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ACR Appropriateness Criteria® Vision Loss.

, Elliott R Friedman1, Amy F Juliano2

  • 1Houston Methodist Hospital, Houston, Texas.

Journal of the American College of Radiology : JACR
|November 5, 2025
PubMed
Summary
This summary is machine-generated.

This study provides guidelines on when imaging is appropriate for adults experiencing vision loss. It helps clinicians choose the right imaging tests based on the suspected cause and location of the visual pathway problem.

Keywords:
AUCAppropriate Use CriteriaAppropriateness Criteriademyelinating diseaseorbitorbital cellulitisorbital massorbital traumavision loss

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Area of Science:

  • Ophthalmology
  • Radiology
  • Medical Imaging

Background:

  • Vision loss stems from diverse causes like trauma, ischemia, infection, inflammation, demyelination, and mass lesions.
  • Ophthalmologic examination typically diagnoses globe pathologies, often negating the need for imaging.
  • Imaging is reserved for suspected causes and specific anatomical locations within the visual pathway.

Purpose of the Study:

  • To establish evidence-based guidelines for the appropriate use of imaging in adults presenting with vision loss as the primary symptom.
  • To guide clinicians in selecting the most suitable imaging studies based on clinical context.

Main Methods:

  • Systematic analysis of peer-reviewed medical literature.
  • Adaptation of established methodologies like Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
  • Utilizing the RAND/UCLA Appropriateness Method for procedure evaluation, with expert opinion supplementing literature where needed.

Main Results:

  • The American College of Radiology Appropriateness Criteria provide recommendations for imaging in vision loss.
  • Guidelines are developed through a multidisciplinary expert panel review process.
  • Methodology ensures evidence-based recommendations for specific clinical scenarios.

Conclusions:

  • Imaging appropriateness for vision loss is determined by the suspected etiology and anatomical site.
  • These guidelines aim to optimize diagnostic accuracy and resource utilization in managing vision loss.
  • Expert consensus plays a crucial role when literature evidence is limited.