Brief Answer: As below: Detailed Answer: Hi, Thank you for your query. 1. If you can upload a few MRI images, I will be able to give you a better assessment. 2. Ideally, a plain CT (PNS) with 1 mm coronal, axial and saggital cuts will give additional information since bone is invisible in an MRI. I would consider a contrast CT, however, since the creatinine level is raised (1.1), if should not be done at present. 3. The optic nerves are related to the roof of the Sphenoid Sinus and in some patients with an Onodi type posterior ethmoid cells. As the complaint mentioned on the Brain MRI report is double vision, it is better to investigate this area further. 4. Isolated Sinus involvement may also be fungal, which I have found in many patients with Diabetes. If all else is normal, a limited FESS with biopsy and drainage of the retention cyst may help improve vision. Balloon Sinuplasty is also a newer option. 5. The raised ESR signifies a chronic process. It may be due to the sinus disease or the chest (thorax) findings. The cause of the chest findings is not known at present, but it is unlikely to cause visual problems. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.

---