title: Clinical presentation, aetiology and prognosis of orbital apex syndrome.
abstract: OBJECTIVE
  To present the clinical features, determine the causes and evaluate the prognosis of orbital apex syndrome in patients of Songklanagarind Hospital.
  
  
  METHODS
  A retrospective review was conducted of patients diagnosed with orbital apex syndrome between January 1, 2002 and December 31, 2008.
  
  
  RESULTS
  In our series, the major cause of orbital apex syndrome was carotid-cavernous sinus fistula, for which 30 patients were diagnosed. After excluding those patients whose condition was caused by carotid-cavernous sinus fistula, 50 patients (58 eyes) were analyzed. The mean age of the patients was 47.60 ± 18.88 years (27 male patients and 23 female patients). The most common presenting symptom was blurred vision (86%). The median duration of the presenting symptom was 37.5 d. Of the 50 patients the most frequent aetiology of orbital apex syndrome was neoplasia (48%), of which lymphoma was the most common in this group. After treatment, the vision of 19.4% of the patients improved and proptosis improved by 68.4%.
  
  
  CONCLUSIONS
  The most common presenting symptom of orbital apex syndrome was blurred vision. The most frequent aetiology of orbital apex syndrome of all patients was carotid-cavernous sinus fistula, while the next most frequent was neoplasm, of which lymphoma was the most common in this group. Patients had a good outlook, after treatment directed at the cause, with a modest improvement in vision and exophthalmos in more than half of patients.
authors.affiliation: Faculty of Medicine, Department of Ophthalmology, Prince of Songkla University, Hat Yai, 90112, Thailand. all_or_none22781@hotmail.com
authors.forename: Orapan
authors.initials: O
authors.lastname: Aryasit
authors.forename: Passorn
authors.initials: P
authors.lastname: Preechawai
authors.forename: Nipat
authors.initials: N
authors.lastname: Aui-Aree
mesh_terms: D001706:Biopsy; D020216:Carotid-Cavernous Sinus Fistula / Q000150:complications* / Q000175:diagnosis; D005134:Eye Neoplasms / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000175:diagnosis* / Q000209:etiology; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000209:etiology; D009916:Orbital Diseases / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014786:Vision Disorders / Q000175:diagnosis* / Q000209:etiology