Retrospective analysis of clinical profile of pediatric proptosis in a tertiary care hospital of Eastern India

Abstract

Background: Pediatric proptosis can often present with puzzling clinical features and needs a systematic approach to avoid diagnostic dilemma. Aims and Objectives: To study the clinical and etiological profile, management, and outcome of pediatric proptosis. Materials and Methods: This retrospective noncomparative study involved the analysis of record files of 41 cases of childhood proptosis, who presented in the eye outpatient department and oculoplastic clinic between January 2013 and December 2016. Results: There were a total of 41 children, age varied from 6 months to 15 years. The maximum number of cases 25 (61%) were in the age group of 0–5 years. Male:female ratio was 1.77:1. Unilateral cases were found to be 31 (76%) and bilateral cases be 10 (24%). Neoplastic lesions constituted 22 (54%) of which benign lesions were 3 (14%) and malignant were 19 (86%). Among malignant, primary were 11 (58%) and secondary were 8 (42%). Inflammatory/infective lesions were 8 (20%). Conservative/medical management was given to 11 cases (27%). Surgery with pre- or post-operative chemo- or radio-therapy was the treatment of choice. Conclusion: Neoplastic lesions were found to the most common cause of proptosis in this study. Apart from detail ocular and systemic examination, final etiological diagnosis is possible in certain cases only after investigations such as peripheral smear, bone marrow examination, histopathological examinations, ultrasonography B-scan, computed tomography scan, and magnetic resonance imaging. Timely diagnosis and management can save the vision and many a times lives.

Keywords

• neoplasia
• neuroimaging
• pediatric proptosis