1/105. Severe ocular and orbital toxicity after intracarotid etoposide phosphate and carboplatin therapy.PURPOSE: To report severe ocular and orbital toxicity after administration of intracarotid etoposide phosphate and carboplatin. METHOD: Case report. RESULTS: A 52-year-old man with glioblastoma multiforme underwent left intracarotid administration of eto poside phosphate and carboplatin inferior to the ophthalmic artery. Within 7 hours, a nonpupillary block angle-closure glaucoma developed secondary to uveal effusion in the ipsilateral eye, which was relieved by cycloplegia. Four days later, severe orbital inflammation resulted in a visual acuity of counting fingers, proptosis, optic neuropathy, and total external ophthalmoplegia in the eye. The patient's condition improved after a lateral cantholysis and administration of high-dose intravenous corticosteroids. Two weeks later, an anterior uveitis occurred in the left eye, which responded to topical corticosteroids. During a 2-month period, the patient recovered to a visual acuity of 20/70, near normal motility, and normal intraocular pressure, and the ocular and orbital inflammation resolved. Preexisting ipsilateral chemotherapy-induced maculopathy became more pronounced. CONCLUSION: Ocular and orbital toxicity after intracarotid etoposide phosphate and carboplatin therapy is infrequently reported.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/105. orbital pseudotumor: case report and literature review.The term orbital pseudotumor refers to a broad category of non-specific idiopathic inflammations of the orbit. This disease, which may affect any orbital structure, is one of the commonest causes of exophtalmus, occurring with a similar incidence in both sexes. The diagnosis is based on a combination of clinical, radiological and histopathological findings, after careful exclusion of specific systemic and local diseases. Many classification systems have been proposed and a range of therapeutic modalities, including surgery, steroids, immunosuppressive agents, and radiation therapy, have been employed by various authors in heterogeneous series of patients. This slowly proliferating disease, which usually presents with a long clinical history and high variability in clinical manifestations and prognosis, is difficult to manage with any of the available therapeutic options. The difficulties and controversies regarding the diagnostic and therapeutic management of these patients are addressed in an updated review of the literature and exemplified in our case report.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
3/105. Giant orbital cyst after strabismus surgery.We describe the clinical, histopathologic, and radiologic findings and management of a patient who had a giant orbital cyst after reoperative strabismus surgery. In the case report, we describe, in detail, a giant orbital cyst developing on the medial side of the globe after the third operation for repair of strabismus. Imaging studies, including computed tomographic (CT) scan and orbital ultrasound, demonstrate the findings. The observations at surgery and the surgical pathologic condition of the cyst are described. The orbital cyst was successfully removed, advancing the remaining medial rectus muscle and recessing the lateral rectus muscle, which resulted in reduction of a large-angle exotropia to a small exodeviation. Adduction was improved but not normalized. The pathologic examination indicated a benign inclusion cyst of the conjunctiva with fibrosis and chronic inflammation. A possible cause of this type of cyst is an epithelial remnant inadvertently placed with the muscle substance during previous surgery.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
4/105. Pseudotumor of the orbit in early childhood.orbital pseudotumor, also known as idiopathic orbital inflammation, is defined as a nonspecific, nonneoplastic inflammatory process of the orbit without identifiable local or systemic causes. The disorder, first described by Birch-Hirschfield in 1905, is more prevalent in the adult population than in the pediatric population. In our study we discuss two cases of pseudotumor of the orbit in children less than 18 months old. This report will highlight the evaluation and management of pediatric orbital pseudotumor and the importance of its inclusion in the differential diagnosis of orbital disorders in young children.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
5/105. Recurrent steroid-responsive trismus and painful ophthalmoplegia.A 63-year-old woman experienced two episodes of trismus and painful ophthalmoplegia at an interval of six years. She suffered left visual loss, and enhanced CT scan and MR imaging revealed heterogeneous enlargement of the left extraocular muscles extending to the orbital apex. In addition, the left pterygopalatine fossa was filled with a mass isointense with muscle without evidence of surrounding tissue invasion; 67Ga scintigraphy showed high uptake in this lesion. Steroid administration dramatically resolved the trismus, and the mass in the orbit and extraorbit vanished completely. orbital pseudotumor is characterized by self-limited, relapsing, steroid-responsive painful ophthalmoplegia, and this case could be a variant of this entity with inflammation extending into the extraorbital area.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
