DESCRIPTIVE STUDY ON LACRIMAL GLAND LESIONS IN A TERTIARY EYE CARE CENTRE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 17
Abstract
BACKGROUND There has been an increasing interest among ophthalmologists to study the management algorithms of lacrimal gland lesions. Unlike other ophthalmic conditions, lacrimal gland lesions have difficulty in clinical examination, diagnosis and surgical approach, as final diagnosis cannot be accurately predicted. Occurrence of these lesions can have relationship with age, gender, demographic and other socioeconomic factors. Aims and Objectives: To study the demographic profile, clinical features, treatment options and outcome of lacrimal gland lesions; to determine demographic profile, clinical presentation, management algorithm and treatment outcomes of patients with various lacrimal gland lesions. MATERIALS AND METHODS A descriptive study of lacrimal gland lesions from the period of June 2012 to July 2017 are included for this study. Data included age, gender, place, ocular complaints, visual acuity, laterality, proptosis, EOM restriction and mass description. All patients underwent imaging, biopsy and histopathology. Treatment and follow-up was analysed. RESULTS A total of 45 patients presented to our orbit department with lacrimal gland lesions from June 2012 to July 2017, of whom 22 patients were males (48%) and 23 (52%) were females. The age of presentation ranged from 7 - 64 years. In our study, the patients were clinically classified into six categories- Benign, Malignant, Inflammatory, Infective, Lymphoproliferative and Structural lesions. Benign and malignant tumours are completely rare, below 10 years. There is significantly increased incidence of structural lesions (Dacryops) presented in this study. Rare tumours of Haemangiopericytoma, Adenocarcinoma, Langerhans cell histiocytosis and Tuberculous dacryoadenitis were reported in this case series. Treatment options include lateral orbitotomy, excision/ incisional biopsy, histopathological examination, postoperative steroids, chemotherapy and chemoradiotherapy depending on the nature of the lesion. In 6 months and 1-year follow-up, recurrence is seen only in two cases of adenoid cystic carcinoma. CONCLUSION In any lacrimal gland lesion imaging, lateral orbitotomy and biopsy with appropriate treatment and follow-up is mandatory in all cases.
Authors and Affiliations
Rajendran Vijay, Ravikumar Anand, Anbazhagan Amudha, Muralikrishnan Muralikrishnan, Jothimani Dheebalakshmi, Govindaraju Harshini
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