DOCSLIB.ORG

Luth): a 15 Year Review

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Luth): a 15 Year Review REVIEW OF MANAGEMENT OF ORBITO-OCULAR MALIGNANCIES IN LAGOS UNIVERSITY TEACHING HOSPITAL (LUTH): A 15 YEAR REVIEW BY DR. ADEWUMI OLABIMPE ALABI (MBBS, IBADAN) AF/012/11/002/554 A PART II DISSERTATION SUBMITTED IN PARTIAL FULFILMENT OF THE AWARD OF FELLOWSHIP IN RADIOTHERAPY, FACULTY OF RADIOLOGY, NATIONAL POSTGRADUATE MEDICAL COLLEGE OF NIGERIA. NOVEMBER, 2015 1 DECLARATION I declare that this study titled “REVIEW OF MANAGEMENT OF ORBITO- OCULAR MALIGNANCIES IN LAGOS UNIVERSITY TEACHING HOSPITAL (LUTH): A 15 YEAR REVIEW” was carried out by me and to the best of my knowledge contains no material previously published or written by another person, nor material which has been submitted or accepted for the award of any degree or Fellowship except where due acknowledgement has been made in the text. _______________________________ DR. ADEWUMI OLABIMPE ALABI (MBBS, IBADAN) 2 CERTIFICATION This is to certify that this research project “REVIEW OF MANAGEMENT OF ORBITO- OCULAR MALIGNANCIES IN LAGOS UNIVERSITY TEACHING HOSPITAL (LUTH) : A 15 YEAR REVIEW” was conducted in the Departments of Radiotherapy and Ophthalmology (Guinness Eye Centre), LUTH, Idi-araba, Lagos and Supervised by: Professor A. T. Ajekigbe Head, Department of Radiotherapy/Consultant Clinical & Radiation oncologist, Lagos University Teaching Hospital, Idi-araba, Lagos. Signature/Date: _____________________ Professor (Mrs) F. B. Akinsola Head, 3 Department of Ophthalmology/Consultant Ophthalmologist, Guinness Eye Centre, Lagos University Teaching Hospital, Idi-araba, Lagos. Signature/Date: _____________________ Department of Radiotherapy, Lagos University Teaching Hospital, Idi – araba, Lagos state. 2nd of August, 2015. This is to certify that this research project “REVIEW OF MANAGEMENT OF ORBITO- OCULAR MALIGNANCIES IN LAGOS UNIVERSITY TEACHING HOSPITAL (LUTH) : A 15 YEAR REVIEW” by Dr Alabi, Adewumi Olabimpe of the Department Of Radiotherapy, LUTH was conducted in the Departments of Radiotherapy and Ophthalmology (Guinness Eye Centre), LUTH, Idi-araba, Lagos State. Professor A. T. Ajekigbe (B.pharm (Hons), MBBS, DMRT, FWACS, FMCR) Head, 4 Department of Radiotherapy/Consultant Clinical & Radiation Oncologist, Lagos University Teaching Hospital/College of Medicine, Idi-araba, Lagos. DEDICATION This book is dedicated to God Almighty for His grace and favour and to my late Father Engr. Ganiyu Toye Layioye for laying a good foundation. 5 ACKNOWLEDGEMENTS I wish to acknowledge the Department of Radiotherapy, Lagos University Teaching Hospital, Idi -araba, Lagos for the privilege to undergo my training in Radiation Oncology. My Teachers and Consultants at Lagos University Teaching Hospital namely Prof K.K. Ketiku, Prof. F.A. Durosinmi-Etti, Prof A.T. Ajekigbe, Dr A.C. Sowunmi and Dr M.Y.M. Habeebu for their immeasurable contributions and inspiration. You gave me the best of your wealth of knowledge and time. Prof (Mrs) F. B. Akinsola for supervising the project and the motherly role you have played in my home. To my Teachers and Consultants in other Institutions namely Prof. O. B Campbell, Dr A.A. Adenipekun, Dr R.A. Oyesegun, Dr T.N. Elumelu-Kupoluyi, Dr A.A. Abdussalam, Dr A.I. Ntekim, Dr A.M. Folasire, Dr O. Ogunnorin, Dr Igbinoba, Dr N.Y. Okunnuga, Dr O. Iyare, Dr O. Salako and Prof M.A. Aweda. I say thank you for your 6 contributions to my training. You are all highly appreciated. I thank my colleagues and other members of the Department both medical and non-medical for their support and assistance during my period of study. My appreciation also goes to my darling husband (Dr Adegboyega Alabi) for his untiring love, support and encouragements all the way, my adorable sons: Timi and Temi, thank you for understanding