Assuntos
Neoplasias da Coroide , Neovascularização de Coroide , Osteoma , Humanos , Corioide , Neovascularização de Coroide/complicações , Neovascularização de Coroide/diagnóstico , Osteoma/complicações , Osteoma/diagnóstico , Tomografia de Coerência Óptica , Angiofluoresceinografia , Neoplasias da Coroide/complicações , Neoplasias da Coroide/diagnósticoRESUMO
PURPOSE: During the surgical correction of dysthyroid diplopia, the risk of ischemia by transection of the anterior ciliary arteries is well-known. In order to avoid this, we modified the classical surgical technique: (1) through the preservation of the vascular pedicles during muscle recession and (2) if necessary, through a plication (instead of a resection) of the ipsilateral antagonist muscle. The objective to be achieved is thus the resolution of the diplopia without ischemic complications. SUBJECTS AND METHODS: We report a prospective series of 10 patients with dysthyroid ophthalmopathy, causing strabismic diplopia, all operated on by the same surgeon (BR) after at least 12 months of euthyroidism. Data collection included: history of previous decompressive surgery, surgical procedure, and oculomotor status before and after surgery. RESULTS: Ten patients (8 females), aged 51 to 74 years (mean age, 58.00 ± 7.62 years), were collected between 2008 and 2012. All patients had one or more vascular risk factors (diabetes, smoking, obesity, high blood pressure). With a follow-up from 16 to 67 months (mean ± SD 27.7 months ± 14.87), surgical outcomes were excellent: diplopia was cured in all cases, with recovery of stereoscopic vision. We had no operative or postoperative complications. CONCLUSIONS: The technique of preservation of the anterior ciliary vascularization, which is particularly justified for these fragile patients, is compatible with moderate muscle recessions. For larger deviations, in which a larger recession might increase the proptosis, it is possible to add a plication of the ipsilateral antagonist. This surgical technique made possible the suppression of the diplopia in all cases.
Assuntos
Artérias Ciliares/cirurgia , Diplopia/cirurgia , Oftalmopatia de Graves/cirurgia , Tratamentos com Preservação do Órgão/métodos , Idoso , Diplopia/etiologia , Feminino , Oftalmopatia de Graves/complicações , Humanos , Isquemia/prevenção & controle , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Estudos RetrospectivosRESUMO
Cavernous hemangioma is the most common primary vascular neoplasm. It typically occurs in middle-aged women, causing a progressive painless proptosis as the principal symptom. It exceptionally compresses the optic nerve. We report the case of a cavernous hemangioma revealed by optic neuropathy in a 33-year-old female.