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12.04.2019 | original article

Clinical and tomographic features of acute inflammatory disorders of the orbit

verfasst von: Darya Zubkova, Pavlo Bezditko, Olesya Zavoloka, Yevgeniya Ilyina, Oleksandr Zubkov

Erschienen in: Spektrum der Augenheilkunde | Ausgabe 1/2020

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Summary

Background

Acute inflammatory disorders of the orbit can cause not only blindness but also intracranial complications that directly threaten the patient’s life. Accurate and timely diagnosis of the type of orbital lesion is necessary for determining the treatment tactics.

Methods

The clinical and tomographical data of 57 patients with acute inflammatory disorders of the orbit were analyzed prospectively (2008–2017) along with the data of 37 patients analyzed retrospectively (1999–2007). Morphometric and functional parameters of the patients’ orbits on the healthy side were used as a control group (94 orbits). All patients underwent visometry, biomicroscopy, ophthalmoscopy, measuring the width of the palpebral fissure in the central part, and exophthalmometry, measuring the lateral displacement of the eyeball. All patients underwent computed tomography examination. The scanning was performed in axial, coronary, and orbitomeatal projections with a step size of 1 mm.

Results

Osteoperiostitis and subperiostal abscess were characterized by moderate pathological changes of the eyelids and orbital soft tissues and normal visual functions. Retrobulbar infiltrate and edema of orbital cellular tissue were characterized by pathological changes of the eyelids and orbital soft tissues and a decrease in visual acuity in 42.9% of cases of edema of the orbital tissue.. Orbital abscess and phlegmon of the orbit were characterized by heavily expressed pathological changes of the eyelids and orbital soft tissues and a marked decrease in visual acuity in all patients with phlegmon of the orbital.

