PURPOSE: To assess the value of contrast-enhanced MR in the evaluation of radiation-induced optic neuropathy. MATERIALS AND METHODS: Three patients with rapid visual loss 1 1/2 to 3 years after radiation therapy to the optic nerves were studied with gadopentetate dimeglumine-enhanced MR images. All patients received over 5000 cGy, experienced rapid, permanent visual loss over several days to weeks, and underwent MR within weeks of presentation. RESULTS: Enhanced MR images on each patient revealed focal discrete enhancement of the intracranial optic nerve. One patient underwent biopsy of the enhancing segment; this revealed pathologic changes of radiation optic neuropathy. Optic nerve enhancement in a patient with visual loss and a prior history of radiation therapy to the orbits or optic nerves suggests radiation optic neuropathy. CONCLUSION: Contrast-enhanced MR of the orbits, optic nerves, and chiasm is the imaging test of choice in patients with vision loss after radiation therapy for sellar or skull base disease; MR findings may obviate the need for biopsy.
PURPOSE: To assess the value of contrast-enhanced MR in the evaluation of radiation-induced optic neuropathy. MATERIALS AND METHODS: Three patients with rapid visual loss 1 1/2 to 3 years after radiation therapy to the optic nerves were studied with gadopentetate dimeglumine-enhanced MR images. All patients received over 5000 cGy, experienced rapid, permanent visual loss over several days to weeks, and underwent MR within weeks of presentation. RESULTS: Enhanced MR images on each patient revealed focal discrete enhancement of the intracranial optic nerve. One patient underwent biopsy of the enhancing segment; this revealed pathologic changes of radiation optic neuropathy. Optic nerve enhancement in a patient with visual loss and a prior history of radiation therapy to the orbits or optic nerves suggests radiation optic neuropathy. CONCLUSION: Contrast-enhanced MR of the orbits, optic nerves, and chiasm is the imaging test of choice in patients with vision loss after radiation therapy for sellar or skull base disease; MR findings may obviate the need for biopsy.
Authors: A P Barbosa; D Carvalho; L Marques; M Monteiro; A Castro Neves; A Machado Carvalho; J Cruz; J L Medina Journal: J Endocrinol Invest Date: 1999-04 Impact factor: 4.256
Authors: Jigisha P Thakkar; John T Slevin; Charles D Smith; Padmaja Sudhakar; William St Clair; John L Villano Journal: Neuroophthalmology Date: 2017-05-30