Pitfalls of ophthalmic radiographic imaging.
OBJECTIVE
Ophthalmologists are dependent on computed tomography (CT) and MRI to aid in the diagnosis and management of patients with orbital and visual conditions. Pitfalls in the imaging process can lead to inefficient care or patient harm. This review summarizes these problems and provides methods to reduce imaging errors.


RESULTS
There has been exponential growth in the number of radiographic scans performed, resulting in increased awareness of the risks from medical radiation. Strategies to minimize radiation exposure include reducing the need for sequential scans, using appropriate technology, and substituting MRI for CT. Contrast administration can be associated with systemic reactions, renal disease, and thyroid dysfunction. Scan interpretation errors are reduced by the ophthalmologist reviewing the study and communication with the radiologist.


CONCLUSIONS
Medical radiation exposure can be reduced by initially ordering the appropriate scan and substituting MRI for CT when possible. MRI is contraindicated in patients with certain implants and metallic foreign bodies. Noncontrast studies are adequate to evaluate many conditions and some patients should not receive contrast. Imaging errors can be reduced by the ophthalmologist personally reviewing the orbital scans and correlating the results with the clinical findings.
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, Missouri, USA.
Philip L
PL
Custer
Tiffany L
TL
Kent
D000075202:Contraindications; D003951:Diagnostic Errors / Q000517:prevention & control; D005128:Eye Diseases / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019300:Medical Errors / Q000517:prevention & control; D011832:Radiation Injuries / Q000517:prevention & control; D014057:Tomography, X-Ray Computed / Q000379:methods*