Conclusion

Clarification of the type of orbital inflammatory disease via the clinical and tomographic criteria determined in this study led to a decrease in the number of unjustified transcutaneous orbitotomy procedures.
Literatur
1.
Zurück zum Zitat Uy H, Tuan P. Preseptal and orbital cellulitis in a developing country. Orbit. 2007;26:33–7.CrossRef Uy H, Tuan P. Preseptal and orbital cellulitis in a developing country. Orbit. 2007;26:33–7.CrossRef
2.
Zurück zum Zitat Das J, Choudhury B, Medhi J. Orbital abscess and hemi-occlusion of the central retinal vein in a child. Orbit. 2007;26:295–7.CrossRef Das J, Choudhury B, Medhi J. Orbital abscess and hemi-occlusion of the central retinal vein in a child. Orbit. 2007;26:295–7.CrossRef
3.
Zurück zum Zitat Luemsamran P, Pornpanich K, Vangveeravong S, et al. Orbital cellulitis and endophthalmitis in pseudomonas septicemia. Orbit. 2008;27:455–7.CrossRef Luemsamran P, Pornpanich K, Vangveeravong S, et al. Orbital cellulitis and endophthalmitis in pseudomonas septicemia. Orbit. 2008;27:455–7.CrossRef
4.
Zurück zum Zitat Lip P, Moutsou M, Hero M. A postoperative complication far worse than endophthalmitis: the coexistence of orbital cellulitis. Br J Ophthalmol. 2001;85:625–33.CrossRef Lip P, Moutsou M, Hero M. A postoperative complication far worse than endophthalmitis: the coexistence of orbital cellulitis. Br J Ophthalmol. 2001;85:625–33.CrossRef
5.
Zurück zum Zitat Carter K, Lee A, Tang R, et al. Neuro-ophthalmologic complications of sinus surgery. Neuroophthalmology. 1998;19(2):75–82.CrossRef Carter K, Lee A, Tang R, et al. Neuro-ophthalmologic complications of sinus surgery. Neuroophthalmology. 1998;19(2):75–82.CrossRef
6.
Zurück zum Zitat Muhtaseb M, Marjanovic B, Waddilove L, et al. Cavernous sinus thrombosis secondary to MRSA septicaemia. Neuroophthalmology. 2004;28(5):245–50.CrossRef Muhtaseb M, Marjanovic B, Waddilove L, et al. Cavernous sinus thrombosis secondary to MRSA septicaemia. Neuroophthalmology. 2004;28(5):245–50.CrossRef
7.
Zurück zum Zitat Goawalla A, Mansell N, Pearson A. Septic cavernous sinus thrombosis with bilateral secondary orbital infection. Orbit. 2007;26:113–6.CrossRef Goawalla A, Mansell N, Pearson A. Septic cavernous sinus thrombosis with bilateral secondary orbital infection. Orbit. 2007;26:113–6.CrossRef
8.
Zurück zum Zitat Harstein M, Steinvurzel M, Cohen C. Intracranial abscess as a complication of subperiostal abscess of the orbit. Ophthalmol Plast Reconstr Surg. 2001;17(6):398–403.CrossRef Harstein M, Steinvurzel M, Cohen C. Intracranial abscess as a complication of subperiostal abscess of the orbit. Ophthalmol Plast Reconstr Surg. 2001;17(6):398–403.CrossRef
9.
Zurück zum Zitat Murphy C, Livingstone I, Foot B, et al. Orbital cellulitis in Scotland: current incidence, aetiology, management and outcomes. Br J Ophthalmol. 2014;98:1575–8.CrossRef Murphy C, Livingstone I, Foot B, et al. Orbital cellulitis in Scotland: current incidence, aetiology, management and outcomes. Br J Ophthalmol. 2014;98:1575–8.CrossRef
10.
Zurück zum Zitat Chaudhry I, Shamsi F, Elzaridi E, et al. Outcome of treated orbital cellulitis in a tertiary eye care center in the Middle East. Ophthalmology. 2007;114:345–54.CrossRef Chaudhry I, Shamsi F, Elzaridi E, et al. Outcome of treated orbital cellulitis in a tertiary eye care center in the Middle East. Ophthalmology. 2007;114:345–54.CrossRef
11.
Zurück zum Zitat Dissel J, de Keizer J. Bacterial infections of the orbit. Orbit. 1998;17(4):227–35.CrossRef Dissel J, de Keizer J. Bacterial infections of the orbit. Orbit. 1998;17(4):227–35.CrossRef
12.
Zurück zum Zitat Briscoe D, Cruz A. A new classification of orbital cellulitis. Book of Abstracts 10th Congress of International Ocular Inflammation Society Prague; 30.05.–02.06.. 2009. p. 51. Briscoe D, Cruz A. A new classification of orbital cellulitis. Book of Abstracts 10th Congress of International Ocular Inflammation Society Prague; 30.05.–02.06.. 2009. p. 51.
13.
Zurück zum Zitat Harris G. Subperiosteal abscess of the orbit. Arch Ophthalmol. 1983;101:751–7.CrossRef Harris G. Subperiosteal abscess of the orbit. Arch Ophthalmol. 1983;101:751–7.CrossRef
14.
Zurück zum Zitat Stubinger S, Leiggener C, Sader R, et al. Intraorbital abscess. J Am Dent Assoc. 2005;136(7):921–5.CrossRef Stubinger S, Leiggener C, Sader R, et al. Intraorbital abscess. J Am Dent Assoc. 2005;136(7):921–5.CrossRef
15.
Zurück zum Zitat Group C, Ong C, Chew N, Syrimi M, et al. Streptococcal subperiosteal abscess of the orbit. Orbit. 2009;28:160–1.CrossRef Group C, Ong C, Chew N, Syrimi M, et al. Streptococcal subperiosteal abscess of the orbit. Orbit. 2009;28:160–1.CrossRef
16.
Zurück zum Zitat Shibasakii H, Hayasakaiy S, Setogawa T, et al. Ophthalmic complications in patients with paranasal sinusitis. Orbit. 1992;11(1):1–5.CrossRef Shibasakii H, Hayasakaiy S, Setogawa T, et al. Ophthalmic complications in patients with paranasal sinusitis. Orbit. 1992;11(1):1–5.CrossRef
