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Ocular Orbit

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1. Orbital reconstruction for tumor-associated proptosis: quantitative analysis of postoperative orbital volume and final eye position. (Abstract)

Orbital reconstruction for tumor-associated proptosis: quantitative analysis of postoperative orbital volume and final eye position. OBJECTIVESurgical resection of sphenoid wing tumors and intraorbital pathology carries the dual goal of appropriately treating the target pathology as well as correcting proptosis. Residual proptosis following surgery can lead to cosmetic and functional disability. The authors sought to quantitatively assess the effect of orbital volume before and after (...) reconstruction to determine the optimal strategy to achieve proptosis correction.METHODSAll surgeries involving orbital wall reconstruction for orbital or intracranial pathology that preoperatively resulted in proptosis between 2007 and 2017 were reviewed. Proptosis was measured by the exophthalmos index (EI): the ratio of the distance of the anterior limit of each globe to a line drawn between the anterior limit of the frontal processes of the zygomas, comparing the pathological eye to the normal eye

2019 Journal of Neurosurgery

2. Orbital radiotherapy plus three-wall orbital decompression in a patient with rare ocular manifestations of thyroid eye disease: case report. Full Text available with Trip Pro

Orbital radiotherapy plus three-wall orbital decompression in a patient with rare ocular manifestations of thyroid eye disease: case report. Thyroid eye disease (TED) is a debilitating autoimmune orbital disease that is often a result of Graves' disease. Dysthyroid optic neuropathy (DON) is a rare but sight-threatening manifestation of TED with therapeutic challenges that can potentially lead to visual loss.A 74-year-old man experienced active TED with extremely severe redness and swelling (...) and severe case of DON with therapeutic challenges. To date, no cases has been reported of a patient with such severe and unusual ocular manifestations. Early awareness of the occurrence of optic nerve compression and prompt treatment are important to prevent irreversible outcomes. Orbital radiotherapy should be considered as a useful surgery-delaying alternative for DON, especially in patients who have contraindications to steroids.

2018 BMC Endocrine Disorders

3. Peri-orbital and orbital cellulitis

ocular dysfunction and is usually due to underlying bacterial sinusitis. Orbital cellulitis is a far more serious condition and warrants hospital admission. It has much higher morbidity than peri-orbital cellulitis, and warrants urgent imaging and surgical evaluation by oculoplastic as well as a head-and-neck consultant. History and exam presence of risk factors recent sinus infection recent eyelid injury redness and swelling of eye ocular pain decreased vision proptosis eyelid oedema insect bite (...) on eyelid stye or chalazion ear or facial infection ophthalmoplegia and diplopia orbital trauma skin infection chemosis tenderness around eye fever eyelid erythema elevated intra-ocular pressure headache malaise previous dental infection or dental work orbital fracture foreign body in eye or orbit drowsiness nausea/vomiting nasal discharge sinusitis young age male sex lack of Hib vaccine in children Diagnostic investigations clinical examination CT sinus and orbits with contrast WBC count blood culture

2018 BMJ Best Practice

4. Outcomes of orbital malignancies treated with eye-sparing surgery and adjuvant particle radiotherapy: a retrospective study. Full Text available with Trip Pro

Outcomes of orbital malignancies treated with eye-sparing surgery and adjuvant particle radiotherapy: a retrospective study. To report the clinical experience of eye sparing surgery (ESS) and adjuvant carbon-ion or proton radiotherapy (CIRT or PRT) for orbital malignancies.An analysis of the retrospective data registry from the Shanghai Proton and Heavy Ion Center for patients with orbital tumors was conducted. The 2-year local progression-free, regional recurrence-free, distant metastasis-free (...) , progression-free, and overall survival (LPFS, RRFS, DMFS, PFS, OS) rates as well as associated prognostic indicators were analyzed. Radiotherapy-induced acute and late toxicities were summarized.Between 7/2014 to 5/2018, 22 patients with orbital malignancies of various pathologies received ESS followed by CIRT (18), PRT (1), or PRT + CIRT boost (3). With a median follow-up of 20.25 (range 3.8-38.8) months, the 2-year OS, PFS, LPFS, RRFS, and DMFS rates were 100, 57.9, 92.9, 93.3, and 72.8%, respectively

