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Apical involvement with fibrous dysplasia: implications for vision
Antonio Augusto V Cruz1, Marcio Constanzi, Flavia A Attié de Castro
1School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. aavecruz@fmrp.usp.br
Ophthalmic Plastic and Reconstructive Surgery
|November 22, 2007
Summary
Fibrous dysplasia of the orbit commonly causes eye dystopia and proptosis. Optic canal narrowing does not always lead to vision loss, and prophylactic decompression is not recommended.
Area of Science:
- Ophthalmology
- Neurosurgery
- Radiology
Background:
- Fibrous dysplasia is a benign bone disorder where normal bone is replaced by immature fibrous tissue.
- Orbital involvement can lead to significant cosmetic and functional deficits.
Purpose of the Study:
- To detail the ophthalmic manifestations and imaging characteristics of fibrous dysplasia affecting the orbit.
- To evaluate the impact of orbital fibrous dysplasia on vision and optic canal patency.
Main Methods:
- Prospective case series of 21 patients with orbital fibrous dysplasia.
- Comprehensive ophthalmic examinations and computed tomography (CT) imaging of the orbit were performed.
Main Results:
- Facial distortion, proptosis, and eye dystopia occurred in 62% of patients.
- Optic canal narrowing was observed in 55.9% of affected orbits, but blindness occurred in only one patient.
- Disease involvement frequently affected multiple orbital walls, with apical involvement being common.
Conclusions:
- Orbital fibrous dysplasia primarily results in proptosis and dystopia.
- Optic canal narrowing does not consistently cause vision loss; prophylactic decompression is not supported by these findings.
- Careful monitoring of patients with apical involvement is advised, with decompression reserved for cases of clear visual deterioration.
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