Orbit by Xiu
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The document describes various anatomical structures of the orbit and eye, including: 1) The bony orbit is formed by the frontal, sphenoid, maxillary, zygomatic, ethmoid, and palatine bones. It contains openings like the optic canal and infraorbital foramen. 2) The extraocular muscles include the four recti and two oblique muscles originating at the orbital apex. 3) The orbit contains the lacrimal gland, eyelids, optic nerve, ophthalmic artery, and ophthalmic veins. 4) Common orbital pathologies discussed include thyroid orbitopathy, dermoid cysts, hematologic cysts, and cholesterol granulomas.
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Orbit by Xiu
- 1. THE ORBIT
- 22. The eyelids
- 37. Intraorbital segment CN II: optic nerve
- 40. Intracanalicular Segment CN II: optic nerve Dura of CN2 fuses with orbital periosteum (Periorbita)
- 42. Axial CT CN II: optic nerve
- 43. CN II: optic nerve Axial T2/ inferior to superior
- 44. CN II: optic nerve
- 45. CN II: optic nerve
- 46. CN II: optic nerve
- 47. CN II: optic nerve
- 48. CN II: optic nerve
- 49. CN II: optic nerve
- 50. CN II: optic nerve
- 51. CN II: optic nerve
- 52. CN II: optic nerve
- 53. CN II: optic nerve
- 54. CN II: optic nerve
- 55. CN II: optic nerve
- 56. CN II: optic nerve
- 57. CN II: optic nerve
- 58. CN II: optic nerve
- 60. PATHOLOGY
- 90. Hematic Cysts and Cholesterol Granuloma MR findings of Subperiosteal hematomas
- 130. STAGING OF ORBITAL CELLULITIS
- 206. Capillary Hemangioma (Benign Hemangioendothelioma) Treatment options include observation and topical, oral, or intralesional corticosteroid therapy. Interferon therapy, laser therapy, and surgery typically are reserved for patients with potentially life-threatening complications .
- 216. At histologic analysis, large dilated vascular channels lined by flattened or attenuated endothelial cells with an intervening fibrous interstitium are visible Vascular lesion > Cavernous Hemangioma
- 218. Copyright ©Radiological Society of North America, 2008 CECT Cavernous malformation in a 39-year-old woman with painless progressive proptosis
- 222. Copyright ©Radiological Society of North America, 2008 Large cavernous malformation cavernous malformation in a 43-year-old woman with painless proptosis of the right eye Axial T1-weighted MR image Axial contrast enhanced T1-weighted fat-suppressed, image, obtained immediately after the intravenous administration of a gadolinium-based contrast material Axial contrastenhanced T1-weighted fat-suppressed MR image, obtained 1 hour later
- 225. Copyright ©Radiological Society of North America, 2008 Venous lymphatic malformation in a 5-year-old girl during an upper respiratory tract viral infection. after the patient recovered from the viral infection
- 228. Copyright ©Radiological Society of North America, 2008 Axial unenhanced CT image Venous lymphatic malformation in an 11-year-old boy with progressive proptosis of the right eye and lateral displacement of the globe
- 232. Copyright ©Radiological Society of North America, 2008 Photograph obtained with the patient at rest Conjunctival orbital varix in a 56-year-old man whose right eyelid bulges when straining Photograph obtained during the Valsalva maneuver
- 233. Copyright ©Radiological Society of North America, 2008 Conjunctival orbital varix in a 56-year-old man whose right eyelid bulges when straining Photograph obtained with the upper eyelid elevated
- 235. Copyright ©Radiological Society of North America, 2008 Orbital varix in a 33-year-old woman with proptosis when straining prone supine CE T1-weighted fat-suppressed images
- 236. Copyright ©Radiological Society of North America, 2008 CECT image obtained with the patient at rest Bilateral orbital varices in a 27-year-old woman with a sensation of eye pressure when stooping to pick up her child CECT image obtained with the patient at Valsalva maneuver
- 242. Copyright ©Radiological Society of North America, 2008 Carotid cavernous fistula in a 52-year-old woman with proptosis, chemosis, and conjunctival injection Axial T2-weighted MR images Axial maximum intensity projection image from MR angiography
Editor's Notes
- The anatomy of the medial orbital wall . Key : ALC, anterior lacrimal crest; LF, lacrimal fossa; PLC, posterior lacrimal crest; LP, lamina papyracea; AEF, anterior ethmoidal foramen; PLF, posterior ethmoidal foramen; OC, optic canal; MES, maxilloethmoid suture .