and the sacrifices you made during the period of my study and to my wonderful Mother for always being there. Finally to the Almighty God without whom all this would have been impossible, you are Highly Honored. TABLE OF CONTENTS TITLE PAGE i DECLARATION ii CERTIFICATION iii DEDICATION v ACKNOWLEDGEMENTS vi TABLE OF CONTENTS vii SUMMARY viii 7 INTRODUCTION 1 AIM AND OBJECTIVES 4 LITERATURE REVIEW 5 MATERIALS AND METHODS 43 RESULTS 47 DISCUSSION 57 LIMITATIONS 60 CONCLUSION 61 RECOMMENDATIONS 62 REFERENCES 63 APPENDIX 68 SUMMARY Introduction: Orbito-ocular malignancies (OOM) generally are rare tumours1 with age adjusted incidence rate of 0.8per 100,000 per year in the United States2. Most ocular tumours are seen in adults with some peculiar to the paediatric age group. Uveal melanomas are the most common primary intraocular malignancies in adult in the United States and Europe3,4. Retinoblastoma is the commonest malignant intraocular tumour in 8 childhood with a potential for curative intent3,4. Studies in Nigeria, have shown prevalence of Squamous cell carcinoma in adults and retinoblastoma as the commonest ocular malignancy and commonest orbital cancer in children5,6. The main goals of treatment for Orbito-ocular tumours (OOT) in order of importance include: to save life, to save the eye and preserve vision7. Aim and Objectives: To review the management of orbito-ocular malignancies in the Departments of Radiotherapy and Ophthalmology, Lagos University Teaching Hospital, between January 1997 and December 2011 in comparison to previous and recent studies globally. Methodology: This is a retrospective study of Orbito-ocular malignancies seen at the Departments of Radiotherapy and Ophthalmology, LUTH from 1997 to 2011. Case files and treatment cards were retrieved through the record departments and the information required was extracted with the aid of a data extraction form. Results: A total of 98 cases with histologically confirmed orbito-ocular malignancies seen during the 15 year study period were analyzed. The age range was to <1 – 83years, mean of 22.94years (SD 24.64years). Majority, 54 were children accounting for <10years of age. Retinoblastoma (52.0%) was the commonest histological type seen in children while Squamous cell carcinoma (25.5%) was the commonest in adult. The most common presenting complaints were proptosis seen in 47 patients followed by leucokoria seen in 20 patients. 17 patients had a combination of Radiotherapy, Surgery and Chemotherapy. 91 9 patients had surgery, 31% had enucleation while 34% had exenteration. 36 patients had Chemotherapy. 44 patients benefited from radiotherapy, radical treatment was offered to 24 patients. Total radical treatment dose was 35-65Gy in 20-35 fractions over 4-7weeks. 84 patients were lost to follow up. 5 died from disease progression and 4 are still alive and are seen in the clinic on follow up. Conclusion: This study showed that the use of multimodality treatment was implemented but did not improve survival because majority of patients presented late. The need for a collaborative effort in early detection and prompt referral for treatment of cancer cases cannot be overemphasized. INTRODUCTION Orbito-ocular malignancies (OOM) generally are rare tumours1,4 with age adjusted incidence rate of 0.8per 100,000 per year in the United States2. Most ocular tumours are seen in adults with some specific to the paediatric age group. These tumours are limited to malignancies developing from the eye, orbit or the lids. The eye consists of various anatomic and functional elements including the Conjunctiva, Cornea, Uvea, Lens, Vitreous, Retina and Optic nerve. All these structures can form malignancies with pathologic processes4. Secondary ocular malignancies are rare but are commoner than primary malignancies of the eye4. 10 Uveal melanomas are the most common primary intraocular malignancies in adult3 in the United States and Europe with incidence estimated at 7 per million per year1,4. Retinoblastoma is the most common malignant intraocular tumour in childhood with a potential for curative intent1. Its incidence is 1 in 15,000-20,000 live births1,2,4. It usually presents before 3 years of age1. A Nigeria based study by Annunobi et al showed that retinoblastoma is the most common ocular malignancy in all age groups5. It accounts for 85% of all Orbito-Ocular Tumours (OOT) in the South Western part of Nigeria5. It also showed Rhabdomyosarcoma as the most common orbital malignancy occurring in childhood in the South Western part of Nigeria5. In adults, Squamous cell carcinoma was the most common malignant conjunctiva lesion with a mean age of 45 years5. The age adjusted incidence rate for Orbito-Ocular malignancies from 2005-2009 was 0.8 per 100,000 men and women per year in the United States2. Overall 5 year survival rate was 83.1% and the life time risk was 0.08% (1 in 1256 persons)2. There is an increase in incidence of both primary and secondary malignancies in both pediatric and adult tumours owing to better diagnosis and increase awareness6. Better treatment options are now available which has helped in proffering better treatment outcomes. The main goals of treatment for OOM in order of importance include: to save life, to save the eye and preserve vision7. In retinoblastoma, cure can be achieved8. The awareness and knowledge of Orbito-Ocular malignancies in developing countries such as Nigeria is low due to suboptimal awareness programmes, poor health seeking attitudes, faith healing belief and etc. These had led to patients seeking alternative traditional 11 treatment thus increasing the number of patients presenting with advanced stage of the disease6,9. Various treatment modalities are available for different stages of disease. These include Surgery, Radiotherapy (External Beam Radiotherapy or Brachytherapy),
Load more

Recommended publications
  • Ocular Oncology and Pathology 2018 Hot Topics in Ocular Pathology and Oncology— an Update
    Ocular Oncology and Pathology 2018 Hot Topics in Ocular Pathology and Oncology— An Update Program Directors Patricia Chévez-Barrios MD and Dan S Gombos MD In conjunction with the American Association of Ophthalmic Oncologists and Pathologists McCormick Place Chicago, Illinois Saturday, Oct. 27, 2018 Presented by: The American Academy of Ophthalmology 2018 Ocular Oncology and Pathology Subspecialty Day Advisory Committee Staff Planning Group Daniel S Durrie MD Melanie R Rafaty CMP DES, Director, Patricia Chévez-Barrios MD Associate Secretary Scientific Meetings Program Director Julia A Haller MD Ann L’Estrange, Subspecialty Day Manager Dan S Gombos MD Michael S Lee MD Carolyn Little, Presenter Coordinator Program Director Francis S Mah MD Debra Rosencrance CMP CAE, Vice R Michael Siatkowski MD President, Meetings & Exhibits Former Program Directors Kuldev Singh MD MPH Patricia Heinicke Jr, Copy Editor 2016 Carol L Shields MD Mark Ong, Designer Maria M Aaron MD Gina Comaduran, Cover Designer Patricia Chévez-Barrios MD Secretary for Annual Meeting 2014 Hans E Grossniklaus MD Arun D Singh MD ©2018 American Academy of Ophthalmology. All rights reserved. No portion may be reproduced without express written consent of the American Academy of Ophthalmology. ii Planning Group 2018 Subspecialty Day | Ocular Oncology & Pathology 2018 Ocular Oncology and Pathology Planning Group On behalf of the American Academy of Ophthalmology and the American Association of Ophthalmic Oncologists and Pathologists, it is our pleasure to welcome you to Chicago and
    [Show full text]
  • Pigmented Medulloepithelioma of the Ciliary Body
