Artikel
Improvement of visual acuity after removal of an orbital vascular malformation
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Veröffentlicht: | 3. August 2011 |
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Gliederung
Text
Introduction: While acute visual loss requires immediate therapeutic action in regard to low retinal ischaemia tolerance, it is uncertain whether improvement of progredient visual loss can be achieved by treatment of slowly progredient lesions.
Methods/Results: A 46-year old patient suffering from a progredient exopthalmus over several weeks and loss of visual acuity (sc 1/40) on the right side was presented to us when diplopia in gazing upwards or temporal occurred. In addition to ophthalmologic and ENT-assessment, ultrasonography, computed tomography and magnetic resonance imaging of the orbit were performed, showing a vascular tumor of the retrobulbar orbital space on the right side. After completion of diagnostics we refrained from performing biopsy and performed a complete removal of the vascular malformation via lateral orbitotomy. Immediately after surgery an improvement of visual acuity and loss of diplopia could be attested. The histologic assessment confirmed our clinical assumption of a cavernous haemangioma.
Conclusion: A vascular malformation has to be considered in patients presenting slowly progredient exophthalmus and loss of visual acuity. The presented lateral orbitotomy is a functionally and aesthetically valuable approach to the orbit, allowing removal of such lesions with minimal blood loss. Should loss of visual acuity increase slowly over a longer period of time, improvement of visual acuity after removal of a vascular orbital tumor is still possible.
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