Recent advances in neuro-imaging and the impact on neuro-ophthalmology

Neuro-imaging is an essential part of the evaluation in patients with neuro-ophthalmologic disorders. Over the last two decades enormous advances in this area have been made allowing noninvasive evaluation of the orbit and brain. The idea of using nuclear magnetic resonance technology to produce images rather than the ionizing radiation of computed tomography (CT) began to emerge clinically in the late 1970s and early 1980s. Although the quality of early magnetic resonance imaging (MRI) scans was not much better than CT images, by the early 1990s, it became obvious that MRI had particular strength in identifying lesions in the posterior fossa, and demyelinating plaques. With advances in magnetic strength, computer software, surface coils, contrast medium, and more attention to the basic physics of magnet technology, the clarity of MR images improved dramatically. Recent advances in CT scanning (spiral and three-dimensional CT) and MRI (functional MRI and cine MRI) continue to affect significant changes in the discipline of neuro-ophthalmology. Furthermore, advances in MR angiography promise to allow excellent and noninvasive analysis of the cerebral vasculature. This review highlights the recent advances in neuro-imaging.