Demographics of Pediatric Orbital Lesions: A Tertiary Eye Center Experience in Saudi Arabia

Hind Manaa Alkatan,Faisal Al Marek,Sahar Elkhamary

doi:10.2991/jegh.k.181224.001

Abstract

Orbital lesions vary in their classification, incidence, and presentation depending on the age and geographic distribution. Such lesions in the pediatric age group have been studied extensively because of the possibility of faster progression of orbital involvement and the higher risk of morbidity in this age group in which vision is still developing. In Saudi Arabia, orbital lesions were studied over a 6-year period in the late 1980s, when retinoblastoma cases used to present late with orbital involvement. In this study, we revisited the same topic 20 years later aiming to find out the most recent prevalence of orbital lesions in a similar population of patients over a longer period (14 years) in the same eye center, and compare the current results to other reports worldwide. A total of 107 lesions from 106 patients were identified by tissue diagnosis, of which more than half of the lesions were benign cystic (being the most common), vasculogenic, and inflammatory in 63% [95% confidence interval (CI, 53.3–72.0)] of all biopsied lesions. Neoplasms accounted for 37% [95% CI (28.0–45.8)] with rhabdomyosarcoma being the most common, accounting for about one third of neoplasms, and no orbital cases of retinoblastoma were found. Our results demonstrated different distribution of orbital lesions in recent years reflecting the indirect effect of the improved health awareness and medical care in Saudi Arabia. This baseline demographic study is expected to be helpful for further clinical and prognostic studies with emphasis on pediatric orbital malignant lesions, their clinical presentation, management, and prognosis.

Highlights

Orbital pathologic conditions comprise a diverse group of pathology including neoplastic and nonneoplastic lesions
A review of the literature discloses variability in the incidence of childhood orbital tumors; this is related to the nature of each reporting center and different geographic areas
Cystic lesions accounted for 47 cases (43.9%) [95% CI (34.6–53.3)], vasculogenic for 17 (15.8%) [95% CI (9.3–24.3)], rhabdomyosarcoma for 11 (10.2%) [95% CI (4.7–15.9)], and peripheral nerve tumors for seven (6.5%) [95% CI (1.9–12.1)]

Summary

Introduction

Orbital pathologic conditions comprise a diverse group of pathology including neoplastic and nonneoplastic lesions. These lesions may cause cosmetic problems, severe ophthalmologic complications with vision loss or eye movement deficit. A review of the literature discloses variability in the incidence of childhood orbital tumors; this is related to the nature of each reporting center (pathology centers, pediatric hospitals, etc.) and different geographic areas. A modified classification has been used by our group, which allows easier comparison of one published series with another. The same group published another review of 645 biopsies of space-occupying lesions of the orbit, showing the incidence of these lesions with a proposal of a classification [2]. Bullock et al [5] reviewed orbital tumors diagnosed clinically and/or histopathologically over a 12-year period

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Discussion

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