Orbital Compartment Syndrome in Eosinophilic Angiocentric Fibrosis.
A 43-year-old man reported right visual loss after biopsy of an intranasal mass, which improved after treatment at another hospital. On first examination at our hospital, his visual acuity was 1.2 OD, and MRI showed a right intraorbital mass involving the ethmoid sinus. His visual acuity decreased to 0.08 OD 12 days after orbital biopsy, with right globe tenting shown by MRI. An emergent lateral canthotomy and cantholysis were performed. The histopathological diagnosis was eosinophilic angiocentric fibrosis, and treatment with intravenous methylprednisolone (125 mg/day) and oral diaminophenyl sulfone (75 mg/day) was started immediately after surgery. One month later, the diaminophenyl sulfone was discontinued and cyclophosphamide (50 mg/day) was started. The methylprednisolone and cyclophosphamide doses were tapered over 9 months and 7 months, respectively. At the 1.5-year follow-up examination, his visual acuity was 1.0 OD. The lesions did not grow in size.
*Department of Ophthalmology, Aichi Medical University; †Department of Pathology, Aichi Medical University Hospital, Nagakute, Aichi; and ‡Department of Plastic Surgery, Kobe University School of Medicine, Kobe, Hyogo, Japan.
Yasuhiro
Y
Takahashi
Emiko
E
Takahashi
Akihiro
A
Ichinose
Hirohiko
H
Kakizaki
D000328:Adult; D003161:Compartment Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004803:Eosinophilic Granuloma / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005005:Ethmoid Sinus / Q000473:pathology*; D005355:Fibrosis; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone; D015508:Nasal Obstruction / Q000175:diagnosis; D013508:Ophthalmologic Surgical Procedures; D009916:Orbital Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone