Ординатура / Офтальмология / Английские материалы / Ocular Differential Diagnosis 7th edition_Roy_2002

a.Medulloepithelioma

b.Neurilemoma

c.Retinoblastoma

d.Uveal melanoma

5. Nasopharyngeal origin

a.Angiofibroma

b.Carcinoma

c.Melanoma

6. Paranasal sinus origin

a.Ethmoid sinus carcinoma

b.Inverting papilloma

c.Maxillary sinus carcinoma

d.Rhabdomyosarcoma Q. Vasculogenic lesions

1. Capillary hemangioma

2. Cavernous hemangioma

3. Hemangiopericytoma

4. Hemangiosarcoma

P.8

5. Kaposi sarcoma

6. Lymphangioma

7. Varices

8. Vascular leiomyoma

9. Vascular leiomyosarcoma

6. Vascular disorders

A.Allergic vasculitis

B.Angioedema (Quincke disease)

C.Arteriovenous aneurysm or varices

D.Arteriovenous fistula (varicose aneurysm)

E.Collagen diseaseâ??lupus erythematosus (Kaposiâ??Libmanâ??Sacks syndrome), periarteritis nodosa (Kussmaul disease), or dermatomucomyositis (Wagnerâ??Unverricht syndrome)

F.Cranial arteritis

G.Thrombophlebitis

H.Scurvy causing bilateral orbital hemorrhage

Archer KF, et al. Orbital nonchromaffin paraganglioma. Ophthalmology 1989;96:1659â??1666.Bibliographic Links

Carter K, et al. Ophthalmic manifestations of allergic fungal sinusitis. Am J Ophthalmol 1999;127:189â??195.Bibliographic Links

Fraunfelder FT, Fraunfelder FW. Drug-induced ocular side effects. Woburn, MA: Butterworth-Heinemann, 2001.

Luxenberg MN. Chloroma. Arch Ophthalmol 1991;109:734â??736.Bibliographic Links

Lyon DB, et al. Epithelioid hemangioendothelioma of the orbital bones. Ophthalmology 1993;99:1773â??1778.Bibliographic Links

Newman NJ, et al. Ectopic brain in the orbit. Ophthalmology 1986;93:268â??272.Bibliographic Links

Shields JA, et al. Classification and incidence of space-occupying lesions of the orbit. Arch Ophthalmol 1984;102:1606â??1611.Bibliographic Links

Sloan B, et al. Scurvy causing bilateral orbital hemorrhage. Arch Ophthalmol 1999;117:842.Bibliographic Links

Syndromes and Diseases Associated with Exophthalmos

1. Actinomycosis

2. Albright syndrome (fibrous dysplasia)

3. Amyloidosis (Lubarschâ??Pick syndrome)

4. Apert syndrome (sphenoacrocraniosyndactyly)

5. Arteriovenous fistula (varicose aneurysm)

6. Aspergillosis

7. Bacillus cereus

8. Blochâ??Sulzberger disease (incontinentia pigment I)

9. Bonnetâ??Dechaumeâ??Blanc syndrome (neuroretinoangiomatosis syndrome)

10. Bourneville syndrome (tuberous sclerosis)

11. Caffey syndrome (infantile cortical hyperostosis)

12. Carotid arteryâ??cavernous sinus fistula

13. Clostridium perfringens

14. Coenurosis

15. Craniostenosis

16. Cretinism (hypothyroidism)

17. Crouzon disease (craniofacial dysostosis)

18. Cryptococcosis

19. Cushing syndrome (adrenocortical syndrome) P.9

20. Dejean sign (orbital floor fracture)

21. de Lange syndrome (congenital muscular hypertrophy-cerebral syndrome) 22. Dermatomucomyositis (polymyositis dermatomyositis)

