Orbital metastasis as the primary presentation of nasopharyngeal carcinoma

Association of the nasopharyngeal carcinoma and the subsequent open glaucoma development: a nationwide cohort study

This study aimed to investigate the possible association between nasopharyngeal carcinoma (NPC) and following open angle glaucoma (OAG). A retrospective research applying the National Health Insurance Research Database (NHIRD) of Taiwan was conducted with a follow up period from January 1, 2000 to December 31, 2016. There were 4184 and 16736 participants that selected and categorized into the NPC and non-NPC groups after exclusion. The major outcome of our study was the development of OAG according to diagnostic codes, exam and managements. The Cox proportional hazard regression was employed to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of OAG between the two groups. In this study, a numbers of 151 and 513 OAG episodes occurred in the NPC and non-NPC groups and the NPC population showed a significantly higher incidence of OAG compared to the non-NPC population in multivariable analysis (aHR: 1.293, 95% CI: 1.077-1.551, p = 0.0057). Besides, the cumulative probability of OAG was significantly higher in the NPC group than that in the non-NPC population (p = 0.0041). About other risk factor for OAG, age older than 40 years old, diabetes mellitus and persistent steroid usage were related to OAG occurrence (all p < 0.05). In conclusion, the NPC may be an independent risk factor of following OAG development.

The Nasopharyngeal Carcinoma and Its Effect on the Infectious Eye Disease: A Nationwide Cohort Study

The purpose of this study is to investigate the potential correlation between nasopharyngeal carcinoma (NPC) and both infectious keratitis and orbital cellulitis. The retrospective cohort study used the National Health Insurance Research Database (NHIRD) as a data source. A total number of 4184 patients with NPC diagnosis were selected and matched to 16,736 non-NPC patients via the propensity-score matching (PSM). The main outcomes are the development of infectious keratitis and orbital cellulitis according to diagnostic codes and related medications. The Cox proportional hazard regression was adopted to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) of outcomes between the two groups. A total of 35 and 19 episodes of orbital cellulitis occurred in the NPC and non-NPC groups and the aHR was significantly higher in the NPC group (aHR: 1.34, 95% CI: 1.23−1.46, p = 0.0024). There were 2185 and 659 events of infectious keratitis in the NPC and non-NPC groups, and the NPC group revealed a significantly higher aHR than non-NPC group (aHR: 1.34, 95% CI: 1.23−1.46, p < 0.0001). Besides, the cumulative probability of infectious keratitis was significantly higher in the NPC group than the non-NPC group (p < 0.0001). The other risk factors of infectious keratitis include age from 20 to 30 years old, allergic respiratory diseases, allergic dermatological diseases, and external eye diseases (all p < 0.0001). In subgroup analyses, both the incidences of infectious keratitis (aHR: 1.33, 95% CI: 1.21−1.47) and orbital cellulitis (aHR: 2.36, 95% CI: 1.27−4.39) were significantly higher than the non-NPC group. The incidence of infectious keratitis was significantly higher in NPC patients without radiotherapy (aHR: 1.40, 95% CI: 1.26−1.55) compared to non-NPC population, while the rate of orbital cellulitis was similar between the NPC patients without radiotherapy (aHR: 0.76, 95% CI: 0.27−2.14) and non-NPC population. In conclusion, the existence of NPC associates with higher incidence of infectious keratitis which increases with NPC period, and the radiotherapy may be account for the higher rate of orbital cellulitis in NPC population.

Ophthalmic involvement in nasopharyngeal carcinoma

This article desribes the ophthalmic involvement in patients with nasopharyngeal carcinoma (NPC) pre- and post-treatment. We retrospectively reviewed data for 354 consecutive patients diagnosed with or treated for NPC at a single tertiary centre between April 2007 and July 2015. We identified 27 (7.6%) patients with ophthalmic involvement due to NPC or its treatment. Symptomatic orbital invasion by tumor occurred in 13 of 27 patients (48.1%). The mean age of diagnosis in these patients was 54 years, and 8 (61.5%) had no prior diagnosis of NPC. Ocular signs, but no orbital invasion, was present in 8 patients (29.6%). Incidental orbital involvement was detected on imaging in 2 patients (7.4%). Radiotherapy-related ocular complications affected 4 patients (14.8%). Ophthalmic symptoms from orbital invasion can be the initial presentation of NPC. This disease tends to affect a younger group of patients and early recognition is important to minimize morbidity and mortality.