Felis ISSN 2398-2950

Retrobulbar space-occupying lesion

Contributor(s): Dennis E Brooks, James Oliver

Introduction

  • Cause: neoplasia, abscess, cellulitis, mucocele.
  • Signs: periocular swelling, exophthalmos, nictitans protrusion, ocular discharge, ocular discomfort.
  • Diagnosis: clinical examination, ultrasonography, advanced imaging, cytology, histopathology, culture and susceptibility.
  • Treatment: drainage, surgical excision, radiotherapy, chemotherapy. 
  • Prognosis: good for abscess/cellulitis, poor for neoplasia.

Pathogenesis

Etiology

  • Neoplasia:
  • Abscess/cellulitis  Eye: retrobulbar abscess :
    • Penetrating trauma (via skin, conjunctiva or oral cavity).
    • Migrating foreign bodies.
    • Hematogenous dissemination.
  • Mucocele:
    • Zygomatic salivary gland  Eye: chemosis due to zygomatic salivary gland mucocele .

Predisposing factors

General

  • Older cats.
  • Unpigmented eyelids and sunny climates for squamous cell carcinoma.

Specific

  • High levels of UVB can induce malignant transformation of squamous cell carcinoma.

Pathophysiology

  • High levels of UVB can induce malignant transformation of squamous epithelial cells. Conjunctival squamous cell can invade orbit.
  • Metastatic spread of lymphoma to orbital tissues.
  • Bacterioides Bacteroides fragilisand Pasteurella spp Pasteurella multocida most commonly implicated bacteria in retrobulbar abscess and cellulitis.
  • Aspergillus Aspergillus flavus  anCryptococcus Cryptococcus neoformans spp most commonly implicated fungi in sinoorbital disease.
  • Mucocele derives from zygomatic salivary gland Salivary mucocoele.

Timecourse

  • Weeks to months.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Lederer K, Ludewig E, Hechinger H et al (2014) Differentiation between inflammatory and neoplastic orbital conditions based on computed tomographic signs. Vet Ophthalmol 18 (4), 271-275 PubMed.
  • Kano R, Shibahashi A, Fujino Y et al (2013) Two cases of feline orbital aspergillosis due to Aspergillus udagawae and A. viridinutansJ Vet Med Sci 75 (1), 7-10 PubMed.
  • Murphy S (2013) Cutaneous squamous cell carcinoma in the cat: current understanding and treatment approaches. J Feline Med Surg 15 (5), 401-417 PubMed.
  • Bell C M, Schwarz T, Dubielzig R R (2011) Diagnostic features of feline restrictive orbital myofibroblastic sarcoma. Vet Pathol 48 (3), 742-750 PubMed.
  • Lybaert P, Delbecke I, Cohen-Solal A (2009) Diagnosis and management of a wooden foreign body in the orbit of a cat. J Feline Med Surg 11 (3), 219-221 PubMed.
  • Wang A L, Ledbetter E C, Kern T J (2009) Orbital abscess bacterial isolates ad in vitro antimicrobial susceptibility patterns in dogs and cats. Vet Ophthalmol 12 (2), 91-96 PubMed.
  • Atali-Soussay K, Jegou J P, Clerc B (2001) Retrobulbar tunours in dogs and cats: 25 cases. Vet Ophthalmol (1), 19-27 PubMed.
  • Dennis R (2000) Use of magnetic resonance imaging for the investigation of orbital disease in small animals. JSAP 41 (4), 145-155 PubMed.
  • Speakman A J, Baines S J, Williams J M et al (1997) Zygomatic salivary cyst with mucocoele in a cat. JSAP 38 (10), 468-470 PubMed.

Other sources of information

  • Mitchell N & Oliver J (2015) Feline Ophthalmology - The Manual. Servet. ISBN 978-84-16315-11-6.
  • Gould D & McLellan G (2014) BSAVA Manual of Small Animal Ophthalmology. 3rd edn. British Small Animal Veterinary Association.


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