Abstract
The 3 most common emergencies encountered in a busy clinical ophthalmology practice are loss of vision, ophthalmoplegia, and diplopia. Orbital pathologies are remarkably varied and encompass a broad range of inflammatory/ infectious processes such as pseudotumor, Tolosa-Hunt syndrome (i.e., cavernous sinus syndrome produced by an idiopathic granuloma), and invasive aspergillosis; vascular lesions such as arteriovenous malformations (AVMs) and carotid-cavernous fistulas; neoplasms; and demyelinating disease. Multidetector CT (MDCT) with 2D and 3D reconstructions and contrast-enhanced MRI with fat suppression are essential modalities in the imaging armamentarium. Axial CT angiography (CTA), magnetic resonance angiography (MRA), and conventional digital subtraction angiography are crucial for assessment of vascular entities. A systematic, location-based approach is key for evaluation of ophthalmologic emergencies. Special consideration should be given to the cranial nerves in patients with diplopia and to the optic chiasm in those with vision loss. A thorough understanding of the normal structures within each relevant anatomic subdivision can help the radiologist formulate an accurate differential diagnosis and avoid diagnostic pitfalls and mimics.
Published Version
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