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Phthisis bulbi

Case contributed by Antonio Rodrigues de Aguiar Neto
Diagnosis almost certain

Presentation

Presenting paresthesia in the upper limbs.

Patient Data

Age: 60 years
Gender: Male
ct

Left phthisis bulbi with a small, shrunken left globe, with the thickened sclera, irregular contour, coarse dystrophic calcifications, increased attenuation in vitreous, and enophthalmos.

mri

MRI reveals a heterogeneous small, shrunken, calcified, deformed and irregularly shaped left globe, with enophthalmos - this is the end-stage of a degenerative globe (phthisis bulbi).

Case Discussion

Phthisis bulbi (PB) is a generic descriptive term that represents an end-stage eye disease, which is characterized by an anatomically disfigured, atrophic, and a shrunken globe with disorganization of the eyeball and intraocular contents 1,2,3,4. This condition results from wound healing secondary to various causes that may include inflammation, infection, chronic retinal detachment, trauma, complications from surgery, vascular disease, and malignancy 1,2,3,4.

CT imaging scan of the eye reveals an irregular, scarred shrunken globe, and dense internal calcification 2,3,5,6. These globes are easily recognized on MRI by their characteristic morphology, as well as by their altered signal intensity patterns, reflecting iron and other paramagnetic ion deposition along with the dystrophic calcification 2,3,4.

Case courtesy

  • Erick Cavalcante, MD - PGY-3, Radiology Resident, Department of Radiology
  • Antonio Rodrigues de Aguiar Neto, MD - Radiologist, Department of Radiology
  • Hospital da Restauração – Recife, PE – Brazil

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