23. Dermoid

24. Diencephalic epilepsy syndrome (autonomic epilepsy syndrome)

25. Dirofilariasis

26. Dracontiasis (Guinea worm infection)

27. Engelmann syndrome (diaphyseal dysplasia)

28. Ewing sarcoma

29. Feer disease (infantile acrodynia)

30. Fibrosarcoma

31. Fibrous dysplasia (Albright syndrome)

32. Foix syndrome (cavernous sinus thrombosis)

33. Gardner syndrome

34. Grönbladâ??Strandberg syndrome (pseudoxanthoma elasticum)

35. Hallermannâ??Streiffâ??François syndrome (oculomandibulofacial dyscephaly)

36. Handâ??Schüllerâ??Christian disease (histiocytosis X)

37. Heerfordt syndrome (uveoparotid fever)

38. Hemangiomas

39. Herpes zoster

40. Hodgkin disease

41. Hollenhorst syndrome (chorioretinal infarction syndrome)

42. Horner syndrome (cervical sympathetic paralysis syndrome)

43. Hunter syndrome (MPS [mucopolysaccharidosis] II)

44. Hurler (MPS I-H) syndrome

45. Hutchinson disease (adrenal cortex neuroblastoma with orbital metastasis) 46. Hydatid cyst

47. Hydrocephalus chondrodystrophicus congenita (extreme hydrocephalus syndrome)

48. Hypertension

49. Hyperthyroidism (Basedow syndrome)

50. Hypervitaminosis A

51. Hypophosphatasia (phosphoethanolaminuria)

52. Jansen disease (metaphyseal dysostosis)

53. JXG (nevoxanthoendothelioma)

54. Kleeblattschädel syndrome (cloverleaf skull)

55. Leiomyoma

56. Leopard syndrome (multiple lentigines syndrome)

57. Leprechaunism

58. Leukemia

59. Linear nevus sebaceous of Jadassohn

60. Lupus erythematosus (Kaposiâ??Libmanâ??Sacks syndrome)

61. Lymphoid hyperplasia

62. Lymphangioma

63. Lymphosarcoma

64. Melnickâ??Needles syndrome (osteodysplasty)

65. Meningioma

66. Mikulicz syndrome (dacryosialoadenopathy)

67. Möbius disease (congenital paralysis of sixth and seventh nerves) P.10

68. Mucocele

69. Mucormycosis

70. Multiple myeloma

71. Mumps

72. Myasthenia gravis (Erbâ??Goldflam syndrome)

73. Neurilemoma

74. Noonan syndrome (male Turner syndrome)

75. Osteopetrosis (Albersâ??Schönberg syndrome)

76. Paget syndrome (osteitis deformans)

77. Periarteritis nodosa (Kussmaul syndrome)

78. Periocular and ocular metastatic tumors

79. Pfeiffer syndrome

80. Pierreâ??Robin syndrome (micrognathia-glossoptosis syndrome)

81. Progeria (Hutchinsonâ??Gilford syndrome)

82. Pyknodysostosis

83. Quincke disease (angioedema)

84. Relapsing polychondritis

85. Retinoblastoma

86. Rhabdomyosarcoma

87. Rochonâ??Duvigneaud syndrome (superior orbital fissure syndrome)

88. Rollet syndrome (orbital apexâ??sphenoidal syndrome)

89. Sarcoidosis syndrome (Schaumann syndrome)

90. Scaphocephaly syndrome

91. Scheie syndrome (MPS I-S)

92. Scurvy (avitaminosis C)

93. Sebaceous gland carcinoma

94. Seckel syndrome (bird-headed dwarf syndrome)

95. Sézary syndrome (mycosis fungoides syndrome)

96. Shyâ??Gonatas syndrome (orthostatic hypotension syndrome)

97. Siegrist sign (pigmented choroidal vessels)

98. Silverman syndrome (battered baby syndrome)

99. Sphenocavernous syndrome

100. Streptococcus

101. Sturgeâ??Weber syndrome (encephalofacial angiomatosis)

102. Syphilis (lues)

103. Thermal burns

104. Trichinellosis

105. Trisomy syndrome (Edward syndrome)

106. Tuberculosis

107. Turner syndrome (gonadal dysgenesis)

108. von Hippelâ??Lindau syndrome (retinocerebral angiomatosis)

109. von Recklinghausen disease (neurofibromatosis)

110. Wegener syndrome (Wegener granulomatosis)

Goodman RM, Gorlin RJ. The face in genetic disorders. St. Louis: CV Mosby, 1970.

