Abstract

Introduction: Proptosis is defined as bulging of eye anteriorly out of the orbit. Our main objective was to analyze the pattern of computerised tomographic findings in evaluation of proptosis. Computerised tomography (CT) is noninvasive, easily accessible, affordable and reliable imaging which helps in early diagnosis and prompt treatment.
 Methods: A descriptive cross sectional study of total 58 patients presenting with proptosis referred to our department of radiology for computerised tomography evaluation during one year period were undertaken into study. The clinical information provided by ophthalmologist also helped our study to derive into conclusion. SPSS version 20 software was used for statistical data analysis.
 Results: Out of 58 patients, the most common cause of proptosis was neoplasm constituting of 25 cases (43.1%). Retinoblastoma was the commonest orbital tumor. Out of remaining cases, 15 (25.8%) were infective, 14 (24.1%) were inflammatory, two (3.44%) were traumatic and remaining two cases (3.44%) had no definitive cause for proptosis. Bilateral proptosis was commonly associated with thyroid ophthalmopathy. Among the subjects 32 were male, 26 were female. Male: Female ratio was 1:1.23. Age group was ranging from 1 month to 73 years.Mean age was 26.4 ± 22 years.
 Conclusions: Computerised tomography has an important role in distinguishing the different types of lesions based on their characteristics, location and extension prior to undertaking definitive surgical and medical treatment. Overall accuracy of CT in our study was 81%, sensitivity of 82.6%, specificity of 80.6%, positive predictive value of 76% and negative predictive value of 86.2%.

Highlights

  • Proptosis is defined as bulging of eye anteriorly out of the orbit

  • Amongst 25 cases of neoplasm, orbital tumor constitute about 23 of cases and rest 2 cases accounted for paraorbital tumor

  • The patient were high myopic on clinical examination After proper follow up, histopathological, operative findings correlation, our study showed sensitivity of 82.6%, specificity of 80.6%, positive predictive value of 76%, and negative predictive value of 86.2% and accuracy of 81%

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Summary

Introduction

Proptosis is defined as bulging of eye anteriorly out of the orbit. Our main objective was to analyze the pattern of computerised tomographic findings in evaluation of proptosis. Computerised tomography (CT) is noninvasive, accessible, affordable and reliable imaging which helps in early diagnosis and prompt treatment. If the distance between corneal apex and anterior to lateral orbital rim is more than 21mm or a difference of 2mm between the two globes position is termed proptosis.[1] The shape of the orbit is like a quadrilateral pyramid with only anterior opening and the rigidity of the bony orbit explains that expansion of any of the orbital contents will displace the eyeball forward.[2] Computerised tomography is easy, noninvasive, cost effective, accessible diagnostic modality of investigation in proptosis and has excellent spatial resolution with speed. Multiplanar reformation allows a lesion to be assessed in relation to neighbouring structure including adjacent bone, sinus and central nervous structures. This helps clinician in diagnosis and for treatment planning and follow up monitoring.[3]

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