Lee Peng-Hsuan, Shao Shih-Chieh, Lee Wan-Ju Annabelle
Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Front Med (Lausanne). 2022 Mar 8;9:845411. doi: 10.3389/fmed.2022.845411. eCollection 2022.
Orbital apex syndrome (OAS) is a rare ocular complication following by infection, inflammation, trauma, neoplasms, and vascularity. The epidemiological features of OAS remained limited, so this study aimed to present ophthalmic clinical features, determine the causes to evaluate the visual prognosis of orbital apex syndrome (OAS) patients in Taiwan.
This was a retrospective study by reviewing the electronic medical records from National Cheng Kung University Hospital in Taiwan during 2017-2019. We included patients diagnosed with OAS to review their ocular symptoms and signs, visual acuity, ocular images, etiologies, treatment and visual prognosis.
Twenty cases (mean age: 65.55 ± 13.06; male: 75%) with the diagnosis of OAS were included in this study. All patients presented as unilateral involvement, but the initial ocular presentations and etiologies varied. For example, blurred vision was reported in 80% of these patients, and tumor-related compression (55%) and infection (15%) were the most frequent causes for the OAS. After the follow-up, we found 35% of patients' visions declined or worsened to the blindness, 15% of patients' visions remained stable, 20% of patients' visions had mild improvement, and 35% of patients' visions were not measured because of debilitating clinical condition. We identified three OAS patients with mortality (15%), and all of them were attributed to the underlying malignancies.
The clinical magnifications and etiologies of OAS are heterogeneous in Taiwan. Our findings indicated the tumor-related compression is the most frequent causes of OAS in Taiwan, and it is also related to poor clinical outcomes.
眶尖综合征（OAS）是一种继发于感染、炎症、创伤、肿瘤和血管病变的罕见眼部并发症。眶尖综合征的流行病学特征仍然有限，因此本研究旨在呈现台湾眶尖综合征（OAS）患者的眼科临床特征，确定病因以评估其视力预后。
这是一项回顾性研究，通过查阅台湾成功大学医院2017 - 2019年的电子病历。我们纳入了被诊断为眶尖综合征的患者，以回顾他们的眼部症状和体征、视力、眼部影像、病因、治疗及视力预后。
本研究纳入了20例诊断为眶尖综合征的患者（平均年龄：65.55 ± 13.06；男性：75%）。所有患者均为单侧受累，但初始眼部表现和病因各不相同。例如，80%的患者报告有视力模糊，肿瘤相关压迫（55%）和感染（15%）是眶尖综合征最常见的病因。随访后，我们发现35%的患者视力下降或恶化为失明，15%的患者视力保持稳定，20%的患者视力有轻度改善，35%的患者因病情严重未测量视力。我们确定有3例眶尖综合征患者死亡（15%），且均归因于潜在的恶性肿瘤。
台湾眶尖综合征的临床症状和病因具有异质性。我们的研究结果表明，肿瘤相关压迫是台湾眶尖综合征最常见的病因，且与不良临床结局相关。