Miller NR, et al. Lytic Paget disease as a cause of orbital cholesterol granuloma. Arch Ophthalmol 1999;117:1084â??1085.Bibliographic Links

Roy FH. Ocular syndromes and systemic diseases, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2002.

P.11

Specific Exophthalmos

1. Age

A.Newbornâ??most common

1. *Orbital sepsis

2. Orbital neoplasm including congenital malignant teratoid neoplasm

B.Neonatalâ??osteomyelitis of the maxilla

C.Early childhood (up to 1 year of ageâ??most common)

1. *Dermoid

2. *Hemangioma

3. Dermolipoma

4. Histiocytosis X including Handâ??Schüllerâ??Christian disease

5. *Orbital extension of retinoblastoma

D.One to five yearsâ??most common

1. *Dermoid

2. Metastatic neuroblastoma

3. Rhabdomyosarcoma

4. Epithelial cyst, such as sebaceous cyst and epithelial inclusion cyst 5. Glioma of optic nerve

6. Sphenoid wing meningioma

7. *Orbital extension of retinoblastoma

8. Fibrous dysplasia (Albright syndrome)

9. Metastatic embryonal sarcoma

10. *Hemangioma

E.Five to ten yearsâ??most common 1. Pseudotumor

2. Orbital extension of retinoblastoma

3. Malignant lymphomas and leukemias

4. *Dermoid

5. *Hemangioma

6. Meningioma

7. Fibrous dysplasia (Albright syndrome)

8. Rhabdomyosarcoma

9. Orbital hematoma

10. Glioma of optic nerve

F.Ten to thirty yearsâ??most common 1. *Pseudotumor

2. Mucocele

3. Meningioma

4. *Endocrine ophthalmopathy (thyroid-related ophthalmopathy)

5. Lacrimal gland tumor

6. Malignant lymphomas and leukemias

7. Dermoid

8. Hemangioma

9. Peripheral nerve tumors

10. Undifferentiated sarcomas

11. Osteoma

12. Fibrous dysplasia (Albright syndrome)

13. Rhabdomyosarcoma P.12

14. Glioma of optic nerve

G.Thirty to fifty yearsâ??most common

1. *Pseudotumor

2. Mucocele

3. Malignant lymphomas and leukemias

4. *Hemangioma

5. *Endocrine ophthalmopathy (thyroid-related ophthalmopathy)

6. Lacrimal gland tumors

7. Rhinogenic carcinoma

8. Malignant melanoma

9. Osteosarcoma

10. Fibrosarcoma

11. Metastatic carcinoma

12. Meningioma

13. Dermoid

H.Fifty to seventy yearsâ??most common 1. *Pseudotumor

2. *Mucocele

3. *Malignant lymphomas and leukemias

4. Dermoid

5. Carcinoma of palpebral or epibulbar origin

6. *Meningioma

7. *Endocrine ophthalmopathy (thyroid-related ophthalmopathy)

8. Lacrimal gland tumor

9. Osteosarcoma

10. Fibrosarcoma

11. Undifferentiated sarcoma

12. Metastatic carcinoma

13. Osteoma

14. Fibrous dysplasia (Albright syndrome)

15. Neurofibroma

16. Hemangioma

I.More than seventy yearsâ??most common 1. Melanoma

2. Pseudotumor

3. *Lymphoma

4. *Metastatic tumor

5. Basal cell carcinoma

6. Mucocele

2. Unilateral exophthalmosâ??most common

A.Anatomical conditions

1. Unilateral myopia of high degree

2. Defects in the vault of the orbit: meningocele, encephalocele, hydroencephalocele 3. Exophthalmos associated with arterial hypertension

4. Recurrent exophthalmos from retrobulbar hemorrhage, lymphangioma

5. Intermittent exophthalmos associated with venous anomalies within the cranium 6. Disease of the pituitary gland; meningiomas involving sphenoid ridge

P.13

7. *Unilateral exophthalmos associated with endocrine or thyroid-related ophthalmopathy

