RESUMO
BACKGROUND: Cavernous venous malformation (CVM) is a common benign vascular lesion of the orbit. It was previously known as "orbital cavernous hemangioma". Localization within the lacrimal gland is extremely rare. CASE PRESENTATION: We describe the case of a 76-year-old man with an asymptomatic CVM of the left lacrimal gland incidentally discovered on a routine MRI. A curative and diagnostic en bloc surgical resection was performed, allowing for histological diagnosis. CONCLUSIONS: CVM of the lacrimal gland is extremely rare and usually asymptomatic. Proptosis is the main symptom. On MRI, the lesion appears hypointense with heterogeneous enhancement after Gadolinium injection on T1-weighted imaging and hyperintense on T2 STIR-weighted imaging. Histological examination is mandatory for the diagnosis. Surgical resection is usually performed.
Assuntos
Exoftalmia , Hemangioma Cavernoso , Aparelho Lacrimal , Neoplasias Orbitárias , Idoso , Humanos , Imageamento por Ressonância Magnética , MasculinoRESUMO
PURPOSE: To demonstrate a decrease in distance visual acuity (VA) following instillation of mydriatic eyedrops in eyes with exudative age-related macular degeneration (AMD). MATERIALS AND METHODS: A prospective assessment in clinical practice was conducted in our ophthalmology department at the University Hospital of Tours from 7/19/2018 to 8/29/2018. Distance (ETDRS) and near (Parinaud) VA were assessed before and after instilling one drop each of tropicamide 0.5% and phenylephrine 10% in the 40 included eyes with exudative AMD. RESULTS: The mean difference in distance VA before and after pupillary dilation (PD) was 0.06 LogMAR (SD=0.14) (P<0.01), i.e. -3.05 letters read (SD=7.52) on the ETDRS chart (P=0.01). For near VA, the mean difference was 0.16 LogMAR (SD=0.16) (P<0.001), i.e. -1.58 paragraphs read (SD=1.63) on the Parinaud chart (P<0.001). DISCUSSION: The absence of a clinically significant loss in post-dilation distance VA for exudative AMD could be explained by negligible glare coming from the ETDRS chart, milder photophobia, low pre-dilation VA's and a balance between higher order optical aberrations and diffraction. The opposite result for near VA could essentially be explained by greater glare induced by the light illuminating the Parinaud chart. CONCLUSION: Our primary goal was not achieved. A study presuming the absence of a clinically significant decrease in post-dilation distance VA would be necessary to consider directly measuring post-dilation VA in eyes with exudative AMD in our daily practice.