Abstract

DO.19.09

Imaging techniques in disorders of lacrimal drainage system

Tost F. 
Department of Ophthalmology, Ernst-Moritz-Arndt-University, Greifswald

Tearing, mucous secretion and painless tumors are unspecific symptoms in various diseases of lacrimal draining system. Functional disorders include: chronic inflammation (lacrimal stenosis and lacrimal occlusion), pseudotumor, implants (lacrimal plugs), intracanalicular foreign bodies, infection (sarcoidosis) or benign and malign tumor. At the centre for Dacryology imaging techniques are routinely conducted. Diagnostic spectrum of imaging techniques comprise: high frequency ultrasound, dacryoendoscopy, digital subtraction dacryocystography, radionuclide dacryocystography, magnetic resonance tomography and computed tomography. The high frequency ultrasound (probes with 20 – 33 MHz) allows the detection of intracanalicular lacrimal plugs, foreign bodies or concrements of chronic canaliculitis. The dacryoendoscopy allows the assessment of intracanalicular structure (lumen and epithelium). However, despite of positive nasolacrimal duct irrigation, dacryoendoscopy permitts a specific diagnosis, such as dacryolith.
During microdrill procedures and subsequent minimal invasive therapy it can be difficult to detect an infiltrative tumor into the lacrimal draining system. Now and then epithelium surface structure of lacrimal canaliculus and long-distance lacrimal duct occlusion provides clinical evidence. It is then necessary to make a biopsy or surgical tumor excision. Magnetic resonance tomography and computed tomography are used preoperative in suspected diagnosis of tumor. Possibilities and limits of imaging techniques are discussed.

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