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Amyloid in the orbital apex and cavernous sinus
Angela J Oh1, Angela C Chen1, Nathan Pirakitikulr1
1Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, USA.
Orbit (Amsterdam, Netherlands)
|May 28, 2025
Summary
A rare case of orbital amyloidosis extending to the cavernous sinus caused severe vision issues. Surgical decompression and radiation therapy helped manage this posterior orbital apex lesion.
Area of Science:
- Ophthalmology
- Neurology
- Pathology
Background:
- Orbital amyloidosis is a rare condition.
- Posterior orbital apex lesions can cause significant symptoms like diplopia.
Purpose of the Study:
- To report a rare case of posterior orbital amyloidosis with cavernous sinus involvement.
- To discuss diagnostic and management strategies for this condition.
Main Methods:
- Case report of a 78-year-old male with progressive diplopia.
- Magnetic resonance imaging (MRI) for lesion characterization.
- Surgical decompression and histopathological analysis using Congo red dye.
- Review of treatment options including radiation therapy.
Main Results:
- The patient presented with binocular diplopia and restricted eye motility.
- MRI revealed a posterior orbital mass extending into the optic canal and cavernous sinus.
- Histopathology confirmed amyloidosis via Congo red staining and polarization microscopy.
- Surgical decompression provided symptomatic relief, and radiation was considered for stabilization.
Conclusions:
- Orbital amyloidosis should be considered in patients with posterior orbital apex lesions.
- A combined surgical approach may aid biopsy and decompression.
- Radiation therapy can be beneficial for stabilizing orbital amyloidosis with cavernous sinus involvement.
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