Prevalence of significant pathology on MRI of brain and orbits in patients presenting with visual disturbance

The aim of our study was to determine the frequency and variety of abnormalities detected on MRI studies of the brain and orbits (MRBO), in patients referred for investigation of visual disturbance from a tertiary ophthalmology centre in Ireland. A secondary objective was to assess the various imaging pathologies identified in this cohort of patients.

The inclusion criteria were patients who underwent an Magnetic resonance imaging (MRI) brain or MRI brain and orbits over a 12-month period for investigation of first episode of visual disturbance, who were over 18 years of age, with visual disturbance of unknown aetiology. Statistical analysis was performed to calculate the percentage of abnormalities and corresponding 95% confidence interval (CI). Additionally, logistic regression was used to investigate any association between age, gender and the pathologies which presented.

135 MRI brain and orbit examinations fulfilled the inclusion criteria. Abnormalities were identified on 86 of the 135 examinations (63.7%; 95% CI: 55.3% to 71.3%). Nonspecific T2 hyperintensities were identified on 28 (20.7%) of the examinations, 13 (9.6%) examinations showed images suggestive of demyelination and 11 (8.1%) showed optic neuropathy. The logistic regression analysis showed no evidence of an association between age (p = 0.223), gender (p = 0.307) and abnormalities in this study.

This represents a relatively high detection rate of abnormalities on MRBO when compared with similar studies and shows the important role MRI has in patients with a visual disturbance.