MRI Head MRI of the head without and with IV contrast may be helpful to evaluate for intracranial abnormalities in children presenting with isolated nystagmus [29]. Batmanabane et al [29] retrospectively reviewed charts of 148 children who underwent MRI for isolated nystagmus; 23 (15.5%) of these children had abnormal intracranial findings. Most common abnormalities on MRI included abnormal T2 hyperintense signal in white matter (4%), Chiari 1 malformation (3.4%), and optic pathway glioma (2%). MRI Orbits There is no relevant literature to support MRI orbits without or with IV contrast as initial imaging in children with isolated nystagmus. However, it may be considered an adjunct to the MRI of the brain if obtained concurrently. Batmanabane et al [29] retrospectively reviewed charts of 148 children who underwent MRI for isolated nystagmus; 23 (15.5%) of these children had abnormal intracranial findings. Most common abnormalities on MRI included abnormal T2 hyperintense signal in white matter (4%), Chiari 1 malformation (3.4%), and optic pathway glioma (2%). Variant 4: Child. Congenital or developmental abnormality leading to decreased visual acuity or vision loss. No leukocoria. Unilateral or bilateral. Initial imaging. Various developmental abnormalities that typically present with decreased acuity or loss of vision primarily include abnormalities of the globes and optic nerves. Abnormalities of the globe may include anophthalmus, microphthalmos, macropthalmos, anterior segment dysgenesis, or coloboma [2]. These disorders are best evaluated with clinical examination, ophthalmoscopy, and measurement of the size of the globe with ocular US. However, imaging may be helpful in complex abnormalities, which are difficult to delineate by US or for evaluation of the associated syndromes and developmental abnormalities in the brain (eg, coloboma on the setting of Aicardi syndrome) [2].
Orbital Imaging and Vision Loss Child. MRI Head MRI of the head without and with IV contrast may be helpful to evaluate for intracranial abnormalities in children presenting with isolated nystagmus [29]. Batmanabane et al [29] retrospectively reviewed charts of 148 children who underwent MRI for isolated nystagmus; 23 (15.5%) of these children had abnormal intracranial findings. Most common abnormalities on MRI included abnormal T2 hyperintense signal in white matter (4%), Chiari 1 malformation (3.4%), and optic pathway glioma (2%). MRI Orbits There is no relevant literature to support MRI orbits without or with IV contrast as initial imaging in children with isolated nystagmus. However, it may be considered an adjunct to the MRI of the brain if obtained concurrently. Batmanabane et al [29] retrospectively reviewed charts of 148 children who underwent MRI for isolated nystagmus; 23 (15.5%) of these children had abnormal intracranial findings. Most common abnormalities on MRI included abnormal T2 hyperintense signal in white matter (4%), Chiari 1 malformation (3.4%), and optic pathway glioma (2%). Variant 4: Child. Congenital or developmental abnormality leading to decreased visual acuity or vision loss. No leukocoria. Unilateral or bilateral. Initial imaging. Various developmental abnormalities that typically present with decreased acuity or loss of vision primarily include abnormalities of the globes and optic nerves. Abnormalities of the globe may include anophthalmus, microphthalmos, macropthalmos, anterior segment dysgenesis, or coloboma [2]. These disorders are best evaluated with clinical examination, ophthalmoscopy, and measurement of the size of the globe with ocular US. However, imaging may be helpful in complex abnormalities, which are difficult to delineate by US or for evaluation of the associated syndromes and developmental abnormalities in the brain (eg, coloboma on the setting of Aicardi syndrome) [2].