2019 BMC Cancer

5. Influence of orbital morphology on proptosis reduction and ocular motility after decompression surgery in patients with Graves' orbitopathy. Full Text available with Trip Pro

factors in computed tomography (CT), which influence the surgical effect and postoperative ocular motility and diplopia.Pre- and postoperative CT-scans of 125 eyes of 68 patients, who mainly underwent a balanced orbital decompression for disfiguring proptosis (≥18mm Hertel Index), have been analyzed. Proptosis, ductions, misalignment and diplopia were assessed before and after surgery. Medial and lateral orbital wall length, conus angle, depth of ethmoidal sinus, orbital surface, length of medial (...) Influence of orbital morphology on proptosis reduction and ocular motility after decompression surgery in patients with Graves' orbitopathy. Orbital decompression surgery is performed in patients with Graves' orbitopathy to treat dysthyroid optical neuropathy (DON) and reduce disfiguring proptosis. The intended proptosis reduction can deviate from the postoperative result and changes of motility with consecutive diplopia can occur. We performed a retrospective study to identify anatomical

2019 PLoS ONE

6. Elevated Optic Disc Height and Increased Optic Nerve Sheath Diameter on Bedside Ultrasound in a Pediatric Patient With Orbital Cellulitis: More Than Meets the Eye. (Abstract)

Elevated Optic Disc Height and Increased Optic Nerve Sheath Diameter on Bedside Ultrasound in a Pediatric Patient With Orbital Cellulitis: More Than Meets the Eye. Orbital cellulitis is an uncommon ophthalmological emergency in children, but rapid emergency department (ED) diagnosis is essential.A 13-year-old boy presented to our pediatric ED with left orbital cellulitis secondary to pansinusitis. Emergency bedside ocular ultrasonography was used to evaluate and expedite his management. Besides (...) inflammatory changes observed on ultrasound of his affected orbit, the patient had an elevated optic disc height and increased nerve sheath diameter, which were not commonly reported in published literature on orbital cellulitis. Emergent computed tomography of the orbits and head showed orbital cellulitis without complications of orbital abscess or cavernous sinus thrombosis. Despite initiating early appropriate antibiotics, there was rapid progression of his disease and he developed intraconal abscess

2018 Journal of Emergency Medicine

7. Transcriptome Analysis of Orbital Adipose Tissue in Active Thyroid Eye Disease Using Next Generation RNA Sequencing Technology Full Text available with Trip Pro

Transcriptome Analysis of Orbital Adipose Tissue in Active Thyroid Eye Disease Using Next Generation RNA Sequencing Technology This study utilized Next Generation Sequencing (NGS) to identify differentially expressed transcripts in orbital adipose tissue from patients with active Thyroid Eye Disease (TED) versus healthy controls.This prospective, case-control study enrolled three patients with severe, active thyroid eye disease undergoing orbital decompression, and three healthy controls (...) undergoing routine eyelid surgery with removal of orbital fat. RNA Sequencing (RNA-Seq) was performed on freshly obtained orbital adipose tissue from study patients to analyze the transcriptome. Bioinformatics analysis was performed to determine pathways and processes enriched for the differential expression profile. Quantitative Reverse Transcriptase-Polymerase Chain Reaction (qRT-PCR) was performed to validate the differential expression of selected genes identified by RNA-Seq.RNA-Seq identified 328

2018 The open ophthalmology journal

8. Orbital decompression in the system of treatment for complicated thyroid eye disease: case report and literature review Full Text available with Trip Pro

Orbital decompression in the system of treatment for complicated thyroid eye disease: case report and literature review Orbital decompression is a surgical procedure aimed at increasing the orbital volume and/or decreasing the volume of the orbital fat. The indications for orbital decompression are determined in the course of thorough eye examination. An important objective of examination of a patient with thyroid eye disease (TED) is determination of inflammation activity and severity. Orbital (...) and strabismus. In addition, other parameters may change as well, including the position of the globe, the eyelids, the angle of deviation of the eye, and intraocular pressure. Thus, bone orbital decompression is a major step of a comprehensive, often multistage, system of rehabilitation of patients with severe refractory TED.

