What abnormal findings would be detected in a CT scan of a patient with optic nerve atrophy?

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At the outset, I want to tell you that MRI (magnetic resonance imaging) is the imaging modality of choice for evaluating the optic nerves and the visual pathway. However, I have been provided with only CT (computed tomography) images (attachments removed to protect the patient's identity); therefore, my comments would be based on the CT study only. On CT, both optic nerves in the intraorbital region appear normal in thickness (left side optic nerve of the same thickness as the one on the right side).

In optic atrophy, the affected nerve would be thin, and its overall volume would be reduced compared to the non-affected nerve. No obvious mass or lesions are noted within or adjacent to the optic nerve pathway in the orbits. Both side globes and intraocular muscles appear normal. In addition, the tissues surrounding the optic nerves appear normal.

Therefore in this CT study, optic nerves in the orbital portion appear normal. Still, again, since this is not the imaging modality of choice for optic nerves, an MRI of Orbits would be recommended in case of symptomatic patients.