[Detection of orbital foreign bodies by CT: are plain radiographs of foreign bodies still useful?]. / Darstellbarkeit von Orbita-Fremdkörpern in der CT. Ist die Fremdkörperübersicht noch sinnvoll?

PURPOSE: To prove the visualisation of orbital foreign bodies by CT. MATERIALS AND METHODS: In vitro we examined defined small objects of various materials (metal, wood, glass, stone) which are common as orbital foreign bodies, Density and minimum detectable size were studied. The findings of 27 patients with suspected orbital foreign bodies were compared with the results of plain radiographs, Comberg radiographs, sonography, and surgery. RESULTS: For iron, the minimum detectable size was 0.02 mm3. A differentiation of various materials by CT was not always possible, especially in small objects. There were wide differences in density of wood (-600 HU to +130 HU) according to hardness and water content. The CT scans correctly showed number and location of foreign bodies. Other methods were inferior in detection of foreign bodies. CONCLUSION: In diagnosis of foreign body injuries of the orbit, CT is the imaging method of choice.

[Acute blindness caused by fungal infection in chronic myeloid leukemia]. / Akute Erblindung durch Pilzinfektion bei chronisch myeloischer Leukämie.

PATIENT: A 35-year-old man had suffered from leukemia since September 1990. A transplantation of bone marrow was carried out in February 1994. He developed a graft-versus-host disease in November 1995. In December 1995 a keratoplasty was necessary because of a perforated corneal ulcer. 17 days later the patient noted a complete loss of vision, first in the left and one day later in the right eye. The optic nerve head was white and the retina looked ischaemic like in central retinal artery occlusion. A hypodensic area was found in the frontal brain reaching up to the optic chiasm in computer tomography. Inspite of intensive treatment the immunosuppressed patient died 4 days after he had become blind. Autopsy showed a mycotic infiltration by mucormycosis of the brain and the right optic nerve sheath. This human- pathogenic fungal infection belongs to the group of mould as well as aspergillus. CONCLUSION: Mycosis should be considered in the differential diagnosis of acute visual loss in immunosuppressed patients.