Descompresión orbitaria en la orbitopatía tiroidea / Orbital decompresion in thyroid-related orbitopathy

La orbitopatía tiroidea, se caracteriza por: exoftalmos, retracción palpebral y neuropatía óptica comprensiva en los casos más severos. La descompresión orbitaria se realiza en estos casos para preservar la visión. Objetivo: Mostrar la experiencia de nuestro hospital en esta cirugía por diferentes vías de abordaje: transcraneal, anterior y endoscópica nasal. Métodos: Se realizó un corte evaluativo de 30 casos operados en el período de enero de 1999 a febrero del 2005. La efectividad de la cirugía se evaluó en cuanto a: disminución del exoftalmos y mejoría visual por las tres vías de abordaje. Resultados: Todos los casos operados disminuyeron el exoftalmos y mejoraron su visión. En la vía endoscópica se obtienen excelentes resultados con menor trauma quirúrgico. Conclusiones: Se concluye que la descompresión orbitaria es un tratamiento muy efectivo en la orbitopatía tiroidea y que la vía endoscópica es un procedimiento de acceso mínimo con buenos resultados.

Thyroid-related orbitopathy is characterized by exophthalmos, palpebral retraction and compressive optic neuropathy in the most severe cases. Orbital decompression is performed to preserve the vision in these patients. Objective: To show the experience gained by our hospital in performing this type of surgery using several approaches such as transcranial, anterior and nasal endoscopic paths. Methods: An evaluating study was carried out in 30 cases operated on from January 1999 to February 2005. The surgical effectiveness was evaluated in terms of reduction of exophthalmos and visual improvement using the three approaches. Results: According to data from tables 1, 2 and 3, all the operated patients reduced exophthalmos and improved their vision. The endoscopic approach exhibited excellent results with lower surgical trauma. Conclusions: It was concluded that orbital decompression is a very effective treatment for thyroid-related orbitopathy and that endoscopic approach is a minimum access procedure with good results.

Retrobulbar injection of triamcinolone in thyroid associated orbitopathy.

OBJECTIVE: To identify the result of retrobulbar triamcinolone injection in patients with thyroid associated orbitopathy MATERIAL AND METHOD: Prospective noncomparative pilot study in 27 eyes of 19 patients who had been diagnosed as thyroid associated orbitopathy during October 2000 through April 2002. The patients received retrobulbar 40 mg triamcinolone treatment for each orbit weekly, totaling 4 applications. RESULTS: Three months after treatment, most of the patients demonstrated no significant change in visual acuity and visual field. Improvement of proptosis was observed in 15 eyes (56%) and stable in 10 eyes (37%). Seven patients (41%) had improvement of extraocular muscle function as demonstrated by Hess test. These results remained stable in the majority of patients at the 6 months follow up period. No systemic side effects were observed The only significant local side-effect was intraocular pressure elevation which was found in 8 eyes and responded to antiglaucoma therapy. CONCLUSION: This preliminary study demonstrated the potential benefit of retrobulbar triamcinolone injection in cases of thyroid associated orbitopathy. Long-term study in these patients is required.

A Case of Complete Ophthalmoplegia in Herpes Zoster Ophthalmicus

PURPOSE: To report a case with complete ophthalmoplegia after herpes zoster ophthalmicus. METHODS: A 70-year-old male patient visited a clinic because of vesicular eruptions over the left side of his face with severe pain. Drooping and severe swelling of the left eyelid were present, along with keratitis and uveitis. While the lid swelling and uveitis were improving, external ophthalmoplegia and exophthalmos were discovered. Intramuscular injections of dexamethasone 5 mg were given for 10 days, followed by oral administration of prednisolone at a dosage of 15 mg for two weeks and 10 mg for two weeks. RESULTS: The patient was fully recovered from the complete ophthalmoplegia and exophthalmos six months after the onset of the cutaneous lesion. CONCLUSIONS: Complete ophthalmoplegia is a rare ophthalmic complication of herpes zoster infection. Therefore, an evaluation of extraocular muscle and lid function should be performed during the examination of herpes zoster patients in order to screen for ophthalmoplegia.

Weber-Christian disease presenting with proptosis: a case report

Weber-Christian disease (WCD) is a rare inflammatory disease of adipose tissue, which is characterized by painful cutaneous nodules and constitutional symptoms. Although any area of the body containing fat can be affected by WCD, the involvement of retrobulbar fat is uncommon and proptosis is a rare presenting manifestation. We report a case who presented with proptosis of the right eye which is accompanied by painful subcutaneous nodules, high fever and myalgia. Biopsies of retrobulbar tissue and suprapubic nodule showed lobular panniculitis with mixed cellular infiltration, mainly composed of histiocytes and lymphocytes. He responded well to high-dose glucocorticoid.

Weber-Christian disease presenting with proptosis: a case report

Weber-Christian disease (WCD) is a rare inflammatory disease of adipose tissue, which is characterized by painful cutaneous nodules and constitutional symptoms. Although any area of the body containing fat can be affected by WCD, the involvement of retrobulbar fat is uncommon and proptosis is a rare presenting manifestation. We report a case who presented with proptosis of the right eye which is accompanied by painful subcutaneous nodules, high fever and myalgia. Biopsies of retrobulbar tissue and suprapubic nodule showed lobular panniculitis with mixed cellular infiltration, mainly composed of histiocytes and lymphocytes. He responded well to high-dose glucocorticoid.

Orbitopatía tiroidea. Primera parte / Thyroid orbitopathy. First part

Se hace una revisión bibliográfica de las principales características de la orbitopatía tiroidea y se menciona la experiencia de nuestro servicio

Tuberculose de órbita: relato de caso / Orbital tuberculosis: case report

Os autores relatam o caso de uma criança com exoftalmia unilateral, em que o estudo tomográfico e ultra-sonográfico sugeriam neoplasia. Feita abordagem cirúrgica da lesao, a histopatologia revelou tuberculose. Utilizou-se a quimioterapia por 6 meses e está sendo feito o seguimento do paciente.

Pseudomotor orbitario : reporte de un caso / Pseudomotor arbitary : one case report

Se reporta un caso de pseudotumor orbitario en un paciente de 13 años de edad

Management of progressive exophthalmos.

The present study reveals our experience in the medical management of 30 cases of progressive/malignant exophthalmos, employing costicosteroid, b-blocker, diuretic and a preparation containing proteolytic enzymes. There was encouraging improvement in terms of symptoms, proptosis and optic nerve compression, while reduction of ophthalmoplegia was not so satisfactory. However, none of the patients needed decompression surgery.

Sulfato de guanetidina e exoftalmia tireotóxica

Uma mulher jovem portadora de microcórnea, exoftalmia tireotóxica e glaucoma incipiente apresentou acentuada melhora com tratamento local por sulfato de guanetidina a 10%. A guaneditina (Ismelina) é um bloqueador adrenérgico e age como uma síndrome de Horner farmacológica

Tirotoxicosis neonatal en hijo de madre con hipotiroidismo posiodo radiactivo / Neonatal thyrotoxicosis in the child of mother with hy-pothyroidism secondary to radioactive iodine administration

Presenta el caso de una paciente que desarrolla en el transcurso del embarazo un hipotiroidismo secundario a la administración de iodo radiactivo y a pesar de ello el neonato desarrolló el cuadro clínico de una tirotoxicosis neonatal de evolución favorable. Se discute la probable causa de ese cuadro clínico