The clinical and high-resolution computed tomographic (CT) findings in 71 patients (142 orbits) with Graves orbitopathy and 20 healthy patients (40 orbits) were retrospectively reviewed. The orbits with orbitopathy were subgrouped at clinical examination into those with (n = 18) and those without (n = 124) optic neuropathy. Mean extraocular muscle diameters and the calculated muscle diameter index were significantly increased in all orbits with ophthalmopathy, particularly in those with optic neuropathy. Graves orbitopathy affected the superior muscle group (63.4%) more than the medial (61.3%) or inferior (57%) recti. The most common pattern of muscle involvement involved all five measured extraocular muscles. Solitary muscle involvement most frequently involved the superior muscle group (6.3%). Significant enlargements of the retrobulbar optic nerve sheath and superior ophthalmic vein were noted only in orbits with optic neuropathy. Anterior displacement of the lacrimal gland at CT correlated with clinical palpability and occurred more frequently in patients with optic neuropathy. Severe apical crowding was the most sensitive indication of optic neuropathy at CT.

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To assess the value of computed tomography (CT) in evaluation of orbital lymphangioma, the CT findings in 11 patients were retrospectively analyzed and correlated with the clinical, hemodynamic, surgical, and pathologic findings. The lesions were classified by location in three categories: superficial (n = 1), deep (n = 6), or combined (n = 6); the latter were evident earlier in life. The CT findings correlated well with the surgical and histologic findings. Orbital lymphangiomas were poorly defined lesions that crossed anatomic boundaries such as the conal fascia and orbital septum. Some degree of enhancement was the rule, ranging from scattered patchy areas to enhancement of the majority of the lesion. Areas of hemorrhage caused cystlike masses with rim enhancement. Preoperative identification of the vascular enhancing component at CT examination enables the surgeon to resect this area to prevent postoperative hemorrhage. High-resolution CT is of great value in the diagnosis and preoperative treatment planning of orbital lymphangioma.

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The computed tomographic (CT) features of orbital dermoids were retrospectively reviewed in 17 patients; 15 of the lesions were proved histologically. On the basis of clinical and CT features, the tumors were classified as superficial or deep. All but one were extraconal in location. Seven lesions appeared cystic; only six showed typical fat density. The presence of a margin or rim, often partially calcified, was identified in ten lesions. Irregular scalloping of adjacent bone was a highly suggestive feature, occurring with 11 dermoids. Other bone changes, such as linear defects, thinning, or sclerosis, also occurred. Superficial dermoids showed less apparent bone changes. An extraconal orbital lesion associated with adjacent bone thinning or notching should raise the possibility of a dermoid, especially if a rim with calcification is seen. The appearance is pathognomonic if fat density is also present.