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Purpose:Tumors located in the intraconal portion of the orbital apex,especially those inferior to the optic nerve,can be difficult to access surgically,carrying a significant risk of ocular morbidity.The purpose of this study was to investigate outcomes in 5 patients with benign-appearing but symptomatic tumors located in the intraconal portion of the orbital apex in which orbital decompression was performed as an alternative management strategy to resection.Design:Retrospective interventional case series.Participants:Five patients were diagnosed with a compressive optic neuropathy secondary to a benign-appearing tumor at the orbital apex.Intervention:Each patient underwent surgical decompression of the affected orbit.None of the patients had the tumor biopsied or resected.Main Outcome Measures:Best-corrected visual acuity(VA) ,pupillary responses,visual fields(VFs) ,color vision,and orbital imaging.Results:Each of the patients demonstrated improvement in visual function,as measured by VA,VFs,and,in some cases,color vision.One patient required a second orbital decompression for recurrent optic neuropathy 4 years after the initial decompression.Complications included ptosis and enophthalmos in 2 patients and diplopia in the extreme right gaze in 1 patient.Conclusions:Orbital decompression is a therapeutic option for patients with compressive optic neuropathies from benign orbital apex tumors,offering potential improvement in optic nerve function while sparing morbidity from attempts at surgical resection.
Purpose: Tumors located in the intraconal portion of the orbital apex, especially those inferior to the optic nerve, can be difficult to access surgically, carrying a significant risk of ocular morbidity. Purpose of this purpose was this study was to investigate findings in 5 patients with benign -appearing but symptomatic tumors located in the intraconal portion of the orbital apex in orbital decompression was performed as an alternative management strategy to resection. Design: Retrospective interventional case series. Participants: Five patients were diagnosed with a compressive optic neuropathy secondary to a benign -appearing tumor at the orbital apex.Intervention: Each patient underwent surgical decompression of the affected orbit. None of the patients had the tumor biopsied or resected. Main Outcome Measures: Best-corrected visual acuity (VA), pupillary responses, visual fields ( VFs), color vision, and orbital imaging. Results: Each of the patients demonstrated improvement in visual function, as measured by VA, VFs, and, in some cases, color vision. One patient required a second orbital decompression for recurrent optic neuropathy 4 years after the initial decompression .Complications included ptosis and enophthalmos in 2 patients and diplopia in the extreme right gaze in 1 patient. Conclusions: Orbital decompression is a therapeutic option for patients with compressive optic neuropathies from benign orbital apex tumors, offering potential improvement in optic nerve function while sparing morbidity from attempts at surgical resection.