PubMed · 5144446
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A N Vershinin. [A portable optometric unit].. https://pubmed.ncbi.nlm.nih.gov/5144446/
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With improved imaging methods, the possibility of demonstrating pathological changes in the visual pathways has increased substantially. However, optimal evaluation of visual disorders requires familiarity with the anatomy and pathology of the visual pathways, and with the many advances in neuroimaging. The purpose of this article is to provide clinicians with a practical approach for selecting the most appropriate imaging modalities. Choice of technique is discussed with reference to anatomical regions rather than a complete list of diseases. Ophthalmoscopy reveals many intraocular abnormalities. Imaging studies help in cases where opaque media preclude a view of the fundus. In addition, imaging studies assist in confirming the extraocular extent of the lesion. The advantages and disadvantages of x-ray, computed tomography and magnetic resonance imaging are discussed and illustrated by examples.
Optimal imaging of the orbital structures presents a challenge. Images of this region may be disturbed by ocular movements, and orbital fat may prevent visualisation of the optic nerve and retrobulbar lesions. In this article, we intend to provide practical guidelines for the evaluation of orbital abnormalities, on the basis of our own experiences and a study of selected literature. Computed tomography (CT) and magnetic resonance imaging (MRI) are both useful for the detection and characterisation of orbital abnormality. However, for diagnostic work-up of the optic nerves, contrast-enhanced, fat-suppressed MRI best demonstrates the pattern and severity of optic nerve abnormality and allows assessment of the intracranial part of the optic nerves and associated intracranial abnormality. In the case of bony involvement, spiral CT imaging is the modality of choice. It is quick, inexpensive and allows multiplanar reconstruction. Not uncommonly, CT as well as MRI may be needed to characterise an orbital lesion.