THE FREQUENCY OF OCCURRENCE OF DISEASES OF THE ORBIT, ACCORDING TO THE DATA OF APPEALS TO STATE INSTITUTION “THE FILATOV INSTITUTE OF EYE DISEASES AND TISSUE THERAPY OF THE NAMS OF UKRAINE” FOR 2010-2020.

Abstract

Introduction: anatomical and topographic features of the orbit, its relationship with the skull cavity and paranasal sinuses, the state of the vascular system (direct connection of the arterial system of the orbit with the external and internal carotid arteries, the absence of valves in the veins of the orbit) create conditions for the development of various pathological processes that are characteristic not only for the orbit and its surrounding structures, but also for some general diseases. Timely differential diagnosis of the pathological condition of the orbit is very difficult, meanwhile, the tactics of treatment and its final result depend on the correct diagnosis. Mistakes in establishing a diagnosis, incorrect treatment tactics can lead not only to the loss of visual functions and the eye as an organ of vision, but sometimes to the life of the patient. Purpose: to analyze the frequency of occurrence of orbital diseases in Ukraine, according to the data of patients' appeals to the SI “The Filatov Institute of Eye Diseases and Tissue Therapy of the AMS of Ukraine” for 10 years (2010-2020). Material and methods: 2941 treatment results of the patients with orbital diseases, who were treated at the Institute in 2010-2020, were analyzed retrospectively. The average age of the patients was 51.3±14.5 years old. There were 1949 (66.3%) women and 992 (33.7%) men. 1188 patients were operated on. There were 1016 orbitotomies and 172 orbital exenterations were performed, 5 of which were orbitosinual. Over the years of the study, the ratio of the number of women and men, as well as the average age of the patients, did not differ. Results: the analysis of diseases of the orbit according to their genesis showed that patients with endocrine ophthalmopathy - 1005 (34.1%) cases and with inflammation of orbital tissues, both acute and chronic - 973 (33.1%) cases came to the institute most often, among which Dacryoadenitis was diagnosed in 142 (14.6%) cases. Orbital tumors accounted for 816 (27.8%) cases of all orbital diseases, among them benign – 373 (45.7%), malignant – 443 (54.3%). Cysts of various origins (dermoid, epithelial, cholesteatoma) were found in 86 (2.9%) patients. Anomalies of the development of the vascular system were observed in 12 (0.4%) cases, Wegener's disease - in 4 (0.14%), sarcoidosis - in 1 (0.03%), post-traumatic hematoma - in 1 (0.03%), heartworm disease - in 43 (1.5%). Among benign tumors (373 patients), tumors of vascular genesis prevailed (cavernous hemangiomas – 185 (49.6%) cases). The second place was occupied by tumors of neurogenic origin (neurinoma, meningioma, neurolemoma, neurofibroma, arachnoendothelioma) - 69 (18.5%), then - benign epithelial tumors of the lacrimal gland (pleomorphic adenoma) - 57 (15.3%), fibroids (soft, solid, vascular) – 25 (6.7%), rare tumors of the orbit (osteoma, mesenchymoma, histiocytoma, xanthogranuloma, leiomyoma, embryonal tumor) – 22 (5.9%) and lymphoid hyperplasia of orbital tissues – 15 (4, 0%) cases. Malignant tumors of the orbit (443 patients) were represented mainly by tumors of epithelial origin - 211 (47.6%). Of them, malignant tumors of the lacrimal gland (adenocarcinoma, cancer in pleomorphic adenoma, adenocystic cancer) accounted for 48 (22.8%) cases, skin cancer and cancer from paranasal sinuses with spread to orbital tissue - 163 (77.2%). In second place are malignant lymphomas of different cellular structure, which accounted for 169 (38.1%) cases. The third place was occupied by metastatic tumors - 29 (6.6%) cases, among which metastatic lesions of orbital tissue from breast cancer predominated in women, and lung and prostate cancer in men. On the fourth place - primary melanomas - 19 (4.3%). Then there are malignant tumors of vascular genesis (hemangioendothelioma, hemangiopericytoma, angiosarcoma) - 13 (2.9%) and neurogenic genesis (neuroblastoma, glioblastoma) - 2 (0.5%). Tumor-like orbital diseases (chronic productive inflammation and endocrine ophthalmopathy) accounted for 67.2% of all diseases of the orbit and lead among them, as well as according to the data of our previous studies. It should be noted that malignant tumors took the first place (54.3%) with a predominance of epithelial tumors (60.5%), among which cancer of the eyelids and paranasal sinuses with spread to the orbit (60.8%) is in first place. Earlier, we noted that among malignant tumors of the orbit, the first place was occupied by tumors of lymphoid origin (29.1%), the second - metastatic tumors (23.6%), the third - eyelid cancer with spread to the orbit - 22.4%, the fourth - epithelial tumors lacrimal gland (14.0%), followed by soft tissue sarcomas of the orbit (5.5%), melanomas of the orbit (5.8%), tumors of vascular origin (1.6%) and osteosarcoma (0.8%). Conclusion: the obtained make it possible to partially assess the incidence of orbital diseases in Ukraine, based on the data of patient appeals to the State Institution “The Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine”.