Prognosis of Ocular Injury Caused by Wasp Sting: Case Reports

PURPOSE: In the present study, the prognosis of ocular injury caused by a wasp sting was evaluated in two cases: Case 1 was treated by anterior chamber irrigation and Case 2 was simultaneously treated by anterior chamber irrigation and vitrectomy. CASE SUMMARY: Both patients had unilateral damage and complained of severe eye pain and blurred vision. Severe corneal edema, conjunctival injection, marked anterior chamber inflammatory reaction and the wasp sting through the cornea at the anterior chamber were observed in both cases. In Case 1, anterior chamber irrigation was performed, however, corneal edema was not recovered. Six months after the wasp sting, phthisis was observed. In Case 2, anterior chamber irrigation and vitrectomy were simultaneously performed, corneal edema decreased and epithelial healing occurred. Four months after the wasp sting, the eyeball was stable, but there was no wave on the electroretinogram. CONCLUSIONS: Unlike the ocular damage resulting from a bee sting, the ocular damage from a wasp sting causes severe toxic reactions and results in poor prognosis. Aggressive treatment including vitrectomy is necessary shortly after wasp sting injury to save both the vision and eyeball.

A Case of Extra-axial Anaplastic Meningioma with Direct Orbital Extension

PURPOSE: We report the first case of extra-axial anaplastic meningioma with direct orbital extension for differential diagnosis of orbital tumors. CASE SUMMARY: An 83-year-old woman presented with a protruding left eye and a palpable mass on the forehead. A brain computed tomography scan revealed a huge sarcomatous mass that had directly invaded the surrounding tissues. We removed the tumor by craniotomy and found that it involved the extradural and intradural spaces, brain parenchyma, subcutaneous tissue, left temporalis, orbital roof, and the other frontal lobe across the midline. A cranioplasty was performed, and the orbital roof was reconstructed with artificial bone and bone cement. The final histological diagnosis was anaplastic meningioma. The left eyeball was restored to its normal position 1 month after the surgery. Also, visual acuity and eye movement of the left eye were preserved. CONCLUSIONS: Direct orbital extension of originated extra-axial cerebral convexity anaplastic meningioma is rare but should be considered in the differential diagnosis of a rapidly growing orbital mass.

Measurement of Orbital Volume from Different Slice Thickness Facial Computed Tomography Scans Using a Semi-automatic Program

PURPOSE: To compare the orbital volume calculated from various slice thickness facial computed tomography scans using a semi-automated computer program. METHODS: Axial and coronal scans of 2, 2.5, 3 mm slice thickness facial computed tomography scans were used to measure the orbital volume. The cross-sectional area was determined from each slice using a semi-automated computer program (MATLAB 2009a®, MathWorks, Inc., Natick, MA, USA), and then the volume was calculated from serial reconstruction of the cross sections. RESULTS: The measured value in the 2 mm images was 33.14 ± 2.37 cm³ in the right orbit and 34.32 ± 2.60 cm³ in the left orbit for the axial scans, and 35.54 ± 3.58 cm³ in the right orbit and 34.96 ± 4.05 cm³ in the left orbit for the coronal scans. In the 2.5 mm images, the values were 33.28 ± 3.35 cm³ in the right orbit and 33.73 ± 4.10 cm³ in the left orbit for the axial scans, and 35.24 ± 3.98 cm³ in the right orbit and 35.10 ± 3.93 cm³ in the left orbit for the coronal scans. In the 3 mm images, the values were 33.23 ± 2.70 cm³ in the right orbit and 33.39 ± 2.69 cm³ in the left orbit for the axial scans, and 33.20 ± 3.64 cm³ in the right orbit and 32.95 ± 3.45 cm³ in the left orbit for the coronal scans. In the 3 mm image, there was not a significant difference in the calculated volume between the axial and coronal scans (p(3mm) = 0.62). CONCLUSIONS: Because there is no difference in the results of the orbital volumetric measurements between three other slice thicknesses in the axial scan, using axial scan images with a computer program that semi-automatically calculates orbital volume is useful. In addition, the volume measured by thick slice images has more reproducibility than the volume measured by thin slice images.