Magnetic resonance imaging in patients implanted with Ex-PRESS stainless steel glaucoma drainage microdevice

Am J Ophthalmol. 2009 May;147(5):907-11, 911.e1. doi: 10.1016/j.ajo.2008.12.011. Epub 2009 Feb 20.

Abstract

Purpose: To evaluate whether artifacts caused by a stainless steel glaucoma drainage device can alter the interpretation of magnetic resonance imaging (MRI) scans of the optic nerve and brain.

Design: Consecutive case series.

Methods: Five patients (7 eyes) with Ex-PRESS devices (Optonol Ltd, Neve Ilan, Israel) positioned at the limbus were studied. For each subject, an axial T1-weighted, axial and coronal T2-weighted with fat saturation, and whole brain proton density (PD)/T2-weighted MRI scan was obtained. Standard MRI protocol was not optimized for the imaging of patients harboring Ex-PRESS implants. The effects of the device on PD/T2 pulse sequence imaging of the optic nerve and brain were rated from 1 (optic nerve margins unidentifiable or brain details altered) to 5 (excellent visualization of the optic nerve and brain).

Results: For optic nerve visualization, 1 optic nerve scored 2, 3 optic nerves scored 3, and 3 optic nerves scored 4 (mean, 3.3 +/- 0.8 standard deviation). For whole brain imaging, 4 patients scored 4 and 1 patient scored 5 (mean, 4.2 +/- 0.4 standard deviation).

Conclusions: Our data demonstrate that interpretation of MRI scans of the orbit and brain is unaffected by the artifacts caused by the Ex-PRESS shunt, whereas optic nerve imaging may be affected. We are unaware of previous reports of this finding and could find no reference to it in a computerized search using PubMed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anterior Eye Segment / pathology*
  • Aqueous Humor / metabolism
  • Artifacts
  • Brain / pathology
  • Female
  • Glaucoma Drainage Implants*
  • Glaucoma, Open-Angle / diagnosis*
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Intraocular Pressure
  • Magnetic Resonance Imaging*
  • Male
  • Optic Nerve / pathology
  • Prosthesis Implantation
  • Stainless Steel*
  • Tonometry, Ocular
  • Visual Acuity

Substances

  • Stainless Steel