title: Using Diffusion-Weighted Magnetic Resonance Imaging to Confirm a Diagnosis of Posterior Ischaemic Optic Neuropathy: Two Case Reports and Literature Review.
abstract: Posterior ischaemic optic neuropathy is a rare cause of visual loss believed to be due to infarction in the territory of the pial branches of the ophthalmic artery. The disorder most commonly occurs in the context of prolonged surgery or giant cell arteritis, and the absence of clinical signs in the eye means that the diagnosis is one of exclusion. Here, we present two cases studies of patients who developed posterior ischaemic optic neuropathy confirmed by the observation of secondary changes on diffusion-weighted imaging sequences. In the first case visual loss followed robotic pelvic surgery, and in the second case it was associated with multiorgan dysfunction secondary to severe pancreatitis. Our cases demonstrate that in the right clinical context, diffusion-weighted imaging can provide a positive diagnosis of acute posterior ischaemic optic nerve injury in the acute phase.
authors.affiliation: Royal Free London Hospital , London, United Kingdom.
authors.forename: Ayyaz
authors.initials: A
authors.lastname: Quddus
authors.affiliation: Department of Clinical Ophthalmology, University of Sydney , Sydney, Australia , and.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Lawlor
authors.affiliation: Guys and St. Thomas' Hospital , London, United Kingdom.
authors.forename: Ata
authors.initials: A
authors.lastname: Siddiqui
authors.affiliation: Guys and St. Thomas' Hospital , London, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Holmes
authors.affiliation: Guys and St. Thomas' Hospital , London, United Kingdom.
authors.forename: Gordon T
authors.initials: GT
authors.lastname: Plant
keywords: DWI; PION; Diffusion restriction; diffusion-weighted imaging; posterior ischaemic optic neuropathy