Ophthalmology in China

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Medical imaging for the diagnosis of systemic disease with ocular problem as the first symptom

YAN Fei1, LI Mei2   

  1.  1. Department of Radiology, 2. Department of Nuclear Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2015-07-21 Online:2015-09-25 Published:2015-10-10
  • Contact: YAN Fei, Email: yanever@163.com

Abstract:

Modern medical imaging technology plays an increasingly important role in diagnosis of ocular diseases, and can assist in speculating the origin of lesions originated from intracranial part or systemic disease. In patients with benign intracranial hypertension usually presenting with ocular symptoms as a chief complaint, the orbit or craniocerebral MRI image could disclose empty sella in 79% of cases; distension of the perioptic subarachnoid space in 74% of cases, and papilledema in 56%. MRI and CT could find metastatic tumor of retinoblastoma and provide basis for clinical treatment. MRI is useful to find the causes of most oculomotor nerve palsy. Most lesions locate at the nuclei in brain stem and oculomotor nerve trunk and the surroundings, the minority in the supraorbital fissure. The characteristic imaging findings of IgG4-related disease (IgG4-RD) with primary ocular symptom were diffuse enlargement of bilateral lacrimal glands and extraocular muscles. Somatostatin receptor scintigraphy of SPECT/CT has a good prospect for evaluating activity and treatment effect of IgG4-RD. (Ophthalmol CHN, 2015, 24: 289-291)

Key words:  magnetic resonance imaging, ocular symptom, intracranial hypertension, retinoblastoma, oculomotor nerve palsy, IgG4-related disease, somatostatin receptor scintigraphy, holistic integrative ophthalmology