- The anatomy of the medial orbital wall . Key : ALC, anterior lacrimal crest; LF, lacrimal fossa; PLC, posterior lacrimal crest; LP, lamina papyracea; AEF, anterior ethmoidal foramen; PLF, posterior ethmoidal foramen; OC, optic canal; MES, maxilloethmoid suture .
- The anatomy of the medial orbital wall . Key : ALC, anterior lacrimal crest; LF, lacrimal fossa; PLC, posterior lacrimal crest; LP, lamina papyracea; AEF, anterior ethmoidal foramen; PLF, posterior ethmoidal foramen; OC, optic canal; MES, maxilloethmoid suture .
- 1 , Frontal sinus; 2 , orbital plate of frontal bone; 3 , nasal bone; 4 , frontal process of maxilla; 5 , lacrimal groove; 6 , lacrimal bone; 7 , lamina papyracea; 8 , palatine bone; 9 , sphenoid bone; 10 , lesser wing of the sphenoid bone; 11 , optic canal; 12 , posterior ethmoid foramen; 13 , anterior ethmoid foramen; 14 , infraorbital canal (foramen); 15 , inferior concha; 16 , maxillary hiatus; 17 , palatine bone; 18 , sphenopalatine foramen opening into pterygopalatine fossa; 19 , vidian canal, opening into pterygopalatine fossa; 20 , pterygoid plate; 21 , alveolar process of maxilla.
- The anatomy of the medial orbital wall . Key : ALC, anterior lacrimal crest; LF, lacrimal fossa; PLC, posterior lacrimal crest; LP, lamina papyracea; AEF, anterior ethmoidal foramen; PLF, posterior ethmoidal foramen; OC, optic canal; MES, maxilloethmoid suture . Lacrimal sac in lacrimal groove Lacrimal gland in lacrimal fossa
- The anatomy of the medial orbital wall . Key : ALC, anterior lacrimal crest; LF, lacrimal fossa; PLC, posterior lacrimal crest; LP, lamina papyracea; AEF, anterior ethmoidal foramen; PLF, posterior ethmoidal foramen; OC, optic canal; MES, maxilloethmoid suture .
- 8 , palatine bone;
- 2 , orbital process of maxilla; infraorbital groove ( black arrowheads ), and infraorbital foramen ( curved arrow ). V2, IOV
- Anatomy of the lateral orbital wall, anterior view. Key: GWS, greater wing of sphenoid; SOF, superior orbital fissure; FZS, frontozygomatic suture; FSS, frontosphenoid suture; ZSS, zygomaticosphenoid suture; ZB, zygomatic bone; ZFF, zygomaticofacial oramen; LT, lateral tubercle.
- Anatomy of the lateral orbital wall, anterior view. Key: GWS, greater wing of sphenoid; SOF, superior orbital fissure; FZS, frontozygomatic suture; FSS, frontosphenoid suture; ZSS, zygomaticosphenoid suture; ZB, zygomatic bone; ZFF, zygomaticofacial oramen; LT, lateral tubercle.
- B , Schematic frontal drawing of bony orbit. 1 , Frontal process of maxilla; 2 , lacrimal groove; 3 , lacrimal bone; 4 , lamina papyracea; 5 , optic canal (foramen); 6 , superior orbital fissure; 7 , frontal bone; 8 , greater wing of the sphenoid; 9 , orbital plate of zygomatic bone; 10 , inferior orbital fissure; 11 , infraorbital groove; 12 , zygoma (malar bone); 13 , infraorbital foramen; 14 , supraorbital foramen.
- B , Schematic frontal drawing of bony orbit. 1 , Frontal process of maxilla; 2 , lacrimal groove; 3 , lacrimal bone; 4 , lamina papyracea; 5 , optic canal (foramen); 6 , superior orbital fissure; 7 , frontal bone; 8 , greater wing of the sphenoid; 9 , orbital plate of zygomatic bone; 10 , inferior orbital fissure; 11 , infraorbital groove; 12 , zygoma (malar bone); 13 , infraorbital foramen; 14 , supraorbital foramen. The pterygoid canal ( also vidian canal ) is a passage in the skull leading from just anterior to the foramen lacerum in the middle cranial fossa to the pterygopalatine fossa . It transmits the vidian nerve (CN VII) and vidian a . ECA
- Meibomian glands These glands secrete oil into the tear film that keeps the tears from evaporating too quickly. Meibomian glands may become inflamed and swell into a granulomatous chalazion that needs to be excised. Don’t confuse a chalazion with a stye. A stye is a pimple-like infection of a sebaceous gland or eyelash ollicle, similar to a pimple, and is superficial to the tarsal plate. Styes are painful, while chalazions are not.
