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Clinical and tomographic features of acute inflammatory disorders of the orbit

Klinische and tomographische Merkmale akuter entzündlicher Erkrankungen der Orbita

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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.

Zusammenfassung

Hintergrund

Akute entzündliche Erkrankungen der Orbita können nicht nur Blindheit verursachen, sondern auch intrakranielle Komplikationen, die für den Patienten unmittelbar lebensbedrohlich sind. Eine genaue und zügige Diagnose der Art einer Orbitaläsion ist notwendig, um die Behandlungsstrategie festzulegen.

Methoden

Prospektiv wurden die klinischen und tomographischen Daten von 57 Patienten mit akuter entzündlicher Erkrankung der Orbita ausgewertet (2008–2017), damit einher ging die retrospektive Analyse der Daten von 37 Patienten (1999–2007). Morphometrische und funktionelle Parameter der Orbitae der Patienten auf der gesunden Seite dienten als Kontrollgruppe (94 Orbitae). Bei allen Patienten wurde eine Visometrie, Biomikroskopie, Ophthalmoskopie, Messung der Lidspaltenweite im zentralen Bereich, Exophthalmometrie und Messung der lateralen Abweichung des Augapfels durchgeführt. Auch erfolgte bei sämtlichen Patienten eine computertomographische Untersuchung. Die Aufnahmen wurden in axialer, koronarer und orbitomeataler Projektion mit einer Schichtdicke von 1 mm durchgeführt.

Ergebnisse

Osteoperiostitis und subperiostaler Abszess waren durch mittelgradige pathologische Veränderungen der Augenlider und Orbitaweichgewebe bei normalen Sehleistungen gekennzeichnet. Ein retrobulbäres Infiltrat und Ödem der orbitalen Zellgewebe zeichneten sich durch pathologische Veränderungen der Augenlider und der Orbitalweichgewebe sowie in 42,9% der Fälle mit Ödem des Orbitagewebes durch eine Abnahme der Sehschärfe aus. Charakteristisch für einen Orbitaabszess und eine Orbitaphlegmone waren schwergradige pathologische Veränderungen der Augenlider und der Orbitaweichgewebe sowie eine deutliche Abnahme der Sehschärfe bei allen Patienten mit Orbitaphlegmone.

Schlussfolgerung

Die Abklärung der Art einer entzündlichen Erkrankung der Orbita anhand der klinischen und tomographischen Kriterien, die in der vorliegenden Studie ermittelt wurden, führte zu einer Abnahme der Anzahl ungerechtfertigter transkutaner Orbitotomieoperationen.

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Authors and Affiliations

  1. Department of Ophthalmology, Kharkiv National Medical University, 4 Nauky av., 61022, Kharkiv, Ukraine

    Darya Zubkova, Pavlo Bezditko, Olesya Zavoloka & Yevgeniya Ilyina

  2. Department of Neurosurgery, Kharkiv City Hospital—center of the cerebro-vascular diseases, Kharkiv, Ukraine

    Oleksandr Zubkov

  3. Department of the Neurology and Neurosurgery of Kharkiv Medical Academy of Postgraduate Education, Saltovskoe highway 266, 61176, Kharkiv, Ukraine

    Oleksandr Zubkov

Authors
  1. Darya Zubkova
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  2. Pavlo Bezditko
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  4. Yevgeniya Ilyina
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Correspondence to Darya Zubkova.

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D. Zubkova, P. Bezditko, O. Zavoloka, Y. Ilyina, and O. Zubkov declare that they have no competing interests.

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Zubkova, D., Bezditko, P., Zavoloka, O. et al. Clinical and tomographic features of acute inflammatory disorders of the orbit. Spektrum Augenheilkd. 34, 10–17 (2020). https://doi.org/10.1007/s00717-019-0426-0

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  • DOI: https://doi.org/10.1007/s00717-019-0426-0

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