IRLs are common in mixed active/inactive MS lesions in the anterior visual pathway. IRLs are the pathologic correlate of paramagnetic rim lesions (PRLs) on MRI, the number of which in the brain correlates with the extent of disability. PRLs have, heretofore, not been described in the anterior visual pathway. Future work aimed at overcoming the challenges in detecting these lesions in the anterior visual pathway is warranted, to ensure that extent of chronic inflammation is not underestimated.
Lockhart et al. (Tue,) studied this question.