    CLINICOPATHOLOGIC REPORTS, CASE REPORTS, AND SMALL CASE SERIES SECTION EDITOR: W. RICHARD GREEN, MD lomata acuminata. While receiving flamed fibrovascular cores Conjunctival Papillomas highly active antiretroviral therapy (Figure 2). Nucleated keratino- Caused by Human (HAART), including indinavir sul- cytes from the paraffin-embedded Papillomavirus Type 33 fate, nevirapine, and combivir, he has specimen were microdissected un- had no new opportunistic infections der direct visualization. After protein- Conjunctival papillomas are associ- and his CD4+ cell count has in- ase K digestion, DNA sequences for ated with human papillomavirus creased above 200/mm3. He sought HPV genotypes 16, 18, and 33 were (HPV) infection. In children, the le- ophthalmic care because of occa- amplified with a kit (PCR Human sions are typically manifestations of sional bleeding from the conjuncti- Papillomavirus Detection Kit; Pan an infection acquired during deliv- val lesions. An initial ocular exami- Vera, Madison, Wis) and transblot- ery.1 In adults, conjunctival papillo- nation revealed bilateral inferior ted for Southern blot hybridization. mas are most likely venereal and are palpebral conjunctival papillomas that Briefly, the common sense primer for often associated with anogenital le- were excised from the right eye. The HPV types 16, 18, and 33 was 5Ј- sions.2 Papillomas due to HPV more results of a histopathologic examina- AAGGGCGTAACCGAAATC- frequently progress to malignancy in tion showed conjunctival papillo- GGT-3Ј and the antisense primers of patients with the human immuno- mas without atypia. The results of an each HPV strain were as follows: 5Ј- deficiency virus (HIV) infection.3 Hu- immunohistochemistry test for HPV GTTTGCAGCTCTGTGCATA-3Ј for man papillomavirus types 6, 11, 16, types 6, 11, 16, 18, 31, and 33 was HPV 16, 5Ј-GTGTTCAGTTCCGT- and 18 have been identified in be- negative.
    [Show full text]
  • Bilateral Iridociliary T-Cell Lymphoma
    CLINICOPATHOLOGIC REPORTS, CASE REPORTS, AND SMALL CASE SERIES SECTION EDITOR: W. RICHARD GREEN, MD lomata acuminata. While receiving flamed fibrovascular cores Conjunctival Papillomas highly active antiretroviral therapy (Figure 2). Nucleated keratino- Caused by Human (HAART), including indinavir sul- cytes from the paraffin-embedded Papillomavirus Type 33 fate, nevirapine, and combivir, he has specimen were microdissected un- had no new opportunistic infections der direct visualization. After protein- Conjunctival papillomas are associ- and his CD4+ cell count has in- ase K digestion, DNA sequences for ated with human papillomavirus creased above 200/mm3. He sought HPV genotypes 16, 18, and 33 were (HPV) infection. In children, the le- ophthalmic care because of occa- amplified with a kit (PCR Human sions are typically manifestations of sional bleeding from the conjuncti- Papillomavirus Detection Kit; Pan an infection acquired during deliv- val lesions. An initial ocular exami- Vera, Madison, Wis) and transblot- ery.1 In adults, conjunctival papillo- nation revealed bilateral inferior ted for Southern blot hybridization. mas are most likely venereal and are palpebral conjunctival papillomas that Briefly, the common sense primer for often associated with anogenital le- were excised from the right eye. The HPV types 16, 18, and 33 was 5Ј- sions.2 Papillomas due to HPV more results of a histopathologic examina- AAGGGCGTAACCGAAATC- frequently progress to malignancy in tion showed conjunctival papillo- GGT-3Ј and the antisense primers of patients with the human immuno- mas without atypia. The results of an each HPV strain were as follows: 5Ј- deficiency virus (HIV) infection.3 Hu- immunohistochemistry test for HPV GTTTGCAGCTCTGTGCATA-3Ј for man papillomavirus types 6, 11, 16, types 6, 11, 16, 18, 31, and 33 was HPV 16, 5Ј-GTGTTCAGTTCCGT- and 18 have been identified in be- negative.
