ACR Appropriateness Criteria® Vision Loss

Vision loss is a common medical problem that can arise secondary to a variety of pathologies including trauma, ischemia, infection or inflammation, demyelination, and mass lesions anywhere along the visual pathway. Most nontraumatic pathology to the globe is diagnosed by ophthalmologic examination and does not require imaging. When needed, the choice of imaging study is directed at the known or suspected cause and the expected anatomic location of the insult along the visual pathway. This document focuses on the appropriateness of imaging in adults where vision loss is the primary presenting symptom. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.