ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2014-2-48-54ophthalmology-24Research ArticleКЛИНИЧЕСКИЕ И ЭКСПЕРИМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯCLINICAL & EXPERIMENTAL RESEARCHОбъемно-топографические и структурные изменения мягких тканей вершины орбиты при оптической нейропатии у пациентов с отечным экзофтальмомVolumetric, topographic and structural changes of orbital apex soft tissues in optic neuropathy caused by edematous exophthalmosЯценкоО. Ю.YatsenkoO. Yu.

Кафедра офтальмологии

Department of Ophthalmology

olegyatsenko@rambler.ruГБОУ ДПО «Российская медицинская академия последипломного образования» Министерства здравоохранения России ГБУЗ ОКБ Департамента здравоохранения г. МосквыРоссияRussian Medical Academy of Postgraduate Education State Ophthalmology HospitalRussian Federation2014080720141124854Copyright © Яценко О.Ю., 20142014Яценко О.Ю.Yatsenko O.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/24Цель

Цель: изучение состояния орбитальных структур в вершине орбиты при развитии оптической нейропатии у больных отечным экзофтальмом.

Пациенты и методы

Пациенты и методы: Обследовано 172 человека с отечным экзофтальмом. У 46 из них диагностирована оптическая офтальмопатия (ОН). Первую группу составили 29 больных (58 орбит) с начальной ОН, вторую — 17 больных (33 орбиты) с развитой формой ОН. Всем пациентам проведена компьютерная томография по стандартной методике с получением аксиальных и фронтальных срезов толщиной 1,0 мм и шагом — 1,0 мм.

Результаты

Результаты: Объем костной орбиты у пациентов с ОН, так же как и объем ее вершины, не имеет отличий от нормы. Однако объем экстраокулярных мышц у этих больных увеличен как в целом (5,04 +0,07 см3 при начальной ОН и 6,526 +0,044 см3 при развитой ОН), так и у вершины орбиты (1,556+0,02 см3 и 2,402+0,036 см3, соответственно). При этом отношение объема костной орбиты к объему экстраокулярных мышц при начальной нейропатии снижено до 5,05, а при развитой — до 3,9; снижение отношения объема костной орбиты к объему экстраокулярных мышц у вершины орбиты было более значительным и составило 2,87 и 2,007, соответственно.

Выводы

Выводы: У больных с оптической нейропатией происходит значительное увеличение объема экстраокулярных мышц у вершины орбиты, приводящее к резкому нарушению объемно-топографических взаимоотношений мягких тканей орбиты в этой области со сдавлением сосудисто-нервных пучков.

Aim

Aim. To investigate orbital apex structures in optic neuropathy (ON) due to edematous exophthalmos.

Materials and methods

Materials and methods. 172 edematous exophthalmos patients were examined. In 46 patients, ON was diagnosed. These patients were divided into 2 groups: early ON (29 patients / 58 eyes) and advanced ON (17 patients / 33 eyes). Standard computed tomography (1‑mm axial and frontal scanning) was performed in all patients.

Results

Results.The volume of the orbit and its apex in ON patients was the same as the one in healthy individuals. However, the volume of extraocular muscles was increased in general (5.04±0.07 cm3 in early ON and 6.53±0.044 cm3 in advanced ON) and in orbital apex (1.56±0.02 cm3 and 2.4±0.036 cm3, respectively). The ratio of total orbit volume to extraocular muscles volume was reduced to 5.05 in early ON and to 3.9 in advanced ON. The ratio of orbital apex volume to extraocular muscles volume was reduced to 2.87 and 2.007, respectively.

Conclusion

Conclusion. In ON, the volume of extraocular muscles in orbital apex is significantly increased. This results in the severe disturbance of anatomic topographic relations of orbital soft tissues and the compression of neurovascular bundles.

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The authors declare that there are no conflicts of interest present.