    [Show full text]
  • Review of Ophthalmic Tumors
    REVIEW OF OPHTHALMIC TUMORS Jerry A. Shields MD and Carol L. Shields MD Oncology Service, Wills Eye institute, Philadelphia February 2013 This review covers the most important aspects of selected benign and malignant tumors and related lesions of the eyelids, conjunctiva, globe, and orbit. It is designed as a review for the practicing ophthalmologist and as a preparatory course for the candidate for board examinations in ophthalmology. A self-assessment quiz will be given, followed by a didactic lecture and then the quiz will be repeated. Subjects of less importance will be included in the outline but mentioned only briefly in the lecture. Subjects of greater importance will be covered in more detail. It is not possible to cover all ocular tumors in this outline or in the discussion. For more comprehensive reading, please see the textbooks cited at the end of this outline. They cover all pertinent aspects of intraocular and adnexal tumors and related lesions and are designed to assist the applicant for OKAP and board examinations and also to assist in care of patients with ophthalmic tumors and many other related conditions. Ophthalmic tumor review- Shields - 2 2 Review of Ophthalmic Tumors Self-assessment Quiz 1. This eyelid lesion in an 80-year-old patient has shown slowly progressive enlargement for two years. Which statement is true? A. This viral induced lesion will eventually involute. B. Even though it is malignant, it lacks potential to metastasize. C. The affected patient is most likely HIV positive. D. This lipid-containing lesion is often confused with chalazion. E. It originates from mechanoreceptors for touch.
    [Show full text]
  • Tumores Intra-Oculares
    REVISÃO TEMÁTICA Tumores intra-oculares In tra ocular tumors Ruth Miyuki Santo (ir, Sarnir Jacob Bechara (2l INTRODUÇÃO O exame ocular externo merece destaque pela possibilida­ de de revelar sinais associados ao tumor intra-ocular, tais Os tumores intra-oculares compreendem um extenso elen­ como estrabismo ou heterocromia da íris no retinoblastoma, e co de lesões benignas e malignas, capazes de acarretar não congestão episcleral (vasos sentinelas) na neoplasia do corpo somente a perda da visão mas, também, da própria vida. A ciliar ou da coróide periférica. O exame do olho contralateral é correta abordagem destas lesões fundamenta-se na detecção importante, pelo fato de que tumores como o retinoblastoma, precoce e no diagnóstico preciso. Embora o diagnóstico de metástases uveais, astrocitomas podem ser bilaterais, en­ certeza dos tumores intra-oculares imponha confirmação quanto os melanomas e hemangiomas de coróide são, em histopatológica, técnicas de biópsia totalmente seguras ainda geral, unilaterais. Algumas lesões que podem simular tumor, não foram desenvolvidas 1• 2 e o procedimento da biópsia como a degeneração macular disciforme e a retinosquise, tam­ acaba sendo indicado apenas em casos selecionados. Entre­ bém são afecções usualmente bilaterais. tanto, recentemente, o advento de novos métodos prope­ Em virtude de sua importância para o diagnóstico dos tumo­ dêuticos por imagem em muito têm auxiliado o diagnóstico dos res intra-oculares, duas etapas do exame ocular devem ser subli­ tumores intra-oculares. Não obstante a falta da confirmação nhadas: a biomicroscopia e a oftalmoscopia. A biomicroscopia histopatológica, a decisão diagnóstica e terapêutica tem na lâmpada de fenda proporciona a visão das lesões com freqüentemente se pautado em informações fornecidas pelos magnificação e estereopsia, destacando-se como excelente métodos de imagem 3-5• método para a avaliação dos tumores e pseudotumores do seg­ A abordagem dos casos com suspeita de tumor intra­ mento anterior.
    [Show full text]
  • British Journal of Ophthalmology July 1988 Vol. 72 No. 7 British Medical Association Tavistock Square London WC1H
    British Journal of Ophthalmology July 1988 Vol. 72 No. 7 Br J Ophthalmol: first published as on 1 July 1988. Downloaded from Contents Changing patterns of early complications in cataract surgery with nexx techniques: a surgical a JlditJ\( I.ISON, J D MCHUGH, AND M G [ALC(ON page 481 The Ciapryna coaxial cannUla R V P'lARSON AND J I JAGiGIR page 485 Control of astigmatism in cataract surgerV NI(CHOLA0S A P BROWN \ND JOHN NI SP.\RROW\ page 487 Cobalt plaque versus enucleation for uveal melanoma: comparison of survival rates KIMBI RITY sA D SMS, DAVID H ABRAMSON, ROBI RI M 1-.1,S\VORTH, HARREII Ci HAIK, MIC'IIAII BEDORD. SAMULI PACKI.R, JOHANNA SEDDON, DANIEI AlB[ER[, AND IlllA PO01IVOGIANIS page 494 Intravitreal injection of fibroblasts: the pathological effects on the ocular tissues of the rabbit following aii intravitreal injection of autologous skin fibroblasts CATHRYN A HITC'HINS ANI) IAN CRIIlRSON page 498 Perforating eye injuries caused by darts M l) COIT AND) n SM[FRDON page 511 The one-and-a-half syndrome. Clinical correlation xNith a pontine lesion demonstrated by nucIlear magnetic resonance imaging in a case of multiple sclerosis c N MARlYN AND D KEAN page 515 Single-dose cefotaxime intramuscularlx cures gonococcal ophthalmia neonatorum P5i,(1l.II'PI II JOS BOGAERTS, PHILIIPPE KlS'I'IIYN, AND ANDR[ MIEHEUSpage 518 Intravenous and intraocular ganciclovir for CMV retinitis in patients with AI )S or chemotherapeutic immunosuppression GF.ORGE 1. DAIKOS, JOSI P IDO, SHASHI B KA-lIHPAl.IA. AND Gl1ORGi Gl ISAC(KSON page 521 http://bjo.bmj.com/ Treatment of cytomegalovirus retinitis with ganciclovir (9-1 2-h droxx - -( hx drox\vmeth\ lcthoxyvmethyl) guanine (BW B759U)) JUAN ORFI.IlANA.
