MRI is incorporated into the revised McDonald criteria and MAGNIMS consensus guidelines [53] for diagnosing multiple sclerosis, which is characterized by establishing dissemination of lesions in space and time [51]. Neuromyelitis optica is a demyelinating condition that typically affects the optic nerves and spinal cord and is best assessed with MRI [54]. Serum and cerebrospinal fluid laboratory tests may also be useful in differentiating between these two entities [51,55]. CT Although an imaging test of the brain may be indicated prior to lumbar puncture in patients with optic disc edema to exclude a space occupying mass, CT imaging of the head is typically not indicated specifically for the evaluation of a patient with optic neuritis. CTA, MRA, Arteriography Angiography is not routinely used in the initial evaluation of optic neuritis. Radiography Orbital or skull radiographs are insufficient to detect pathology in patients presenting with clinical concern for vision loss. MRI MRI is not routinely used in the evaluation of non-neoplastic ocular processes. In patients with glaucoma, a primary cause of irreversible blindness, there has been interest in applying advanced MRI techniques to earlier detection of this disease process; however, additional research is needed to validate the utility of these advanced techniques [56]. Orbits, Vision and Visual Loss CT CT is not routinely used in the evaluation of nontraumatic, noninfectious, or non-neoplastic ocular processes. CTA, MRA, Arteriography CTA, MRA, and DSA are not first-line tests in this scenario. Radiography Orbital or skull radiographs are insufficient to detect pathology in patients presenting with vision loss. Variant 6: Visual loss. Intraocular mass, optic nerve, or pre-chiasm symptoms. Initial imaging. Monocular visual loss may be due to an intraocular mass, such as melanoma [57], or may involve the intraorbital, intracanalicular, or pre-chiasm segments of the optic nerve.
Orbits Vision and Visual Loss. MRI is incorporated into the revised McDonald criteria and MAGNIMS consensus guidelines [53] for diagnosing multiple sclerosis, which is characterized by establishing dissemination of lesions in space and time [51]. Neuromyelitis optica is a demyelinating condition that typically affects the optic nerves and spinal cord and is best assessed with MRI [54]. Serum and cerebrospinal fluid laboratory tests may also be useful in differentiating between these two entities [51,55]. CT Although an imaging test of the brain may be indicated prior to lumbar puncture in patients with optic disc edema to exclude a space occupying mass, CT imaging of the head is typically not indicated specifically for the evaluation of a patient with optic neuritis. CTA, MRA, Arteriography Angiography is not routinely used in the initial evaluation of optic neuritis. Radiography Orbital or skull radiographs are insufficient to detect pathology in patients presenting with clinical concern for vision loss. MRI MRI is not routinely used in the evaluation of non-neoplastic ocular processes. In patients with glaucoma, a primary cause of irreversible blindness, there has been interest in applying advanced MRI techniques to earlier detection of this disease process; however, additional research is needed to validate the utility of these advanced techniques [56]. Orbits, Vision and Visual Loss CT CT is not routinely used in the evaluation of nontraumatic, noninfectious, or non-neoplastic ocular processes. CTA, MRA, Arteriography CTA, MRA, and DSA are not first-line tests in this scenario. Radiography Orbital or skull radiographs are insufficient to detect pathology in patients presenting with vision loss. Variant 6: Visual loss. Intraocular mass, optic nerve, or pre-chiasm symptoms. Initial imaging. Monocular visual loss may be due to an intraocular mass, such as melanoma [57], or may involve the intraorbital, intracanalicular, or pre-chiasm segments of the optic nerve.