42
Abstracts
P R O B E
• V o l . L I I I • N o . 3 • A p r – J u n 2 0 1 4
Ophthalmology
Neuro-ophthalmic Manifestations in Sinusitis
Patients who Underwent Endoscopic
Sinus Surgery
Kitthaweesin K, Theerakul T
J Med Assoc Thai
. 2012;95(12):1543–1547.
Aim of the study was to describe neuro-ophthalmic
manifestations in sinusitis patients who underwent
functional endoscopic sinus surgery.
The medical records of 341 patients who underwent
functional endoscopic sinus surgery (FESS) between
October and January 2001 were reviewed in this
retrospective study.
Patient mean age was 37.09 years (range, 3–77) and 171
(50.15%) patients had no underlying disease. Visual loss
and limited ocular motility were revealed in 43 (12.72%)
and 40 (11.83%) patients, respectively. Sphenoid sinus was
the most commonly affected sinus in patients presenting
with either visual loss (odds ratio = 5.88; 95% CI =
2.79–12.38) or ophthalmoplegia (OR = 7.09; 95% CI =
3.28–15.32). Twenty-three percent of patients with visual
loss had abnormal funduscopy, while 30.23% had abnormal
radiologic imaging study. After FESS, 12 (27.91%) patients
had better visual acuity, but 11 (25.58%) had permanent
visual loss. Isolated oculomotor and combined oculomotor
with abducens nerve involvement were revealed in 9
(22.50%), and 31 (77.5%) patients, respectively. Diabetes
was a significant risk factor associated with ocular
complications in patients with either visual loss (OR = 2.98;
95% CI = 1.37–6.44) or ophthalmoplegia (OR = 2.56; 95%
CI = 1.17–5.61).
Sphenoid sinusitis significantly increased the risk of neuro-
ophthalmic manifestations, particularly among diabetic
patients.
Ophthalmic Manifestations of Paranasal Sinus
Disease: A Clinical Grading System
Al Anazy FH, Al Dousary SH
Int Forum Allergy Rhinol
. 2012;2(4):331–335.
Ophthalmic complications are common manifestations
of paranasal sinus disease. We propose a clinical grading
system to standardize the category, treatment, and outcome
of these complications.
Forty-two patients with paranasal sinus disease-induced
ophthalmic complications were included in the study.
The patients were categorized according to their clinical
presentation— grade I, patients with anatomical
disturbance; grade II, patients with ophthalmic functional
involvement; grade III, patients with orbital infection; and
grade IV, patients with visual impairment.
Overall, 36% patients had ophthalmologic manifestations
with anatomical disturbance (grade I), 26% had functional
disturbance (grade II), 26% had orbital infections (grade
III), and 12% had visual loss (grade IV). The cause of the
ophthalmic manifestations was allergic fungal sinusitis
in 50%, chronic rhinosinusitis in 36%, acute sinusitis in
10%, and mucocele in 4%. The most common ophthalmic
manifestation was proptosis (36%), followed by orbital
infection (26%), functional involvement (26%), and visual
impairment (12%). The outcome in grades I, II, and III was
favorable; the outcome in grade IV was not favorable.
This simple clinical grading system provides a useful tool
for assessing the overall status of ophthalmic complications
of acute and chronic paranasal sinus disease at the initial
clinical assessment and for subsequent management of these
complications.
