ABSTRACT
PURPOSE: Description of clinical features, radiological characteristics, and management strategies in primary orbital intraosseous venous malformation (OIVM) with pertinent literature review. METHODS: A retrospective analysis including clinical, radiologic, operative, and histopathological data of six cases of histopathologically proven OIVM was done. A comprehensive literature review was conducted using online databases and augmented with manual search to identify reported cases of OIVM. RESULTS: Study data showed five females and one male in young to middle-age group, with an average age of 30 years (range: 20-48 years). Proptosis was noted in five cases (83.33%), and the duration of symptoms ranged from 6 months to 10 years. Frontal and zygomatic bones were most frequently affected and expansile bony lesion was the most common CT scan finding. Three patients underwent pre-operative embolization of feeders followed by en bloc excision of mass and surgical reconstruction (50%); one patient was managed with partial excision (16.66%) while two were regularly followed-up after incision biopsy (33.33%). Histopathology revealed vascular spaces with endothelial lining, separated by bony trabeculae in all patients. Follow-up periods ranged from 6 to 48 months and no recurrence or progression were noted. CONCLUSIONS: OIVM is an exceptionally rare disorder with a gradually progressive benign course. Ophthalmologists need to be mindful of this entity during patient evaluation as it has propensity for large volume blood loss intra-operatively, owing to its vascular nature. Complete excision with reconstruction of resultant defect is the preferred treatment strategy and without known recurrence.
Subject(s)
Orbit , Tomography, X-Ray Computed , Vascular Malformations , Humans , Adult , Retrospective Studies , Female , Male , Middle Aged , Vascular Malformations/diagnostic imaging , Young Adult , Orbit/blood supply , Orbit/diagnostic imaging , Embolization, Therapeutic , Veins/abnormalities , Veins/diagnostic imaging , Skull/abnormalities , Spine/abnormalitiesABSTRACT
PURPOSE: To assess the causes of visual impairment and blindness in children in all the schools for the blind in eight northeastern states and to determine its temporal trend, and to analyze the result with reference to various regional epidemiological data on childhood blindness in India. METHODS: Children aged ≤16 years, with a visual acuity of ≤6/18 in the better eye, attending 17 schools for the blind were examined between November 2018 and March 2020. WHO protocol and reporting format was used for the evaluation, diagnosis, and classification of the causes. RESULTS: Out of 465 eligible study participants, 93.76% were blind and only 12.26% of causes were avoidable. Anatomical causes of childhood blindness were whole globe (43.2%), cornea (17.20%), optic nerve (12.04%), retina (9.68%), and lens (9.46%). Etiological causes were unknown (52.69%), hereditary (26.02%), intrauterine (15.05%), and 26.08% had blinding congenital ocular abnormality (s). Regional temporal trend revealed a decrease in corneal and childhood causes and an increase in retina, optic nerve, hereditary, and intrauterine causes. CONCLUSION: A constellation of causes were differentiable but matched with the overall emerging trend of childhood blindness in India. Higher corneal, unavoidable, and unknown causes suggest a region-specific action plan for controlling childhood blindness as well as rehabilitation.
Subject(s)
Vision, Low , Visually Impaired Persons , Blindness/diagnosis , Blindness/epidemiology , Blindness/etiology , Child , Education, Special , Humans , India/epidemiology , Vision, Low/epidemiology , Vision, Low/etiologyABSTRACT
Penetrating orbitocranial injuries can present with foreign body/bodies (FBs) lodged in eye, orbit, and/or brain. But limited literatures are available about FBs lodged partly in orbit and partly intracranially. Here, we present a rare case of orbitocranial wooden FB impacted in right palpebral aperture extending intracranially following accidental fall from height. Unexpectedly, the patient himself removed the FB in fully conscious and oriented state while waiting for neurosurgical intervention, later completely recovered under observation and antibiotic prophylaxis. Therefore, it is important to have high suspicion of intracranial extension in impacted orbital FBs and a team approach for managing such cases.
