Clinical Profile and Outcomes of Ocular Dermoid Cysts at the Philippine General Hospital
Justin Alan A. Yao, MD1, Mary Ellaine S. Diaz, MD1, Ruben Lim Bon Siong, MD1,2
1Department of Ophthalmology and Visual Sciences, University of the Philippines-Philippine General Hospital, Manila, Philippines
2Eye Institute, St. Luke’s Medical Center, Quezon City, Philippines
Correspondence: Justin Alan A. Yao, MD
Office Address: Department of Ophthalmology and Visual Sciences, Sentro Oftalmologico Jose Rizal, University of the Philippines– Philippine General Hospital, Taft Avenue, Ermita, Manila, 1000 Philippines
Office Phone Number: +63285548400 local 8502
Email Address: jayao@up.edu.ph
Disclosures: The authors report no conflict of interest.
ABSTRACT
Objectives: This study described the clinical profile and outcomes of patients with ocular dermoid cysts at a subspecialty Ophthalmology clinic of the Philippine General Hospital (PGH).
Methods: Medical records of 38 patients seen at the External Disease & Cornea Clinic from January 2012 to June 2023 were reviewed. Demographics, best-corrected visual acuity (BCVA), refraction, other associated malformations, and dermoid characteristics were collected. For those that underwent surgery, the procedures performed and histopathology reports were reviewed. Most recent refraction, BCVA, presence of amblyopia, recurrence, and complications were recorded.
Results: Mean age at presentation was 8.33 years old with equal male:female distribution (52% vs 48%). Thirty- four (34) participants (89.5%) had unilateral dermoids and 4 participants (10.5%) had bilateral dermoids, for a total of 42 eyes. Thirty-five (35) or 83.3% of the dermoids were located at the inferotemporal quadrant of the cornea. There were 42.1% participants who had associated congenital anomalies, with dermolipoma and pre- auricular tags being the most common ocular and craniofacial findings, respectively. Twenty-seven (27) eyes (64.2%) underwent surgery and the most common procedure was excision with limbal conjunctival autograft (55.6%). In the 8 eyes that underwent simple excision, recurrence of the dermoid was seen in 1 patient and development of pseudopterygium in 5 patients. Dermoid was the histopathological diagnosis in 96.3% of the excised tissues. Twenty-four (24) patients (63.2%) presented with ambylopia with BCVA <20/30, and regardless of type of intervention done, only 7 participants (23.3%) had a visual acuity better than 20/30 during their latest consult.
Conclusion: Ocular dermoid is a common congential anomaly usually presenting as an isolated, unilateral mass at the inferotemporal limbal area. Aside from the obvious effect on the cosmetic appearance of the eye, a more pressing concern is the high incidence of amblyopia. Timely excision with limbal conjunctival autograft is highly recommended coupled with aggressive amblyopia therapy.
Keywords: Ocular dermoid cyst, clinical profile, outcomes, recurrence, amblyopia, limbal conjunctival autograft, pseudopterygium