Intraorbital ophthalmic artery aneurysm: A systematic review.

Abstract

Background: Rare arterial abnormalities known as intraorbital ophthalmic artery aneurysms (IOOAAs) present considerable difficulties in diagnosis and treatment. To effectively manage these uncommon illnesses, sophisticated diagnostic methods and meticulous treatment planning are needed. The purpose of this study is to thoroughly examine the clinical manifestations, diagnostic techniques, therapeutic modalities, and results of IOOAAs.

Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, utilizing the PubMed and Scopus databases. The search terms included "ophthalmic artery," "aneurysm," "intraorbital," and "orbit." Studies were considered if they included patients with clinically confirmed IOOAAs and were published in English. The data collected encompassed patient demographics, aneurysm characteristics, clinical presentations, diagnostic imaging techniques, treatment methods, and outcomes.

Results: An analysis was conducted on fifteen studies involving fifteen patients with an average age of 46.4 years. Females constituted 40% of the study population. The most common symptom presented was loss of vision, which was seen in 93.3% of cases, while proptosis was found in 46.7% and pain in 40%. Aneurysms were found more on the right side, 66.7%, and varied in size and morphology; saccular aneurysms constituted 33.3% of the total number of aneurysms, while fusiform constituted 20%. The availability of advanced imaging techniques, especially angiography, magnetic resonance imaging (MRI), and computed tomography scans, considerably improved the diagnosis rate. Treatment approaches included surgery in 46.7% of the total number of patients, conservative treatment in 33.3%, and endovascular treatment in 20%. The outcome from these managements was variable, with complete resolution of symptoms seen in 33.3% of patients and partial improvement in 40%. The average time of follow-up and observation was 11.18 months.

Conclusion: Ophthalmic artery aneurysms within the intraorbital compartment are rare yet present formidable challenges for their diagnosis and management. Accurate localization of the aneurysm requires the use of very advanced imaging techniques. In this regard, high-resolution MRI and computed tomography angiography play a pivotal role in the detection of these anomalies within the complex structures of the eye. Proper planning of therapy that better suits the condition and proper follow-up care is important for the best outcomes. Future research should focus on guideline standardization in management and long-term outcome improvements.