- The orbicularis oculi closes the eyelids and is innervated by cranial nerve 7. Patients with a facial nerve paralyses, such as after Bell’s Palsy, can’t close their eye and the eye may need to be patched (or sutured closed) to protect the cornea. The levator palpebrae opens the eye and is innervated by CN3. Oculomotor nerve palsy is the major cause of ptosis (drooping of the eye). In fact, a common surgical treatment for ptosis involves shortening the levator tendon to open up the eye. pillar
- peripheral orbital space ( ps ); central orbital (intraconal) space ( CS ); optic nerve; superior rectus muscle ( S ) and inferior rectus muscle ( I ); inferior oblique muscle ( IO ); orbital septum ( curved arrow ); and common tendon of Zinn ( arrows ). Periosteum (periorbita) lines bony orbit as orbital fascia and is loosely attached to bony orbit. Periosteum is united with dura mater and sheath of optic nerve at optic canal. Normally, periosteum cannot be differentiated from adjacent soft tissues. Periosteum is continuous with periosteum of the bones of the face and is also continuous with layer of dura at superior orbital fissure. Note continuity of periorbita with periosteum of pterygomaxillary fossa ( PF ). Infection or infiltrative process of pterygomaxillary fossa may invade orbital subperiosteal space (periorbita) or vice versa.
- Four rectus muscles control each eye. These muscles insert at the sclera, behind the limbus, and each pull the eye in the direction of their attachment. The superior, medial, and inferior rectus muscles are all controlled by the oculomotor nerve (III). The lateral rectus, however, is controlled by the abducens (VI) nerve, which makes sense as the lateral rectus “abducts” the eye.
- Four rectus muscles control each eye. These muscles insert at the sclera, behind the limbus, and each pull the eye in the direction of their attachment. The superior, medial, and inferior rectus muscles are all controlled by the oculomotor nerve (III). The lateral rectus, however, is controlled by the abducens (VI) nerve, which makes sense as the lateral rectus “abducts” the eye.
- Gay anatomy IOV to SOv?
- ส่วนใหญ่จะรู้จาก clinical, Lab และ immaging ใช้ในการ confirm เท่านั้น
- ส่วนใหญ่จะรู้จาก clinical, Lab และ immaging ใช้ในการ confirm เท่านั้น
- ส่วนใหญ่จะรู้จาก clinical, Lab และ immaging ใช้ในการ confirm เท่านั้น
- ส่วนใหญ่จะรู้จาก clinical, Lab และ immaging ใช้ในการ confirm เท่านั้น
- ส่วนใหญ่จะรู้จาก clinical, Lab และ immaging ใช้ในการ confirm เท่านั้น
- ส่วนใหญ่จะรู้จาก clinical, Lab และ immaging ใช้ในการ confirm เท่านั้น
- ส่วนใหญ่จะรู้จาก clinical, Lab และ immaging ใช้ในการ confirm เท่านั้น
- ส่วนใหญ่จะรู้จาก clinical, Lab และ immaging ใช้ในการ confirm เท่านั้น
- ส่วนใหญ่จะรู้จาก clinical, Lab และ immaging ใช้ในการ confirm เท่านั้น
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Mucormycosis is the term used to describe fungal infections caused by fungi in the order Mucorales ,
- Pseudotumor: periscleritis/perineuritis. Postcontrast axial CT scan shows diffuse thickening of the scleral coat with inflammatory infiltration into Tenon’s space ( T ) and perineuritis ( arrow ).
- This disease must be differentiated from true tumors of the orbit such as cavernous hemangioma, hemangiopericytoma, optic nerve sheath meningioma, optic nerve glioma, orbital schwannoma, and metastasis.
- Pseudotumor. Axial CT scan shows diffuse infiltration of the entire retrobulbar space. The optic nerve appears as a lucent band ( arrow ) embedded within the lesion.
- Pseudotumor. A , Axial PW MR image. B , Axial T2-weighted MR image. Scans show infiltrative process ( arrows ) compatible with pseudotumor. The lesion is isointense to brain on PW and T2-weighted MR scans.
- EOM enlargement Thyroid obthalmopathy. Pseudotumor. Carotidcavernous fistula. Aranulomatous disease. Neoplasm (primary or metastatic).
- EOM enlargement Thyroid obthalmopathy. Pseudotumor. Carotidcavernous fistula. Aranulomatous disease. Neoplasm (primary or metastatic).
- Myositic pseudotumor. Postcontrast Axial CT scan shows marked thickening and enhancement of the left medial rectus muscle ( arrow ). Note extension of the process into its tendinous insertion on the globe ( arrowhead ).
- Pseudotumor in a 12-year-old girl simulating a rhabdomyosarcoma.
