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Cohort studyCanadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026

Radiologists' recommendations following MRI for optic neuritis: influence of report wording and patient accessibility in a tertiary neuro-ophthalmology clinic.

Sara Kamali Zonouzi, Samira Jafari, Edward Margolin, Jonathan A Micieli

OphthalmologyCohort study

Radiologists recommend follow-up more often when magnetic resonance imaging shows signs of demyelination

Radiologists' recommendations following MRI for optic neuritis: influence of report wording and patient accessibility in a tertiary neuro-ophthalmology clinic.

Sara Kamali Zonouzi … Jonathan A Micieli

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026

Background

Optic neuritis is often managed by neuro-ophthalmologists.

Purpose

This study aimed to characterize the frequency and nature of radiologists' recommendations in magnetic resonance imaging (magnetic resonance imaging) reports for optic neuritis.

Methods

Referred to a tertiary neuro-ophthalmology clinic between November 2007 and May 2025 with new-onset optic neuritis and Data on imaging protocols, diagnostic terminology, differential diagnoses, recommendations, and incidental findings were obtained from electronic medical records.

n = 109 cases

Results

radiologists gave follow-up advice more often when scans showed nerve-damaging changes

With demyelination

20.2%

Without demyelination

2.7%

More results

We included 219 magnetic resonance imaging reports (73.1% female; mean age: 37.4 ± 13.1 years).

Magnetic resonance imaging of the brain and orbit was the most common protocol (73.5%).

Signs of demyelination or possible demyelination were noted in 109 cases (49.8%).

More results

The top 3 recommendations were an magnetic resonance imaging of the spine (17/22; 77.3%), follow-up imaging (2/22; 9.1%), and follow-up appointment with patient and magnetic resonance imaging of orbit (1/22; 4.5% each).

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Conclusion · 1 of 3

Among participating radiologists, recommendations were given to patients in a minority of optic neuritis cases, with magnetic resonance imaging of the spine being the most common recommendation.

Conclusion · 2 of 3

There was a higher likelihood of a recommendation if there were brain changes (20%) compared with no brain changes (3%).

Conclusion · 3 of 3

These findings highlight variability in reporting practices and support the adoption of standardized language for describing optic nerve abnormalities and appropriate follow-up, reducing unnecessary testing and potential patient anxiety.

Post

Radiologists' recommendations following MRI for optic neuritis: influence of report wording and patient accessibility in a tertiary neuro-ophthalmology clinic.

Radiologists recommend follow-up more often when magnetic resonance imaging shows signs of demyelination

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