Study of causes of proptosis in relation to demographic features among patients of El-Minya University Hospital

ABSTRACT

To analyse causes of proptosis in patients attending El-Minya University Hospital out-patient ophthalmology clinic as regards their frequency in relation to age, sex, and lateralitiy. Fifty six patients with proptosis were examined in the ophthalmology out-patient clinic of El-Minya University hospital between July 2003 and March 2005. All patients were subjected to history taking, orbital, ocular and general examination, orbital echography and axial and coronal orbital CT scans. MR imaging of the orbits, examination of the field of vision, color vision testing, excisional and incisional biopsies, T3 and T4 level, complete blood picture, sternal puncture, chest X ray, abdominal US, therapeutic steroid test and endoscopic examination of paranasal sinuses were done in some patients guided by the results of clinical evaluation and primary studies. The patients were fifty six with 29 males and 27 female. The age ranged between two months and 70 years. 23 patients were in the pediatric age group [patients were adults. 41 patients presented with unilateral proptosis while 15 patients presented with bilateral proptosis. Causes of proptosis were divided according to etiology into five groups Congenital/structural, traumatic, vascular, inflammatory/infectious and neoplastic. Inflammatory/infectious causes of proptosis were the most common [37.5%] followed by neoplastic [35.7%], traumatic [12.5%] then congenital/structural [7.1%] and vascular causes [7.1%] respectively. Almost the same distribution was found in pediatric group. In this study thyroid orbitopathy was the most common cause of proptosis [14.28%]. It was the most common cause of bilateral proptosis [46.6%]. It represented 70% of cases of bilateral proptosis among adults. 75% patients of thyroid opthalmopathy were females and 25% were males. 87.5% of these patients were adults and 12.5% were in the pediatric group. Mucocele of the paranasal sinuses was the second most common cause of proptosis [10.7%]. It was the most common cause of unilateral proptosis in this study [14.6%]. 50% of these patients were adults and 50% in the pediatric age group. 83.3% of these patients were males and 16.6% were females. Mucocele of the paranasal sinuses, capillary hemangioma, orbital hematoma and orbital cellulitis were the most common cause of proptosis among pediatric age group each represented 9.01% of pediatric patients presented with proptosis. In patients with proptosis attending El-Minya University Hospital inflammatory/infectious causes of proptosis are the most common. Thyroid orbitopathy is the most common cause. Mucocele of the paranasal sinuses, capillary hemangioma, orbital hematoma and orbital cellulitis are the most common cause of proptosis among pediatric age group