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A case of orbital apex syndrome due to malignant lymphoma diagnosed after cataract surgery, who complained exacerbation of vision loss Kazuki Imai 1 , Takayoshi Sumioka 1 , Yukihisa Takada 1 , Nobuyuki Ishikawa 1 , Ryuta Iwamoto 2 , Shinichi Murata 2 , Shizuya Saika 1 1Department of Ophthalmology, Wakayama Medical University 2Department of Human Pathology, Wakayama Medical University pp.593-599
Published Date 2023/5/15
DOI https://doi.org/10.11477/mf.1410214792
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Abstract Purpose:We report a case of orbital tip syndrome due to diffuse large B-cell lymphoma in a patient whose visual acuity worsened while waiting for cataract surgery.

Case:A 79-year-old male patient presented to another doctor after becoming aware of decreased visual acuity in his right eye. His right eye corrected visual acuity was 0.8, and he was diagnosed with cataract and scheduled for surgery. While awaiting surgery, his visual acuity decreased(corrected visual acuity 0.5), and the patient revisited the hospital. However, cataract surgery was performed as planned. On the day after surgery, postoperative inflammation was slight, visual acuity was corrected to 0.07, and protruded and omnidirectional oculomotor disorders were observed. Head computed tomography revealed a mucosal lesion filling the paranasal sinuses and swelling of the right optic nerve. A Goldmann visual field test showed that only an island-like visual field remained in the nasal periphery of the right eye. Based on the results of sinus mucosa biopsy, orbital apex syndrome due to diffuse large B-cell lymphoma was diagnosed, and metastatic lesions were also found in the bilateral hilar regions. Therefore, chemotherapy(six courses of R-CHOP therapy)was commended. The course was good, and the final corrected visual acuity in the right eye was 0.1.

Conclusion:When a sudden decrease in visual acuity occurs while waiting for cataract surgery, it is necessary to consider reevaluation of cataract and the potential of other diseases.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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