TY - JOUR
T1 - Clinical Outcomes in Children With Orbital Cellulitis and Radiographic Globe Tenting
AU - Lindsay, Rebecca A.
AU - Weiss, Avery H.
AU - Kelly, John P.
AU - Anderson, Valerie C.
AU - Lindsay, Theodore H.
AU - Cabrera, Michelle T.
N1 - Publisher Copyright:
Copyright © 2018 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Purpose: Axial displacement of the globe with tenting centered on the optic nerve-globe junction is a predictor of visual loss in adults. The purpose of this study was to determine the visual outcomes of children with orbital cellulitis and globe tenting. Methods: The records of 46 consecutive children with orbital cellulitis at a single tertiary children's hospital were reviewed retrospectively. Initial and final visual acuities were available for 34 of 46 patients (74%). Globe tenting was defined by an angle of 130° or less at the optic nerve-globe junction as derived from sagittal CT or MRI. Visual acuities of 4 children with globe tenting (mean age, 10.3 ± 3.3 years) were compared with those of 30 children without globe tenting (mean age, 10.8 ± 3.5 years). Final logarithm of the minimum angle of resolution visual acuities were analyzed. Results: The mean posterior globe angle was 124.5° ± 8.0° in patients with globe tenting, compared with 145.6° ± 7.4° in the affected eye of the patients without globe tenting (p = 0.002). Final visual acuity was logarithm of the minimum angle of resolution = 0 following treatment in patients with globe tenting and logarithm of the minimum angle of resolution = 0.02 in patients without tenting (p = 0.70). Discussion: We propose that the increased elastic compliance of the optic nerve sheath and sclera in children may contribute to better visual outcomes. Conclusions: Pediatric orbital cellulitis with globe tenting may not lead to devastating vision loss as previously seen in adults.
AB - Purpose: Axial displacement of the globe with tenting centered on the optic nerve-globe junction is a predictor of visual loss in adults. The purpose of this study was to determine the visual outcomes of children with orbital cellulitis and globe tenting. Methods: The records of 46 consecutive children with orbital cellulitis at a single tertiary children's hospital were reviewed retrospectively. Initial and final visual acuities were available for 34 of 46 patients (74%). Globe tenting was defined by an angle of 130° or less at the optic nerve-globe junction as derived from sagittal CT or MRI. Visual acuities of 4 children with globe tenting (mean age, 10.3 ± 3.3 years) were compared with those of 30 children without globe tenting (mean age, 10.8 ± 3.5 years). Final logarithm of the minimum angle of resolution visual acuities were analyzed. Results: The mean posterior globe angle was 124.5° ± 8.0° in patients with globe tenting, compared with 145.6° ± 7.4° in the affected eye of the patients without globe tenting (p = 0.002). Final visual acuity was logarithm of the minimum angle of resolution = 0 following treatment in patients with globe tenting and logarithm of the minimum angle of resolution = 0.02 in patients without tenting (p = 0.70). Discussion: We propose that the increased elastic compliance of the optic nerve sheath and sclera in children may contribute to better visual outcomes. Conclusions: Pediatric orbital cellulitis with globe tenting may not lead to devastating vision loss as previously seen in adults.
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U2 - 10.1097/IOP.0000000000000976
DO - 10.1097/IOP.0000000000000976
M3 - Article
C2 - 29990314
AN - SCOPUS:85051085631
SN - 0740-9303
VL - 34
SP - 329
EP - 332
JO - Ophthalmic plastic and reconstructive surgery
JF - Ophthalmic plastic and reconstructive surgery
IS - 4
ER -