- In contrast to optic neuritis, pain is exacerbated with retrodisplacement of the globe, and there is mild proptosis.
- A , Pseudotumor (perineuritis type). Axial CT scan shows the intraconal region of infiltration ( arrowheads ) surrounding the left optic nerve. Slight thickening of the posterior sclera indicates posterior scleritis and fluid (exudate) in Tenon’s space.
- Reactive lymphoid hyperplasia, lymphoma, and pseudotumor of the lacrimal gland. A , Axial proton-weighted MR image showing a presumed reactive lymphoid hyperplasia ( arrow ). B , Axial T1WI showing lacrimal gland lymphoma ( arrow ). C , Axial T1WI showing pseudotumor of the lacrimal gland ( arrow ).
- Orbital sarcoidosis presenting as superior orbital fissure syndrome. A , Unenhanced axial T1 WI . Note the infiltrative process involving the orbital apex on the left side ( large arrow ). Note extension through the superior orbital fissure into the left temporal epidural space ( arrowheads ). B , Enhanced axial T1 WI FS show marked enhancement of this sarcoid granulomatous infiltration ( straight arrows ). Note the abnormal enhancement in the left temporal fossa
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: Radiation optic neuropathy
- Acute inflammatory process involving the optic nerve. Multiple sclerosis = M/C cause of Opic neuritis. Typical unilateral visual loss. Optic neuritis = often an early sign of MS. Infection : syphilis (neuroretinitis, papillitis, and perineuritis); toxoplasmosis; toxocariasis (papillitis); and, uncommonly, borreliosis (Lyme disease) and other granulomatous diseases. parainfections : occurring 10 to 14 days after the primary illness. Chicken pox, rubella, rubeola, mumps, herpes zoster, mononucleosis, and viral encephalitis Typical bilateral visual loss, autoimmune optic neuritis: SLE or other autoimmune states Radiation optic neuropathy
- A , Sarcoidosis chronic dacryoadenitis. Axial CT scan shows enlargement of the right lacrimal gland. Note the mild enlargement of the left lacrimal gland.
- B , Sarcoidosis. Coronal-enhanced CT scan shows moderate enhancement of markedly enlarged lacrimal glands ( arrows ).
- Presumed sarcoidosis of the lacrimal gland. Axial CT scan in this 7-year-old African American child shows marked enlargement of the lacrimal glands ( arrows ).
- Sarcoidosis-granuloma of the optic nerve. Axial T1WI scan shows no obvious lesion. There is a suggestion of slight thickening of the left optic nerve ( arrow ).
- Enhanced axial T1-weighted MR scan shows increased enhancement of the left optic nerve ( arrows ) and a large granuloma involving the intracranial segment of the left optic nerve ( single arrow ).
- Enhanced axial T1-weighted MR scan shows increased enhancement of the left optic nerve ( arrows ) and a large granuloma involving the intracranial segment of the left optic nerve ( single arrow ).
- ( แต่ก็เกิดในเด็กได้ ) ถ้า steroid อย่างเดียวจะไม่ได้ผลนะ ใช้เป็น clue ในการ diagnosis.
- The main chronic inflammatory or granulomatous processes that involve the sinus and the orbit include Wegener’s granulomatosis and sarcoidosis.
- Wegener’s granulomatosis with involvement of the lacrimal gland. Axial postcontrast CT scan shows diffuse enlargement of the right lacrimal gland. The lesion involves both palpebral and orbital lobes. Notice the rather straight configuration of the posterior aspect of the lesion ( hollow arrow ). In epithelial tumors of the lacrimal gland, the posterior border of the tumor has a rounded configuration. In Wegener’s granulomatosis, enlargement of the lacrimal gland may be symmetric and extensive. Notice the slight enlargement of the involved left lacrimal gland in this patient. (From Mafee MF et al. Lacrimal gland and fossa lesions: role of computed tomography. Radiol Clin North Am 1987;25:767–779.)
- Wegener’s granuloma. Axial CT scan showing an infiltrative process involving the right lacrimal gland and extending along the extraorbital space ( arrows ).
- B , Axial postcontrast T1 WI through the mid orbits demonstrates marked enhancement of the inflammatory granulomatous process, which completely obliterates the left orbit, with stretching and anterior displacement of the globe. Note the diffuse enhancement of the tentorium cerebelli. (From Weber AL et al. Pseudotumor of the orbit: clinical, pathologic, and radiologic evaluation. Radiol Clin North Am 1999;37:151–168.)
