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Can ophthalmic requests for neuroimaging be improved?
J P Mathews1, D Mathews, S Walker
1Department of Ophthalmology, Bolton Hospitals NHS Trust, Bolton, UK.
Aim:
To review and set guidelines for all neuroradiological referrals from the ophthalmic service in a typical UK district general hospital.
Method:
Patients referred for diagnostic neuroimaging were identified from the radiology database over a 1-year period. A case note review was undertaken. The clinical indication for and results of neuroimaging performed were ascertained. The justification for neuroimaging was determined.
Results:
Of the total 31,411 patients that were seen in the eye department, 103 (0.32%) had diagnostic neuroradiological imaging performed. The indications for imaging were: suspected compressive lesion of the anterior visual pathway in 57 patients (55.3%), acquired ocular motility disturbance in 20 patients (19.4%), suspected orbital pathology in 11 patients (10.6%), cerebrovascular accident in nine patients (8.7%), and six patients (5.8%) were imaged for either headache or sinusitis. Radiological lesion detection rate was highest for cerebrovascular accident (88.8%) and lowest acquired for ocular motility disturbance (4.9%).
Conclusion:
Ophthalmic requests for diagnostic neuroimaging were found to be unnecessary in only 9% of patients. Guidelines for the referral of ophthalmic patients for neuroimaging are discussed.
