PMC6756819_01
Preoperative image of the patient showing right proptosis and eyelid ptosis
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Clinical examination showed a non-pulsatile, painless, axial, irreducible exophthalmia with no sign of conjunctivitis or keratitis, and right monocular blindness, right ptosis; and fundal examination had objectified right papillary oedema (Figure 1).
Brain MRI Axial sequences: T1 (A), T2 (B), T1 with contrast injection (C) and Flair Sequence (D) objectifying a rounded lesion that appears hypointense T1, hyperintense T2, well limited, thin walled Which takes slightly the contrast product (C), on the Flair sequence (D) it appears hypointense testifying to the liquid content of the lesion, which laterally compresses the optic nerve
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Brain and orbital magnetic resonance imaging (MRI) revealed an extra-connal right orbital lesion near the orbital apex, measuring 28 x 18mm, of oval shape, it appeared hypo-signal in T1 and hyper-signal in T2, limited by a thin wall which took contrast product, this lesion compressed the optic nerve towards the nasal region (Figure 2).
Image of the patient realized after 2 years of surgery showning ocular asymmetry and remarkable regression of proptosis and eyelid ptosis
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The patient however still retains a right unilateral nasal hemianopia after two years of follow-up (Figure 3).
Postoperative brain and orbital MRI, axial T2 weighted sequence (A) and FLAIR (B) showing the total disappearance of the cyst with optic nerve decompression
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An MRI done in the same period shows a cure of the patient by a complete disappearance of the cyst (Figure 4).