Positive diagnosis of acute posterior ischaemic optic nerve neuropathy
Reviewed by Claire Howard

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. There is an absence of clinical signs which means the diagnosis is one of exclusion. This case study article presents two patients who developed posterior ischaemic optic neuropathy which was confirmed by the observation of secondary changes on diffusion-weighted imaging sequences. In the first case, visual loss followed robotic pelvis surgery and in the second it was associated with multiorgan dysfunction secondary to severe pancreatitis. A comprehensive review of the literature is also presented. The cases demonstrate that this imaging method can provide a positive diagnosis of posterior ischaemic optic nerve injury in the acute phase. This has a clinical implication for assessment and diagnosis of patients with this rare visual disorder. An objective positive confirmation of the diagnosis can be very helpful, particularly in the difficult postoperative situation where loss of vision has occurred following a surgical procedure with no direct relationship to vision.

Using diffusion-weighted magnetic resonance imaging to confirm a diagnosis of posterior ischaemic optic neuropathy: two case reports and literature review.
Quddus A, Lawlor M, Siddiqui A, et al.
NEURO-OPHTHALMOLOGY
2015;39(4):161-5.