Clinical analysis of 134 cases of cystic lesions of the orbit

Abstract

Objective To describe the clinical findings, diagnosis and treatment of cystic lesions in volving the orbit. Methods Retrospective observational case series study. The medical records of 134 patients with cystic lesions involving the orbit who underwent treatment from January 2001 to March 2009 were reviewed and analyzed retrospectively. All patients were seen by Professor Yan Jian-hua at Zhongshan Ophthalmic Center of Sun Yet-sen University. The main contents were clinical features, imaging findings and therapeutic efficacy. Results Among 134 patients (134 eyes), there were 66 females and 68 males from ages 3months to 84 years old (average 42 years),with 63 lesions being the right orbit and 71 the left one. The most common symptoms were lumps, proptosis and diplopia. Ultrasonography showed that most lesions were presented as hypo-echoic or anechoic areas with distinct border and no blood flow signals inside. CT revealed that the lesions had homogeneous density. The CT value ranged from -198Hu to 77.5Hu. The cystic walls were enhanced while contents not. The MRI examination demonstrated isointensity or hypointensity in T1 WI and hyperintensity in T2WI. All the cases were operated and diagnosed by pathological examination. There were 46cases of orbital dermoid cysts, 58 epidermoid cysts, 11 mucoceles, 12 orbital hematoma, 3 orbital abscess, 2parasitc cyst, 1 lacrimal dacryops and 1 congenital cystic eye. They were followed up for 3 months to 8 years,2.1 years at average. The cure rate was 98.50% and the relapse rate was 1.50%. Conclusions Diagnosis of cystic lesions involving the orbit should combine with symptoms and signs. Imaging studies contribute to the diagnosis. Surgical treatment is effective. Key words: Orbit; Cystic lesion; Diagnosis; Treatment