Revista argentina de radiología
On-line version ISSN 1852-9992
DE LUCA, Silvina et al. Orbitocranial pathology with ophthalmologic symptoms. Rev. argent. radiol. [online]. 2012, vol.76, n.2, pp. 113-121. ISSN 1852-9992.
Objectives. To report the clinical and etiological correlation of different orbitocranial lesions in patients initially presenting with ophthalmologic symptoms and to determine its contribution to the selection of the diagnostic test of choice for each individual case. Materials and Methods. We have evaluated retrospectively 36 patients with orbital and/or intracranial conditions, who presented at the ophthalmology department of our institution between july 2007 and january 2011. All patients underwent an ophthalmologic examination, computerassisted campimetry, multislice computed tomography (MSCT), magnetic resonance imaging (MRI) and some had a histopathological test performed. Results. The most common initial symptom was decreased or impaired visual acuity, present in 22 patients (61%). Others symptoms were diplopia in 9 patients (25%), exophthalmos in 2 (5.5%), orbital hematoma in 2 (5.5%) and leukocoria in 1 (3%). In the group of patients with visual impairments, the etiological diagnoses were diverse and included: sphenoid meningioma (n=4), Devic's disease (n=2), brainstem glioma (n=1), optic glioma in the context of type 1 neurofibromatosis (n=1), metastasis of breast carcinoma (n= 4), brain lymphoma (n=2), stroke (n=4), lymphocytic hypophysitis (n=1) and pseudotumor cerebri (n=2). In patients with diplopia diagnosis included: a quadrigeminal plate tumor, one pineal cyst with acute hydrocephalus, two posterior communicating artery aneurysms, two intracavernous internal carotid artery aneurysms (one of them giant and dissecting), one ventral supraclinoid internal carotid artery aneurysm and two fronto-ethmoidal mucoceles. We highlight the presence of two optic nerve meningiomas initially presented with exophthalmos and decreased visual acuity, and leukocoria as initial symptom in a West syndrome. Conclusion. The interdisciplinary approach and the proper recommendation of imaging in the evaluation of the major neuro-ophthalmologic entities that present with ophthalmologic symptoms allows us to arrive at an early diagnosis, and hence, to the institution of the appropriate therapy.
Keywords : CT; MRI; Ophthalmologic symptoms; Orbitocranial pathology.