Clinical and tomographic features of acute inflammatory disorders of the orbit

Abstract

Acute inflammatory disorders of the orbit can cause not only blindness but also intracranial complications that directly threaten the patient’s life. Accurate and timely diagnosis of the type of orbital lesion is necessary for determining the treatment tactics. The clinical and tomographical data of 57 patients with acute inflammatory disorders of the orbit were analyzed prospectively (2008–2017) along with the data of 37 patients analyzed retrospectively (1999–2007). Morphometric and functional parameters of the patients’ orbits on the healthy side were used as a control group (94 orbits). All patients underwent visometry, biomicroscopy, ophthalmoscopy, measuring the width of the palpebral fissure in the central part, and exophthalmometry, measuring the lateral displacement of the eyeball. All patients underwent computed tomography examination. The scanning was performed in axial, coronary, and orbitomeatal projections with a step size of 1 mm. Osteoperiostitis and subperiostal abscess were characterized by moderate pathological changes of the eyelids and orbital soft tissues and normal visual functions. Retrobulbar infiltrate and edema of orbital cellular tissue were characterized by pathological changes of the eyelids and orbital soft tissues and a decrease in visual acuity in 42.9% of cases of edema of the orbital tissue.. Orbital abscess and phlegmon of the orbit were characterized by heavily expressed pathological changes of the eyelids and orbital soft tissues and a marked decrease in visual acuity in all patients with phlegmon of the orbital. Clarification of the type of orbital inflammatory disease via the clinical and tomographic criteria determined in this study led to a decrease in the number of unjustified transcutaneous orbitotomy procedures.