6/105. nasolacrimal duct obstruction and orbital cellulitis associated with chronic intranasal cocaine abuse.OBJECTIVE: To report the association of acquired nasolacrimal duct obstruction and orbital cellulitis in patients with a history of chronic intranasal cocaine abuse. methods: Retrospective, consecutive case series. Results of imaging, histopathologic examinations, and clinical courses of these patients were studied. RESULTS: Five women and 2 men (mean age, 41 years) with a history of chronic intranasal cocaine abuse (mean, 11 years; range, 5-20 years) presented with epiphora and in some cases acute onset of periorbital pain, edema, and erythema associated with fever. The suspicion of intranasal cocaine abuse was made on anterior rhinoscopy with the detection of an absent nasal septum and inferior turbinate. Computed tomographic and magnetic resonance imaging findings in 4 patients included extensive bony destruction of the normal orbital wall architecture, opacification of the sinuses, and the presence of an intraorbital tissue mass. Histopathologic examination of the nasolacrimal duct in 2 patients and of the orbital mass in a third patient revealed marked chronic inflammation with fibrosis causing secondary nasolacrimal duct obstruction. Six patients were treated with systemic antibiotics followed by dacryocystorhinostomy in 3 patients, and a pericranial flap to insulate the exposed orbit in 1 patient. CONCLUSIONS: Chronic intranasal cocaine abuse can result in extensive bony destruction of the orbital walls with associated orbital cellulitis, and should be included in the differential diagnosis of acquired nasolacrimal duct obstruction. Anterior rhinoscopy is very helpful in establishing the correct diagnosis in these patients.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
7/105. Idiopathic sclerotic inflammation of the orbit with left optic nerve compression in a patient with multifocal fibrosclerosis.We present the MR imaging findings in a 43-year-old male patient with bilateral idiopathic sclerosing inflammation of the orbit. Bilateral enhancing retrobulbar masses, with concentric compression of the retrobulbar segment of the left optic nerve, were seen. MR imaging proved to be the only means to distinguish between the different intraorbital structures and to determine the exact site of optic nerve compression. To our knowledge, this is the first documented case of MR imaging findings of this entity.- - - - - - - - - - ranking = 2.5keywords = inflammation (Clic here for more details about this article) |
8/105. survival after rhino-orbital-cerebral mucormycosis in an immunocompetent patient.OBJECTIVE: Rhino-orbital-cerebral mucormycosis is usually associated with a poor prognosis and is almost exclusively seen in immunocompromised patients. We report the third documented case of rhino-orbital-cerebral mucormycosis caused by Apophysomyces elegans (a new genus of the family Mucoraceae first isolated in 1979) in an immunocompetent individual. Orbital exenteration and radical debridement of involved adjacent structures combined with intravenous liposomal amphotericin resulted in patient survival. DESIGN: Interventional case report. METHOD: A 59-year-old immunocompetent white man sustained a high-pressure water jet injury to the right inner canthus while cleaning an air conditioner filter. He later had "orbital cellulitis" develop that did not respond to antibiotics and progressed to orbital infarction. Imaging studies and biopsy results led to a diagnosis of mucormycosis. Tissue culture grew Apophysomyces elegans, a new genus of the family Mucoraceae first isolated in 1979. Orbital exenteration and radical debridement of involved adjacent structures, combined with intravenous liposomal amphotericin, resulted in patient survival. RESULTS: After orbital exenteration and debridement of involved adjacent structures along with intravenous liposomal amphotericin, our patient has remained free from relapse with long-term follow-up. CONCLUSIONS: The agent causing this case of rhino-orbital-cerebral mucormycosis (Apophysomyces elegans) contrasts with the three genera most commonly responsible for mucormycosis (rhizopus, Mucor, and absidia) in that infections with this agent tend to occur in warm climates, by means of traumatic inoculation, and in immunocompetent patients. Rhino-orbital-cerebral mucormycosis should be considered in all patients with orbital inflammation associated with multiple cranial nerve palsies and retinal or orbital infarction, regardless of their immunologic status. A team approach to management is recommended for early, appropriate surgery and systemic antifungal agents.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
9/105. Localized orbital inflammation: a case of dacryoadenitis.Nonspecific orbital inflammatory syndrome includes a variety of ocular inflammatory disorders. These may be classified by location (anterior or posterior) and by time of presentation (acute or chronic). The four subclassifications of nonspecific orbital inflammatory syndrome are myositis, perineuritis, periscleritis, and dacryoadenitis. When a proper diagnosis is established using clinical signs, imaging studies, and laboratory results, treatment of the condition can be initiated. Treatment of the acute form is with oral corticosteroids. This case discusses the diagnosis and treatment of a patient with an acute onset of inflammatory dacryoadenitis.- - - - - - - - - - ranking = 2keywords = inflammation (Clic here for more details about this article) |
10/105. Orbital abscess masquerading as a rhabdomyosarcoma.Although orbital cellulitis is the most common cause of acute-onset proptosis with inflammatory signs in a child, the clinician should always be alert to the possibility of rhabdomyosarcoma. We describe an unusual presentation of acute-onset nonaxial proptosis of the left orbit without sinus disease or systemic toxicity in a 6-year-old boy. Our clinical differential diagnosis included orbital cellulitis, metastatic disease, capillary haemangioma, lymphangioma with cyst, ruptured dermoid cyst, and orbital rhabdomyosarcoma. Only after orbital biopsy and subsequent microbiologic confirmation were obtained was a diagnosis of chronic orbital abscess tenable. Features in our patient included paucity of symptoms and signs of inflammation. This case illustrates the difficulty in differentiating a chronic orbital infection from orbital rhabdomyosarcoma on the basis of clinical, laboratory, and orbital imaging findings. Possible causes of this unusual presentation are discussed.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
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