A Study of Cases of Sinus Cysts Presenting with Visual Impairment

<p>　　Sinus cysts are relatively common and patients sometimes present with symptoms of visual impairment, including diplopia and loss of visual acuity, necessitating urgent sinus surgery. In this study, we conducted a review of cases of sinus cysts that presented to us with visual impairment over the last 10 years.</p><p>　　We reviewed the data of 12 cases of sinus cysts that presented with visual impairment among those who underwent sinus surgery at our hospital between April 1, 2010, and March 31, 2020. Visual impairment was defined as diplopia, loss of visual acuity, or visual field disorder. We obtained information about the age, gender, etiology of the cysts, symptoms, location of the cysts, department initially seen at, surgery performed, and outcomes of the patients from the medical records.</p><p>　　Among the 12 patients, 7 presented with diplopia, 5 with visual acuity loss, and 2 with visual field defects. The primary lesions were located in the maxillary sinus in 5 cases, in the anterior ethmoidal sinus in 1 case, in the posterior ethmoidal sinus in 1 case, in the frontal sinus in1 case, and in the sphenoid sinus in 3 cases. Among the 7 cases of diplopia, 6 presented more than a month after the symptom onset, indicating a tendency for delayed medical consultation. Among the 5 cases with visual acuity loss, 4 received treatment intervention within two weeks, while over a month passed between symptom onset and treatment in the remaining 1 case. The prognosis was favorable, with complete improvement in all the cases that presented with diplopia, and significant improvement in all cases, except one who developed total blindness, with visual acuity loss.</p><p>　　Even in cases with a prolonged duration of symptoms, diplopia and non-severe visual acuity loss could improve with surgical treatment. However, for cases with severe visual acuity loss, early diagnosis and prompt surgical intervention are essential. Since there were only a few reported cases of patients presenting with visual field disorders, it is thought necessary to increase the awareness of ophthalmologists about this condition, so that treatment can be initiated before visual impairment sets in.</p>