Presentation
Right orbital pain with exophthalmos and extensive orbital and periorbital edema.
Patient Data
Age: 30 years
Gender: Male
From the case:
Orbital infection
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The MRI sequences demonstrate:
- thickening with enhancement of the soft tissue anterior to the right orbital septum in keeping with a preseptal periorbital cellulitis
- proptosis grade 3 with vitreal exudates seen as peripheral thickening with no enhancement
- Inflammatory stranding of the intraconal fat around the optic nerve with enhancement in keeping with postseptal orbital cellulitis
- diffuse smooth uveal/scleral thickening with enhancement
- swelling with enhancement of the right orbital muscles
- edema with the enhancement of the periorbital soft tissues
- normal appearance of the cavernous sinuses
Retention cyst of the left maxillary sinus is noted as well as partially empty sella.
Case Discussion
MRI features are most consistent with an orbital infection associating pre-and postseptal orbital cellulitis with intraocular extension of the infection (endophthalmitis) and secondary proptosis grade 3.