Etiologic Analysis Of Exophthalmos Due To Orbital Diseases

objective:To understand the causes of exophthalmos classification and distribution. Methods:A retrospective analysis on 583 cases of exophthalmos with complete medical records receiving treatments in our hospital between 1960 to 2008 was conducted. General information, etiology, clinical presentation, assistant examination of patients were analyzed retrospectively. Among them, the general information including gender, age, length of history; clinical presentation including symptoms and signs, such as: visual loss or not, diplopia, red eye, eye pain, with or without strabismus, proptosis, limitation of eye movement, ptosis, conjunctival hyperemia, mydriasis, etc.; assistant examination including CT, MRI, pathological inspection, etc. Results:Causes that result in exophthalmos can be divided into five categories, namely tumor (58.32%), endocrine diseases (21.44%), inflammatory disease (17.15%), trauma (2.74%), and genetic and developmental disorders (0.34%).According to the source, tumor can be divided into tumor origining of intraorbital (72.94%), paranasal sinuses tumor spreading into orbital (18.53%), hematopoietic tumors (4.12%), brain tumor spreading into orbital (3.24%), intraocular tumors spreading into orbital(0.59%) and metastatic carcinoma (0.59%). Common causes of exophthalmos in proper order were thyroid associated ophthalmopathy (21.44%), cavernous hemangioma (11.15%), inflammatory pseudotumor (10.29%), benign meningiomas (6.52%), venous angioma (6.00% ), orbital cellulitis (5.32%), dermoid and epidermoid cysts (4.63%), nerve sheath tumors (3.60%), squamous cell carcinoma (2.92%) and pleomorphic adenoma (2.74%) , etc.. The cause of exophthalmos in children by turns were hemangioma, orbital cellulitis, dermoid and epidermoid cyst, meningioma, inflammatory pseudotumor, schwannoma, glioma, neurofibroma, thyroid eye disease and rhabdomyosarcoma, etc. Conclusion:Exophthalmos can be caused by a variety of orbital disease, unilateral exophthalmos were more common caused by tumor, endocrine diseases, inflammation, bilateral exophthalmos were more common caused by thyroid eye disease, causes of exophthalmos between adult and children were different, in which children with hemangioma were more common, and thyroid associated ophthalmopathy more common for adults.