Atlas of Ophthalmology

Patient: 51 years old, female, BCVA 1.0 at OD, 1.0 at OS. General Medical History: empty. Ocular Medical History: The patient slowly developed 3 mm of well-tolerated relative proptosis with minimal motility disturbance at OS, no visual decline. Main Complaint: proptosis with motility disturbance. Methods: magnetic resonance imaging (MRI), visual evoked response (VEP). Findings: (1) Magnetic resonance imaging (MRI) demonstrated an intraconal rounded mass that perfused slowly, the anterior surface was well circumscribed. There was no compression of the optic nerve. (2) VEP of OS showed regular latencies with attenuated amplitudes at OS. Discussion: Bonavolontà et al. (1) evaluated the frequencies of orbital space-occupying lesions. In this retrospective case series, the authors reviewed 2,480 consecutive patients. Of the 2,480 lesions, 68% were benign and 32% were malignant. The most frequent benign tumors were dermoid cyst (14%) and cavernous hemangioma (9%). The most common malignant tumors were non-Hodgkin lymphoma (12%), basal cell carcinoma (3%), and orbital metastases (3%). Cavernous hemangioma only exceptionally compresses the optic nerve. Literature: (1) Ophthal Plast Reconstr Surg. 2013 Mar-Apr;29(2):79-86. An analysis of 2,480 space-occupying lesions of the orbit from 1976 to 2011. Bonavolontà G, Strianese D, Grassi P, Comune C, Tranfa F, Uccello G, Iuliano A.

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