Neuro-ophthalmologic symptomatology in 246 patients with orbital space-occupying processes

Abstract

A total of 246 patients with orbital space-occupying processes were treated at the Clinic of Neurosurgery, University ‘Alexandrovska’ Hospital, in the period 1986-1999. There were 119 males and 127 females, aged between 2 and 76 years. The pathologies were orbital pseudotumor (14.6%), mucocele of the orbital walls (14.2%), hemangiomas (13%), tumors of the optic nerve and chiasm (9.8%), secondary tumors (11.4%), metastases (6.9%), tumors of the lacrimal gland (4.5%), tumors of peripheral nerves (4.5%), bone tumors (4.0%), tumors of fibrous tissue (4.0%), dermoid and epidermoid tumors (3.2%), lymphomas (1.6%), rhabdomyosarcomas (1.6%), multiple myelomas (1.2%), and other rare tumors. The main clinical symptoms were proptosis (76.8%), limitation of ocular movements (60.9%), diminished visual acuity (52.4%), eyelid swelling (20.7%), orbital pain (26.0%), local tumor (20.7%), optic disc swelling (15.0%), and optic atrophy (20.3%), with the incidence varying among the individual nosologic entities. All patients underwent an operation and the collaboration of the neuro-ophthalmologist, otorhinolaryngologist, and plastic surgeon was requested in some of the cases.The results of treatment depended directly on the nature of the pathological process. Post-operative complications were observed in 4.5% of the patients operated, with surgical lethality in 1.5%.