The value of orbital angiography for diagnosis of unilateral exophthalmos.
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A 14-year-old boy suffered right blunt orbital trauma. X-ray revealed a compressed fracture of the right ethmoidal sinuses. Three months after the trauma, progressive, painless right proptosis developed. Ocular examination revealed a severe proptosis and pronounced down displacement of the right globe without signs of orbital inflammation. A well-demarcated, extraconal right orbital cystic mass was seen on computerized tomography scan. The cyst contents were aspirated and found to contain echinococcal scolices and "hydatid sand." Hypertonic saline was injected and the cyst was excised. Progressive proptosis after blunt orbital trauma in patients from endemic areas should be suspected of being an orbital hydatid cyst.
OBJECTIVE: Primary intraorbital mucoceles arising from the optic canal are extremely rare. We describe a patient with compressive optic neuropathy caused by an intraorbital mucocele. CLINICAL CASE: A 51-year-old woman presented with proptosis and reduced vision. Magnetic resonance imaging showed a mass compressing the optic nerve. There was no direct connection between any paranasal sinus and the mass cavity, as assessed in imaging studies and intraoperatively confirmed. The pathological diagnosis after the operation indicated a mucocele. DISCUSSION: Considering the absence of air pockets in the orbit, the mucocele might have originated from ectopic mucinous tissue that appeared during the development of the optic canal.
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We present the most important ophthalmologic signs related to the angiocinematographic aspects in two patients presenting giant arteriovenous malformations in the frontal part of the brain. In both cases the first clinical sign of the disease was unilateral proptosis associated with scleroconjunctival arteriovenous malformation. In the presented cases we could not establish any relationship between the intensity of the proptosis, the scleroconjunctival vascular malformation and the size of the intracranial arteriovenous malformation. We point on the importance of the proptosis associated with scleoconjunctival vascular malformation representing the first signs in intracranial arteriovenous malformations.
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