Ultrasound parameters of normal lacrimal sac and chronic dacryocystitis / Parâmetros ultrassonográficos do saco lacrimal normal e na dacriocistite crônica

ABSTRACT Purpose: To compared the ultrasound findings of the lacrimal sac between subjects with normal lacrimal systems those with chronic dacryocystitis. Methods: A retrospective study of 10 subjects with a normal lacrimal system (Group 1) and 10 with chronic dacryocystitis (Group 2) diagnosed according to B-mode ultrasound with a 10-MHz transducer and the direct-contact technique (AVISO, Quantel Medical) for lacrimal sac assessment. We analyzed the dimensions, features, and content of the sacs. Characteristics of the population: female: 6, Group 1; 8, Group 2; mean age 48.4 years (SD=19.9; range, 22-80 years), Group 1; 50.5 years (SD=15.5; range, 25-75 years), Group 2. Results: The dimensions of the lacrimal sac were as follows: anteroposterior 1.86 and 10.99 mm in Groups 1 and 2, respectively, p<0.0001; vertical 9.79 and 14.13 mm in Groups 1 and 2, respectively, p=0.049. Qualitative evaluation of the lacrimal sac contents showed hypoechogenic content in Group 1 (10, 100%) and hyperechogenic punctiform content in Group 2 (10, 100%) with partial filling in seven cases (70%). Conclusions: Ultrasonography can differentiate normal lacrimal sacs from sacs compromised by chronic dacryocystitis, thus being useful as an adjunct to clinical examination and surgical planning.

RESUMO Objetivo: Categorizar os achados ultrassonográficos do saco lacrimal em indivíduos com via lacrimal normal e em portadores de dacriocistite crônica. Métodos: Estudo retrospectivo de 20 indivíduos, 10 com via lacrimal normal (Grupo 1) e 10 com diagnóstico de dacriocistite crônica (Grupo 2) utilizando ultrassonografia modo B com transdutor de 10 MHz e técnica de contato (Aviso, Quantel Medical) para avaliar o saco lacrimal. Analisamos os seguintes parâmetros: dimensões, características e conteúdo. Resultados: Características da população estudada: sexo feminino: 6, Grupo 1; 8, Grupo 2; idade média: 48,4 anos (DP=19,93; variação, 22 a 80 anos), Grupo 1; 50,5 anos (DP=15,47; variação, 25 a 75 anos), Grupo 2. As dimensões do saco lacrimal foram aferidas: anteroposterior, 1,86 mm no Grupo 1 e 10,99 mm no Grupo 2, p<0,0001; vertical, 9,79 mm no Grupo 1 e 14,13 mm no Grupo 2, p=0,049. A avaliação qualitativa do conteúdo do saco lacrimal mostrou: conteúdo hipoecogênico no Grupo 1 (10, 100%); e conteúdo puntiforme hiperecogênico no Grupo 2 (10, 100%), com preenchimento parcial em 7 casos (70%). Conclusão: A ultrassonografia foi capaz de diferenciar a via lacrimal normal da acometida por dacriocistite crônica, e de determinar parâmetros úteis para suportar o acompanhamento clínico ou auxiliar no planejamento cirúrgico.

Suppurative dacroadenitis causing ocular sicca syndrome in classic Wegener’s granulomatosis.

Wegener’s granulomatosis (WG) is a multisystem vasculitic disorder which can commonly afflict various components of the eye. Here we describe some unusual ocular manifestations of the disease in one patient. A young male with history of upper respiratory tract symptoms including epistaxis, nasal stuffiness and maxillary sinus pain presented with bilateral lacrimal gland abscess and ptosis. Lacrimal gland biopsy revealed granulomatous vasculitis. Lung cavities, positive cytoplasmic-antineutrophil cytoplasmic antibodies and high titers of serine proteinase-3 antibodies confirmed the diagnosis of WG. The patient developed dry eyes after a month of first presentation. There was no dryness of mouth, suggesting the absence of salivary gland involvement, and antinuclear antibodies as well as antibodies against Ro and La antigens classical of primary Sjogren’s syndrome were absent. Granulomatous vasculitis of lacrimal gland leading to abscess formation and dryness of eyes has not been described in WG and reflects the aggressive nature of inflammatory process in this disease.

Lesiones de la glándula lagrimal / Lagrimal gland lesions

Se analizaron retrospectivamente, 104 lesiones de la glándula lagrimal en un período de 40 años comprendido entre 1957 y 1996. Del total, 21 casos correspondieron a neoplasias malignas, todas ellas de origen epitelial; 38 casos a quistes (dacriops), 16 casos a tumores benignos y 28 casos a glándula lagrimal normal. Sólo se encontró un caso de proceso inflamatorio o dicrioadenitis crónica

Obstruçäo primária do ducto nasolacrimal: proposta de classificaçäo histopatológica / Primary acquired nasolacrimal duct obstruction: proposal of histopathological classifiction

Com o objetivo de determinar e classificar as alteraçöes histológicas que ocorrem na obstruçäo primária do ducto nasolacrimal, realizou-se estudo prospectivo de 51 espécimens biopsiados durante a dacriocistorrinostomia via externa, de 50 indivíduos portadores de obstruçäo primária do ducto nasolacrimal. Os ductos foram classificados em três padröes histopatológicos: inflamável crônico sem obliteraçäo fibrosa ductal (31,4 por cento). Houve associaçäo positiva entre o padräo inflamatório crônico com obliteraçäo fibrosa ductal e ausência de epitélio da mucosa. Os três padröes histopatológicos näo mostraram diferença quando comparados em relaçäo ao tempo de evoluçäo dos sintomas

Functional integrity of lacrimal drainage apparatus by radionuclide dacryocystography.

30 patients with epiphora and related complaints were investigated by Radionuclide Dacrocystography. It was possible to do this procedure easily in all age groups. The site of block in the lacrimal system could be accurately determined by this non-invasive technique.