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Optic Nerve Enhancement and Restricted Diffusion in Postoperative Visual Loss.

Pasquale F Finelli1

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|November 20, 2019
PubMed
Summary

Postoperative visual loss, often from posterior ischemic optic neuropathy, can be uniquely identified on MRI. This case highlights specific MR imaging features of restricted diffusion and focal enhancement in the optic nerves.

Keywords:
MRI, diffusionMRI, enhancedOptic nerveposterior ischemic optic neuropathypostoperative vision losswatershed

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Area of Science:

  • Neurology
  • Radiology
  • Ophthalmology

Background:

  • Postoperative visual loss is a rare but serious complication.
  • Posterior ischemic optic neuropathy (PION) is the most common cause of such vision loss.
  • Aortic aneurysm surgery carries risks, including potential neurological complications.

Purpose of the Study:

  • To describe the magnetic resonance (MR) imaging findings in a patient with postoperative visual loss.
  • To correlate these findings with posterior ischemic optic neuropathy (PION).
  • To identify unique MR imaging characteristics associated with vision loss after surgery.

Main Methods:

  • Case report of a 37-year-old male patient.
  • Detailed optic nerve MR imaging was performed.
  • Analysis of imaging features including diffusion and enhancement patterns.

Main Results:

  • The patient experienced postoperative visual loss following complicated aortic aneurysm surgery.
  • MR imaging revealed restricted diffusion in both optic nerves.
  • Focal enhancement was also observed in both optic nerves.

Conclusions:

  • Combined restricted diffusion and focal enhancement represent a unique MR imaging signature.
  • These findings are indicative of posterior ischemic optic neuropathy (PION).
  • This case underscores the utility of advanced MR imaging in diagnosing rare causes of postoperative visual loss.