17.
Zurück zum Zitat Blake F, Siegert I, Wed I, et al. The acute orbit: etiology, diagnosis, and therapy. J Oral Maxillofac Surg. 2006;64(1):87–93.CrossRef Blake F, Siegert I, Wed I, et al. The acute orbit: etiology, diagnosis, and therapy. J Oral Maxillofac Surg. 2006;64(1):87–93.CrossRef
18.
Zurück zum Zitat Pereira F, Cruz A, Teresinha A, et al. Computed tomographic patterns of orbital cellulitis due to sinusitis. Arq Bras Oftalmol. 2006;69(4):513–8.CrossRef Pereira F, Cruz A, Teresinha A, et al. Computed tomographic patterns of orbital cellulitis due to sinusitis. Arq Bras Oftalmol. 2006;69(4):513–8.CrossRef
19.
Zurück zum Zitat Harris G. Subperiosteal abscess of the orbit: computed tomography and the clinical course. Ophthal Plast Reconstr Surg. 1996;12:1–8.CrossRef Harris G. Subperiosteal abscess of the orbit: computed tomography and the clinical course. Ophthal Plast Reconstr Surg. 1996;12:1–8.CrossRef
20.
Zurück zum Zitat Wang C, Chen D. Diagnostic significance of CT in the orbital inflammatory lesions. Zhonghua Yan Ke Za Zhi. 1996;5:366–8. Wang C, Chen D. Diagnostic significance of CT in the orbital inflammatory lesions. Zhonghua Yan Ke Za Zhi. 1996;5:366–8.
21.
Zurück zum Zitat Leib M, Cooper W, Mai P, et al. Volume determination of the orbit with high resolution CT scans and quantitative digital image analysis. Orbit. 1982;1(3):149.CrossRef Leib M, Cooper W, Mai P, et al. Volume determination of the orbit with high resolution CT scans and quantitative digital image analysis. Orbit. 1982;1(3):149.CrossRef
22.
Zurück zum Zitat Garcia G, Harris G. Criteria for nonsurgical management of subperiosteal abscess of the orbit: analysis of outcomes 1988–1998. Ophthalmology. 2000;107(8):1454–8.CrossRef Garcia G, Harris G. Criteria for nonsurgical management of subperiosteal abscess of the orbit: analysis of outcomes 1988–1998. Ophthalmology. 2000;107(8):1454–8.CrossRef
23.
Zurück zum Zitat Harris G. Subperiosteal abscess of the orbit: age as a factor in the bacteriology and response to treatment. Ophthalmology. 1994;101:585–95.CrossRef Harris G. Subperiosteal abscess of the orbit: age as a factor in the bacteriology and response to treatment. Ophthalmology. 1994;101:585–95.CrossRef
24.
Zurück zum Zitat Harris G. Subperiosteal abscess of the orbit: older children and adults require aggressive treatment. Ophthal Plast Reconstr Surg. 2001;17:395–7.CrossRef Harris G. Subperiosteal abscess of the orbit: older children and adults require aggressive treatment. Ophthal Plast Reconstr Surg. 2001;17:395–7.CrossRef
25.
Zurück zum Zitat Hatano A, Shiva A. Surgical treatment of subperiostal abscess of the orbit. Nippon Libiinkoko Gakkai Kaiho. 2006;109(5):447–54.CrossRef Hatano A, Shiva A. Surgical treatment of subperiostal abscess of the orbit. Nippon Libiinkoko Gakkai Kaiho. 2006;109(5):447–54.CrossRef
26.
Zurück zum Zitat Pakdaman MN, Sepahdari AR, Elkhamary SM. Orbital inflammatory disease: pictorial review and differential diagnosis. World J Radiol. 2014;6(4):106–15.CrossRef Pakdaman MN, Sepahdari AR, Elkhamary SM. Orbital inflammatory disease: pictorial review and differential diagnosis. World J Radiol. 2014;6(4):106–15.CrossRef
27.
Zurück zum Zitat Mary K. Jacob Idiopathic orbital inflammatory disease. Oman J Ophthalmol. 2012;5(2):124–5.CrossRef Mary K. Jacob Idiopathic orbital inflammatory disease. Oman J Ophthalmol. 2012;5(2):124–5.CrossRef
28.
Zurück zum Zitat Weber AL, Romo LV, Sabates NR. Pseudotumor of the orbit. Clinical, pathologic, and radiologic evaluation. Radiol Clin North Am. 1999;37(1):151–68.CrossRef Weber AL, Romo LV, Sabates NR. Pseudotumor of the orbit. Clinical, pathologic, and radiologic evaluation. Radiol Clin North Am. 1999;37(1):151–68.CrossRef
29.
Zurück zum Zitat Rumelt S, Rubin P. Potential sources for orbital cellulitis. Int Ophthalmol Clin. 1996;36(3):207–21.CrossRef Rumelt S, Rubin P. Potential sources for orbital cellulitis. Int Ophthalmol Clin. 1996;36(3):207–21.CrossRef
30.
Zurück zum Zitat Dhariwal D, Kittur M, Farrier J, et al. Post-traumatic orbital cellulitis. Br J Oral Maxillofac Surg. 2003;41:21–8.CrossRef Dhariwal D, Kittur M, Farrier J, et al. Post-traumatic orbital cellulitis. Br J Oral Maxillofac Surg. 2003;41:21–8.CrossRef
31.
Zurück zum Zitat Maheshwari R, Maheshwari S, Shah T. Acute dacryocystitis causing orbital cellulitis and abscess. Orbit. 2009;28:196–9.CrossRef Maheshwari R, Maheshwari S, Shah T. Acute dacryocystitis causing orbital cellulitis and abscess. Orbit. 2009;28:196–9.CrossRef
Metadaten
Titel
Clinical and tomographic features of acute inflammatory disorders of the orbit
verfasst von
Darya Zubkova
Pavlo Bezditko
Olesya Zavoloka
Yevgeniya Ilyina
Oleksandr Zubkov
Publikationsdatum
12.04.2019
Verlag
Springer Vienna
Erschienen in
Spektrum der Augenheilkunde / Ausgabe 1/2020
Print ISSN: 0930-4282
Elektronische ISSN: 1613-7523
DOI
https://doi.org/10.1007/s00717-019-0426-0