilloedema as the main contributor.

• 出版日期2012-10