    [Show full text]
  • Differential Diagnoses Symptoms and Other Useful Lists and Tables Signs Case Presentations for Ophthalmologists
    Differential Diagnoses Symptoms and other Useful Lists and Tables Signs Case Presentations For Ophthalmologists Kenn Freedman MD PhD Department of Ophthalmology and Visual Sciences Texas Tech University Health Sciences Center Lubbock, Texas USA Disclaimer and Acknowledgments The differential diagnoses and lists contained herein are not meant to be exhaustive, but are to give in most cases the most common causes of many ocular / visual symptoms, signs and situations. Included also in these lists are also some less common, but serious conditions that must be “ruled-out”. These lists have been based on years of experience, and I am grateful for God’s help in developing them. I also owe gratitude to several sources* including Roy’s classic text on Ocular Differential Diagnosis. This of course will continue to be a work in progress and any concerns or suggestions as to errors or omissions or picture copyrights will be considered. Please feel free to contact me at [email protected] Kenn Freedman Lubbock, Texas October 2018 * Please see references at end of document Use of this Presentation The lists are divided into three main areas 1. Symptoms 2. Signs from the Eight Point Eye Exam 3. Common Situations and Case Presentations The index for all of the lists is given on the following 3 pages. The lists follow in the presentation in the order shown in the index. Each entry in the index (blue) is also a link and when clicked will take to you that specific list in the document. If you want to go to another list within the document you will
    [Show full text]
  • Masquerade Syndromes
    Masquerade Syndromes Quan Dong Nguyen, M.D. Masquerade syndromes are disorders that occur with intraocular inflammation and are often misdiagnosed as a chronic idiopathic uveitis. The term "Masquerade Syndrome" was first used in 1967 to describe a case of conjunctival carcinoma that manifested as chronic conjunctivitis [22]. Today, it is used to describe disorders that stimulate chronic uveitis. Because of the nature of the underlying diseases, which often have detrimental consequences, early diagnosis and prompt treatment are critical. We present two cases to illustrate malignancy masquerading as chronic uveitis. Case 1 RB was a 30-year-old caucasian female who presented in August , 1984, with a six-month history of blurry vision in the right eye (RE). Her visual acuity was 1/100 RE and 20/20 LE. Slit lamp examination revealed 2+ iritis, RE. Dilated funduscopic examination of RE revealed vitritis with large cells, suspicious for malignancy, and yellow discrete lesions at the RPE with prominent pigment in the central macula (Figure 1). Dilated examination of the left eye only showed few drusen. Figure 1: Vitreous haze with subretinal lesions In September, 1984, the patient underwent pars plana vitrectomy, RE, which revealed atypical cells, suggestive of large cell lymphoma. Cranial magnetic resonance imaging (MRI) showed foci of hyperintensity in the corpus callosum, consistent with central nervous system (CNS) lymphoma. The patient was fully evaluated by an oncologist, and was treated with irradiation at the Massachusetts General Hospital (MGH). In October, 1994, the patient developed vitritis in LE. She was re-evaluated by her oncologist . The patient then received irradiation to the head and both eys.
    [Show full text]
  • Pediatric Orbital and Ocular Masses
    Pediatric Orbital and Ocular Disclosures Masses • No financial disclosure relative to this presentation Bernadette L. Koch, M.D. Departments of Radiology and Pediatrics Cincinnati Children’s Hospital Medical Center University Hospital Cincinnati, Ohio @CincyKidsRad facebook.com/CincyKidsRad Objectives Normal Bony Orbit Anatomy • Review imaging characteristics of the • Bony walls most common non-infectious/ non- • SOF – CN III, IV, V1, V2, SOV inflammatory orbital and ocular masses • IOF – IOV in children • Optic canal – ON, OA, sympathetic plexus Soft Tissue Anatomy Orbit Optic Nerve Sheath Complex • Muscle cone • Optic nerve –SR, IR, MR, LR •Fibrous annulus of Zinn to –Disc to chiasm anterior sclera • Sheath –SO, IO, levator palpebrae –Continuous with –SR complex = SR + LP intracranial meninges • Preseptal/postseptal –Orbital septum - Periosteal • Subarachnoid space reflection from bony orbit to tarsal plates –Barrier to spread of disease Normal Anatomy of Globe Ocular masses • Lens • Retinoblastoma Aqueous & vitreous segment • Retinal astrocytoma • Iris • Melanoma Anterior & posterior chamber • Vascular lesion Sturge Weber • Posterior hyaloid membrane • Medulloepithelioma Lines vitreous cavity • Metastasis • Retina – inner sensory, outer • Hamartoma pigmented • Osteoma • Uvea = choroid, ciliary body, iris • Primary intraocular lymphoma • Sclera/Cornea Ocular masses Leukocoria = white pupillary • Retinoblastoma reflex indicating ocular disease • Retinal astrocytoma • Retinoblastoma • Melanoma • Retinal astrocytoma • Vascular lesion
    [Show full text]