Artikel
Long-term prognosis of visual function in patients with orbital cavernomas
Langfristige Entwicklung der Sehfunktion bei Patienten mit Orbitacavernomen
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Autoren
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A. F. Scheuerle
- Universitäts-Augenklinik Heidelberg
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A. Aschoff
- Klinik für Neurochirurgie, Universitätsklinikum Heidelberg
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G. Kolling
- Universitäts-Augenklinik Heidelberg
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S. Kunze
- Klinik für Neurochirurgie, Universitätsklinikum Heidelberg
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A. Unterberg
- Klinik für Neurochirurgie, Universitätsklinikum Heidelberg
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H. H. Steiner
- Klinik für Neurochirurgie, Universitätsklinikum Heidelberg
| Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
To investigate the long-term prognosis of visual function in patients with orbital cavernomas after conservative and surgical treatment.
Methods
The authors describe the outcome of 20 patients with cavernomas of the orbit treated in their departments between 1988 and 2004. This prospective study included five cases followed by clinical and radiological observation and 15 cases of symptomatic tumors that were completely removed via a frontotemporal or via a transconjunctival approach. The clinical characteristics of orbital cavernomas were analyzed togeather with their appropropriate treatment.
Results
The follow-up period was between three and ten years. All orbital cavernomas in the group of conservatively managed patients remained stable. The transconjunctival excision of a medially located lesion was uncomplicated. The frontotemporal approach was chosen for large tumors situated in the proximity of the orbital apex and was associated with a higher number of complications. A good overall outcome of visual function and patient satisfaction was archieved in 12 of 14 cases operated on via craniotomy.
Conclusions
The combination of clinical signs and magnetic resonance imaging is highly sensitive and specific for the diagnosis of orbital cavernomas. In presence of visual deterioration clearly attributable to the tumor we recommend immediate surgery while lesions producing solely exophthalmos can safely be followed by observation. The transcranial approach offers excellent exposure and a rewarding cosmetic result and may be considered for large lesions superior and medial to the optic nerve, especially if they involve the orbital apex.
