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Orbital Pseudo-tumors in Children with Different Clinical Symptoms
1Karolczak-Kulesza M., 1Gotz-Wieckowska A., 2Niedziela M.,
1K. Marcinkowski University of Medical Sciences Poznan, Department of Ophthalmology (Poznan)
2K. Marcinkowski University of Medical Sciences Poznan, Institute of Pediatrics (Poznan)
Orbital pseudotumor was first discribed by Birch-Hirschfeld in 1905. This is a idiopathic, non-specific, inflamatory orbital disease. Presentation is usually between 20-50 years of age. Bilateral involvament in children occurs in one third cases. The clinical course in small children is different and very unusual. The clinical forms of orbital pseudotumors: - inflamation of the lacrimal gland, - preseptal (anterior) orbital inflamation, - orbital (posterior) inflamation, - orbital myositis.
Aims: Presentation different clinical forms of orbital pseudotumors in children and evaluation of the effectivity of treatment.
Patients and methods: Autors present: 6 patients (6 females) , aged 3-11 yrs with unilateral (5 cases) and bilateral (1 case) loccalization of orbital pseudotumor. In all patients full ophthalmological examination, US, CT, MR investigations were performed. FNAB in 2 cases, histopathological examination in 1 case were performed. Therapy employed in our patients: steroid treatment (6 cases), radiotherapy (1 case).
Results: Clinical features were observed: - oedema of the lids (3 cases), - ptosis of the upper lid (2 cases), - exophthalmos (3 cases), - disturbances of motility of the eye (3 cases), - dicreased VA (6 cases), - chemosis (3 cases), - pain (6 cases), - fever (2 cases), - lost of the consciousness (1 case). After the treatment: - regression in 5 cases, - progression in 1 case, - recrudesce in 2 cases were observed.
Conclisions: 1. Considering vanety of clinical features proper diagnostic process play a crucial role especialy in patients in first decade. 2. The cooperation between the pediatrcian and ophthalmologist plays a important role in diagnostic and therapic process.