Casting An Eye On Fibrous Dysplasia Of The Orbit
Jessica D. Blum, MSc, Dillan F. Villavisanis, BA, Liana Cheung, MBBS, Jinggang Ng, MA, Daniel Y. Cho, MD, Jordan W. Swanson, MD, Jesse Taylor, MD, Scott P. Bartlett, MD.
Children's Hospital of Philadelphia, Philadelphia, PA, USA.
PURPOSE: The presence of orbital fibrous dysplasia (FD) threatens compressive neuropathy and irreversible vision loss. The purpose of this study is to evaluate the longitudinal outcomes of 35 patients with orbital FD who underwent stratified surgical management (Figure 1).
METHODS: All patients treated for FD from 2015-2021 were identified, yielding 186 patients. Thirty-five patients had orbital involvement and 24 had over one year of follow-up. Treatment course, operative records and head imaging were obtained from chart review. RESULTS: Average patient age at FD diagnosis was 11.0 ± 4.7 (IQR 6.7) years with average follow up of 5.1±4.7 years. Nineteen of 35 patients (54.2%) underwent at least one surgery for FD, with two patients requiring up to four serial operations. Average age at initial operation was 5.9 ± 6.9 years. Time from diagnosis to optic canal decompression was 2.5±2.8 years. Sixteen patients (45.7%) underwent surgical pathway 2, and three patients underwent surgical pathway 3. Later diagnosis was associated with an increased total number of surgeries (r=.674, p=.006) and decreased time to decompression (r=-.736, p <.001). Postoperatively, three patients had worsening of vision (16.7%) and fifteen had stable or improved vision (83.3%). CONCLUSION: Later diagnosis of orbital FD was associated with shorter time to orbital decompression and increased surgical burden. This study provides a preliminary description of treatment course and visual outcomes of orbital FD. 
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