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A.R. Kulkarni, M.A. Burdon, A.S. Labhsetwar, M.D. Deshpande; Evaluation of Proptosis and Its Management – The Tropical Experience . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3781.
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This is a prospective study aimed to correlate the various clinical presentations of proptosis with radiological and histopathological findings and assess the treatment modalities.
22 consecutive patients presenting with proptosis to a major teaching hospital in India were included in this 30–month study. They underwent thorough ophthalmic assessment including visual fields, exophthalmometry, ultrasound and imaging where appropriate.
Proptosis was commoner in males (59%). 81.5% (18/22) cases were unilateral and equally distributed amongst males and females, while only males presented with bilateral proptosis .Most cases presented between 0–20 years age(10/22, 45.5%) including cases of trauma, neurofibromatosis and acute myeloid leukaemia(2/22 cases, 9.1%, each); craniofacial abnormalities, orbital haemorrhage due to infective hepatitis, rhabdomyosarcoma and orbital cellulitis(1/22 cases, 4.5% each). Age group 21–40 years included only 1 case(4.5%) of carotid cavernous sinus fistulae. 41–60 year olds included neurofibromatosis and orbital cellulitis (2/22 cases, 9.1% each); trauma, haemangioma, lymphangioma, meningioma and ossifying fibroma (1/22 cases, 4.5% each). 2 patients above 60 years included intraorbital squamous cell carcinoma and frontal mucocoele(1 case, 4.5% each). Surprisingly there were no cases of thyroid eye disease during the study period.
The unusual nature of this series could be as a result of tertiary referrals sent to our teaching hospital which also explains the more severe spectrum of disease seen. To our knowledge this is one of few series evaluating the presentation of proptosis and correlating it with clinical and radiological features in liaison with neurosurgeons and physicians to plan the management of patients.
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