B.Traumatic conditions

1. Contralateral floor fracture with enophthalmos

2. Fracture of the orbit with retrobulbar hemorrhage

3. Laceration and rupture of the tissues of the orbit and the extraocular muscles 4. Intracranial trauma sustained at birth; aneurysm in orbit

5. Pulsating exophthalmos from carotidâ??cavernous aneurysm

6. Spontaneous retrobulbar hemorrhage as seen in whooping cough 7. Chronic subdural hematoma bulging into orbit

8. Posterior exophthalmos (orbital apex lesion)

a.Pseudotumor

b.Malignant tumor

c.Benign tumor

d.Vascular disease e. Infection

C.Inflammatory conditions

1. Retrobulbar abscess and cellulitis

2. Thrombophlebitis of the orbital veins

3. Cavernous sinus thrombosis

4. Erysipelas (St. Anthony fire)

5. Tenonitis

6. Periostitis (syphilitic or tuberculous)

7. Orbital mucocele, pyocele; cholesteatoma

8. Orbital exostosis

9. Paget disease with hyperostosis

10. Actinomycosis, trichinosis, mycotic pseudotumor 11. Herpes (HSV-1) with acute retinal necrosis

D.Disease of blood, lymph, and hematopoietic system 1. Rickets (avitaminosis D)

2. Scurvy (avitaminosis C)

3. Hemophilia (factor VIII deficiency)

4. Lymphosarcoma

5. Chloroma

6. Hodgkin disease

E.Space-taking lesions 1. Vascular anomalies

a.Congenital orbital varix (young patient with systemic abnormalities)

b.Cavernous hemangioma (middle age)

c.Capillary hemangioma (young children) Kasabachâ??Merrit syndrome

d.Lymphangiomas

2. Orbital tumors: pseudotumors, orbital cysts, meningocele, lymphangioma, orbital meningioma, lacrimal gland tumor, sarcoma, metastatic carcinoma, metastatic adrenal tumors, osteomas arising in the accessory nasal sinuses, tumors of the nasopharynx (benign and malignant)

3. Intracranial tumor with orbital extension including chordoma and meningioma

F.Unilateral exophthalmos in children 1. Inflammation

P.14

2. Vascular disorders

3. Neoplasms

4. Metabolic diseases

5. Developmental anomalies

6. Others

7. *Orbital cellulitis

3. Bilateral exophthalmosâ??most common

A.*Thyroid or endocrine ophthalmopathy

B.Orbital myositis (owing to causes other than thyroid dysfunction)

C.Cavernous sinus thrombosis (Foix syndrome)

D.Metastatic neuroblastoma

E.Handâ??Schüllerâ??Christian disease (histiocytosis X)

F.Crouzon disease (craniofacial dysostosis)

G.Paget disease (osteitis deformans)

4. Type proptosisâ??most common

A.Straightforwardâ??glioma of optic nerve, intraconal cavernous hemangioma

B.Down and temporalâ??mucocele of frontal sinus

C.Down and nasalâ??lacrimal gland lesion

D.Downwardâ??tumor of roof of orbit

E.Upwardâ??tumor of floor of orbit

5. Transient exophthalmos

A.*Orbital varices

B.Orbital varices with intracranial extension

C.Arteriovenous malformations

D.Cavernous hemangioma

E.Intraorbital arteriovenous malformation

6. Pulsating exophthalmosâ??most common

A.*Carotid-cavernous fistula

B.von Recklinghausen disease associated with bony defect of skull

C.Large frontal mucocele

D.Meningoencephalocele

E.Blow-in fracture of roof of orbit

F.Neurofibromatosis

G.Fistula

H.Malignancies

I.Mucoceles

J.Orbital varix

K.Dermoid cysts

L.Aneurysm

7. Recurrent exophthalmos

A.Recurrent orbital inflammation (pseudotumor) or hemorrhage

B.Orbital cysts that rupture

C.Lymphangioma (children)

D.Syndrome of intermittent exophthalmos-congenital venous malformations of the orbit: venous angioma and orbital varix

E.Temporal lobe tumor with orbital extension

F.Neurofibromatosis

G.Vascular neoplasm

P.15

8. Intermittent exophthalmos

A.Orbital varices

B.Recurrent hemorrhage