Amblyopia due a dentigerous cyst. Case report and literature review.

PURPOSE: The goal of this article is to present an infrequent clinical case and to review the available literatura, with an emphasis on ophthalmological symptoms. METHODS: We present the case of a 4-year-old girl with a large dentigerous cyst on the maxillary bone, who had long-standing unilateral epiphora associated with progressive ocular dystopia, facial asymmetry and ipsilateral amblyopia. A multidisciplinary approach was taken by the maxillofacial surgery, ophthalmology and optometry teams. This included systemic antibiotic administration, surgical cyst drainage and amblyopia treatment. The literature review was carried out in the MEDLINE database through the free electronic access to PubMed in March 2020. RESULTS: At the 6-month follow-up, the patient was asymptomatic. The most common symptoms of dentigerous cysts are epiphora 36.8%, ocular dystopia 31.2%, diplopia 21.1%, proptosis, nasolacrimal duct obstruction and blurred vision at 10.5%. Amblyopia has not been reported. CONCLUSIONS: Dentigerous cysts are benign odontogenic cysts, which can be found in the jaw and less frequently on the maxillary bone. They are usually asymptomatic, and the occurrence of ophthalmic complications is very infrequent. Multidisciplinary management is essential to avoiding long-term morbidity of maxillary dentigerous cysts and should include an ophthalmologist.

[Uveitis masquerade syndrome as a presenting form of diffuse retinoblastoma]. / Síndrome Mascarada por retinoblastoma difuso.

CLINIC REPORT: A 3-year-old boy presented with an intermediate uveitis. Complete ophthalmic exam, ocular ultrasonography, magnetic resonance imaging and computerized tomography of the orbit were inconclusive. Determination of the aqueous humor/serum rate of Lactate dehydrogenase (LDH) was the key for the diagnosis of a diffuse retinoblastoma. DISCUSSION: A masquerade syndrome is the initial presentation in 1-3% of retinoblastomas. Aqueous humor punction is contraindicated in patients with retinoblastoma but it might be the only way to achieve a correct diagnosis in these difficult and very unusual cases: enzymatic assays such as LDH offer a good sensitivity and specificity for the diagnosis of these patients.

Síndrome mascarada por retinoblastoma difuso / Uveitis masquerade syndrome presenting as a diffuse retinoblastoma

Caso clínico: Paciente de tres años con sospecha deuveítis intermedia. La exploración oftalmológica,ecografía ocular, resonancia nuclear magnética ytomografía computerizada orbitaria no fueron concluyentes.La determinación de la tasa de lactatodeshidrogenasa (LDH) en humor acuoso/suero fuela clave para llegar al diagnóstico de un retinoblastomadifuso.Discusión: El síndrome mascarada es la forma dedebut en un 1-3% de los retinoblastomas. La punciónde cámara anterior está contraindicada enpacientes con retinoblastoma pero podría ser la únicaforma de llegar a un diagnóstico correcto enestos casos difíciles y poco frecuentes. Las pruebasenzimáticas como la LDH nos ofrecen una buenasensibilidad y especificidad para el diagnóstico de estos pacientes(AU)

Clinic report: A 3-year-old boy presented with anintermediate uveitis. Complete ophthalmic exam,ocular ultrasonography, magnetic resonance imagingand computerized tomography of the orbitwere inconclusive. Determination of the aqueoushumor/serum rate of Lactate dehydrogenase (LDH)was the key for the diagnosis of a diffuse retinoblastoma.Discussion: A masquerade syndrome is the initialpresentation in 1-3% of retinoblastomas. Aqueoushumor punction is contraindicated in patients withretinoblastoma but it might be the only way toachieve a correct diagnosis in these difficult andvery unusual cases: enzymatic assays such as LDHoffer a good sensitivity and specificity for the diagnosisof these patients(AU)

Metástasis orbitarias en el adulto / Metastases to the orbit in adults

Las metástasis orbitarias son poco frecuentes en el adulto y constituyen una pequeña parte de la patología orbitaria. En la órbita, las metástasis producen una sintomatología característica de efecto masa o bien infiltración de las estructuras de la misma (AU)

[Orbital metastasis in the adult]. / Metástasis orbitarias en el adulto.

Metastases to the orbit are uncommon in adults and form a small proportion of the diseases of the orbit. In the orbit, metastases cause symptoms due to the space-occupying effect or to infiltration of the structures within the orbit.