Diagnostic Utility of Computerized Tomography in Patients with Orbital Lesions at Tirupati, Andhra Pradesh

Abstract

BACKGROUND Computer tomography (CT) plays a crucial role in elucidating the etiological diagnosis and identifying the extent of orbital lesions related to thyroid eye disease, cellulitis, orbital osteomyelitis, bone tumours, mucocele, orbital varices and cavernous hemangioma. This study was intended to assess the diagnostic utility of CT in patients presenting with orbital lesions. METHODS We enrolled 30 consecutive patients presenting with orbital lesions, who underwent complete ophthalmological, systemic examination, computerized tomography, and other appropriate systemic investigations over one year period. RESULTS In our clinical cohort of 30 patients, the spectrum of encountered orbital lesions included thyroid eye disease in 8 (26.6 %), orbital fractures in 5 (16.6 %), pre-septal hematoma in 3 (10 %), cellulitis in 3 (10 %), lymphoproliferative lesions in 2 (6.6 %), orbital lymphomas in 2 (6.6 %), orbital mucocele in 2 (6.6 %) cavernous hemangioma in 1 (3.3 %), frontal bone osteomyelitis in 1 (3.3 %), orbital varices in 1 (3.3 %), osteoma in 1 (3.3 %) and orbital meningioma in 1 (3.3 %) patients. Proptosis was observed in 22 (77 %) patients. On CT imaging, lesion attenuation was hyperdense in 28 (92 %) and isodense in 2 (8 %) patients. Lesions were extraconal in 19 (63 %), conal in 8 (27 %) and intraconal in 3 (10 %) patients. Extraocular muscle involvement was seen in 8 (27 %) and bone involvement in 11 (37 %) cases. CONCLUSIONS Computerized tomography in the orbital lesions accurately established the nature and extent of lesions. In 100 % of cases, CT was helpful in deciding appropriate systemic investigations to establish the etiological diagnosis. KEY WORDS Computerized Tomography, Orbital Lesions, Etiological Diagnosis.