BACKGROUND: To report an unusual case of compressive optic neuropathy secondary to a large onodi air cell.
METHOD: Case report.
RESULTS: A 50 year-old gentlemen presented to the eye clinic with left eye painless loss of vision for one day. Visual acuity was counting finger in the left eye with a positive relative afferent pupillary defect (RAPD). Dilated left fundus examination revealed a pale optic disc. A computed tomography of orbit and brain showed a large left sphenoid sinus with onodi-cell-like projection on the left superior margin of left optic canal impinging on the left optic nerve. He was referred to the otorhinolaryngology team and subsequently underwent left optic nerve decompression. Post-operatively, his left visual acuity improved to 6/60 with reversal of RAPD.
CONCLUSION: There are many causes of optic neuropathy and compressive optic neuropathy due to large onodi air cell is uncommon. Acute unilateral loss of vision heralds from a multitude of sinister causes and junior residents should be vigilant that onodi air cell pneumotisation could be one of them.
This retrospective case series evaluates the use of intralesional bleomycin injections in treating orbital venolymphatic malformations (OVLM). Three patients, a 7-year-old girl, a 37-year-old woman, and a 56-year-old man, presented with OVLM where the first two were recurrent cases with a history of failed sclerotherapy. All patients received multiple doses of intralesional bleomycin injections, resulting in significant reductions in lesion size, decreased proptosis, and pain relief. Although complete symptom resolution was not achieved, the injections were well-tolerated, and no ophthalmic or systemic side effects were reported. The findings suggest that bleomycin, a sclerosing agent inducing local inflammation and thrombosis, is an effective and safe treatment for OVLM, particularly in cases where excision is not feasible or previous therapies have failed. Intralesional bleomycin injections may offer a valuable alternative for managing this challenging condition.