Cystoid macular edema as an initial symptom of inflammatory orbital pseudotumor.
We report a patient with pseudotumor with cystoid macular edema (CME). The initial finding in our case was only CME with a bilateral visual acuity decrease to 20/25. Approximately 3 months later, the visual acuity dropped to light perception in the right eye and 20/200 in the left eye. Computed tomography scan revealed a mass in the right orbital apex and band-shaped enhancement in the cavernous sinus and along the upper margin of the petrous bone. However, no mass was found intraoperatively, and a biopsy specimen of the bulging levator muscle showed polymorphonuclear leukocyte infiltration. The CME resolved postoperatively. The tumor also seemed to resolve; however, after 1 year, the tumor recurred and invaded the brain tissue. A temporal lobectomy revealed widespread inflammatory cell infiltration. To ensure early diagnosis, pseudotumor should be considered in patients with CME of which the cause is uncertain.
Igarashi
H
H
Department of Ophthalmology, Asahikawa Medical College, Japan.
Igarashi
S
S
Ishiko
S
S
Fukui
K
K
Yoshida
A
A
D000328:Adult; D000792:Angiography; D001921:Brain / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D009915:Orbit / Q000601:surgery; D016727:Orbital Pseudotumor / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012008:Recurrence; D012886:Skull / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity