Pediatric optic nerve and optic nerve sheath diameter on magnetic resonance imaging

Background: The normal values of optic nerve diameter and optic nerve sheath diameter might be beneficial in defining an abnormality such as optic nerve hypoplasia, or enlarged subarachnoid space, reflecting the state of increased intracranial pressure.

Objective: To study the normal optic nerve diameter and optic nerve sheath diameter on magnetic resonance imaging (MRI) in the early years of postnatal visual development from MRI of the brain.

Materials and methods: MRI of the brain in patients ages 4 years and younger were gathered. Forty-two studies with normal intracranial findings and a lack of history of increased intracranial pressure were retrospectively reviewed by two reviewers using axial T2-weighted images. Measurements were performed in transverse diameter perpendicular to the optic nerve at 3 mm behind the globe.

Results: The mean optic nerve diameter of the 77 optic nerves were 2.5 mm (95% confidence interval [CI] 2.4-2.6). The mean optic nerve sheath diameter values of the 79 optic nerve sheath complexes were 5.0 mm (95% CI 4.9-5.1). The mean±standard deviation optic nerve diameter and optic nerve sheath diameter stratified by each age groups were, respectively, 0 to <1 year: 2.3±0.40 and 4.81±0.37; 1 to <2 years: 2.6±0.2 and 5.0±0.4; 2 to <3 years: 2.4±0.3 and 4.9±0.6, and 3 to <4 years: 2.9±0.4 and 5.2±0.60 mm.

Conclusion: Seventy-four of the 77 measurements (96%) were of the measurements were above the threshold of 2 mm for optic nerve diameter. Seventy-seven of the 79 measurements (97%) were of the measurements were below the threshold of 6 mm for optic nerve sheath diameter.