- Amyloidosis of the right orbit with calcification. Axial CT section without infusion of contrast material reveals a mass in the extraconal space of the right orbit with a slight bulge into the intraconal space. Note the speckled calcifications within the amyloid deposit. The adjacent ethmoid sinus is normal.
- Amyloidosis of the lacrimal gland and orbit. A , Axial CT scan shows marked calcification of the left lacrimal gland ( arrow ).
- Capillary hemangioma. A , Enhanced axial CT scan showing a large retrobulbar mass compatible with a capillary hemangioma ( H ). B , Dynamic axial CT scanning reveals rapid wash-in of contrast in hemangioma ( H ).
- A baby boy with a left orbital capillary hemangioma that presented shortly after birth. A , Axial contrast-enhanced CT scan shows a mass filling and expanding the left orbit. The hemangioma appears to extend through the superior orbital fissure into the left cavernous sinus. The mass encircles and stretches the optic nerve sheath complex. Biopsy was performed but was inconclusive, and there was some discussion about further surgery. MR findings convinced the clinicians that this was a capillary hemangioma and the patient was treated with steroids instead. B , Axial T1-weighted MR image reveals a large, heterogeneous, finely lobulated mass expanding the left bony orbit. The focal regions of hypointensity are consistent with flow voids attributable to vessels. C , Axial T1-weighted MR scan shows that the capillary hemangioma involuted completely 2 years after the initial presentation.
- Capillary hemangioma. Postcontrast axial CT scan shows an enhancing mass ( m ) with involvement of the eyelid and extension into the right cavernous sinus ( arrow ).
- Capillary hemangioma. A , Enhanced axial CT scan showing a large retrobulbar mass compatible with a capillary hemangioma ( H ). B , Dynamic axial CT scanning reveals rapid wash-in of contrast in hemangioma ( H ).
- Cavernous hemangioma. A , Serial axial CT scan. B , Reformatted coronal CT scans. A and B show a well-defined intraconal markedly enhancing hemangioma ( H ).
- A , Satittal PW MR scan. B , Sagittal T2-weighted MR scan. Scans show an intraconal mass ( M ), which was presumed to be a cavernous hemangioma.
- Orbital hemangioma. Sagittal MR images obtained without ( top ) and with ( bottom ) intravenous Gd-DTPA show a hemangioma in the anterior floor of the orbit.
- A , Orbital varix. Axial CT scan shows no obvious lesion. B , Coronal CT scan shows a large mass ( arrows ).
- Carotid cavernous fistula. Enhanced axial CT scan shows enlarged intraorbital veins ( arrows ) and an enlarged left cavernous sinus.
- Hemangiopericytoma in a 47-year-old man with proptosis of the left eye. Axial contrast-enhanced CT image shows a lobulated, slightly and homogeneously enhancing left ethmoid sinus mass that has eroded the medial orbital wall. Note the extraconal extension of the lesion into the orbit and the resultant displacement of the globe.
- A , Contrast-enhanced axial CT scan shows an enhancing mass ( M ) compatible with hemangiopericytoma. Note the erosion of the lateral orbital wall ( arrowhead ). B , Recurrent hemangiopericytoma. Enhanced axial T1-weighted MR scan shows a heterogeneously enhancing mass ( arrows ) compatible with recurrent hemangiopericytoma.
- Lymphoma. Postcontrast axial CT scan shows an infiltrative process involving the left lacrimal gland ( 1 ), lateral orbital compartment ( 2 ), and perioptic nerve region ( arrows ).
- Nodular fasciitis. A 36-year-old man presented with an apparent inflammatory left orbital mass, which was unresponsive to 3 weeks of antibiotics. Axial (A) and coronal (B) contrast-enhanced CT. Soft-tissue windows show an ill-defined, enhancing, extraconal or subperiosteal soft-tissue mass in the left superior-lateral orbit, with a low-attenuation central area (arrowheads). Note the subtle enhancement along the anterior cranial fossa (arrow). C, Coronal CT bone windows demonstrate focal erosion in the frontal bone adjacent to this low-attenuation region (arrowhead). D, Coronal T1-weighted image (600/15) reveals an intermediate intensity extending lateral to the orbital rim in addition to eroding the frontal bone. E, Coronal, fat-saturation, postgadolinium, T1-weighted image (650/15). After gadolinium, most of the mass enhances, with a central, nonenhancing focus adjacent to the bone erosion. Note the intracranial dural reaction (arrow). F, Coronal, fast-STIR (2000/12/160) image. The mass is isointense to gray matter, with a focal area of hyperintensity corresponding to the cystic-appearing region on the postgadolinium image. The preoperative diagnosis was ruptured dermoid cyst or an aggressive lacrimal region abscess with osteomyelitis.