2018 International medical case reports journal

9. Man with a Swollen Eye: Nonspecific Orbital Inflammation in an Adult in the Emergency Department. (Abstract)

Man with a Swollen Eye: Nonspecific Orbital Inflammation in an Adult in the Emergency Department. Nonspecific orbital inflammation (NSOI) is a rare idiopathic ocular pathology characterized by unilateral, painful orbital swelling without identifiable infectious or systemic disorders, which can be complicated by optic nerve compromise.A 50-year-old man presented to the Emergency Department with recurring, progressive painless left eye swelling, decreased visual acuity, and binocular diplopia (...) in the absence of trauma, infection, or known malignancy. His physical examination was notable for left-sided decreased visual acuity, an afferent pupillary defect, severe left eye proptosis and chemosis, and restricted extraocular movements; his dilatated funduscopic examination was notable for ipsilateral retinal folds within the macula, concerning for a disruption between the sclera and the retina. Ocular examination of the right eye was unremarkable. Laboratory data were unrevealing. Gadolinium-enhanced

2018 Journal of Emergency Medicine

10. Orbital tumor associated with a microphthalmic eye and colobomatous cleft: Pilocytic astrocytoma (glioma) or massive retinal gliosis Full Text available with Trip Pro

Orbital tumor associated with a microphthalmic eye and colobomatous cleft: Pilocytic astrocytoma (glioma) or massive retinal gliosis A 11-year-old boy with congenital microphthalmos of the right eye presented with gradual protrusion of his ocular prosthesis. MRI showed an orbital mass adjacent to the microphthalmic eye. After removal of the eye and the orbital soft tissue mass a gliotic mass, resembling a pilocytic astrocytoma WHO grade 1 (glioma) was diagnosed. Through a colobomatous cleft (...) in the eye the tumour spread in the orbit. There were no clinical signs of neurofibromatosis 1. This case showed a very rare association between a microphthalmic and colobomatous eye and pilocytic astrocytoma, grade 1. However a far advanced and infiltrative massive retinal gliosis cannot be definitively excluded as differential diagnosis.

2018 Saudi Journal of Ophthalmology

11. More than meets the eye: Varicella zoster virus-related orbital apex syndrome Full Text available with Trip Pro

More than meets the eye: Varicella zoster virus-related orbital apex syndrome A 67-year-old male patient with poorly controlled type-2 diabetes mellitus developed an orbital apex syndrome and anterior cavernous syndrome secondary to herpetic zoster ophthalmicus (HZO), despite being on oral acyclovir. Urgent treatment with intravenous acyclovir led to improvement of the orbital and ocular inflammation but had no effect on the complete ophthalmoplegia and profound visual loss. At the 9-month

2018 Indian journal of ophthalmology

12. Treatment of Ocular Neuralgia After Refractive Surgery With Bilateral Orbital Steroid and Anesthetic Injections. (Abstract)

Treatment of Ocular Neuralgia After Refractive Surgery With Bilateral Orbital Steroid and Anesthetic Injections. To describe a patient with chronic periocular pain after bilateral photorefractive keratectomy (PRK) and ocular neuralgia that was controlled with regular orbital steroid and anesthetic injections.Case report.A 21-year-old man presented 3 months following bilateral PRK surgery in severe bilateral orbital pain. Previous treatments included topical (artificial tears, corticosteroids (...) , and nonsteroidal anti-inflammatory drugs [NSAIDs) and oral (NSAIDs, opioids, and pregabalin) therapies with minimal pain relief. A bilateral orbital triamcinolone acetonide 40 mg/cc and 0.25% bupivacaine injection was done after a successful, diagnostic unilateral 0.25% bupivacaine injection. Following bilateral bupivacaine and triamcinolone acetonide injections, pain intensity improved from 7 of 9 to 1 of 3 out of 10. Repeat injections have been regularly performed over the past 3 years, allowing the patient

2019 Journal of Refractive Surgery

13. Aminobisphosphonate-associated orbital and ocular inflammatory disease. (Abstract)

. The aminobisphosphonate was halted in all patients, and some patients had anti-inflammatory treatment. Literature review included 68 patients (83 eyes), of them the most abundant drugs causing orbital/ocular inflammation were pamidronate (38 eyes) and zoledronate (35 eyes). Overall, among 76 patients, all drugs induced orbital disease, while uveitis was induced mostly by zoledronate and pamidronate, less by alendronate and not found among risedronate users. Time interval from drug administration to symptoms was hours (...) Aminobisphosphonate-associated orbital and ocular inflammatory disease. Aminobisphosphonates may cause orbital/ocular inflammation. Awareness of the clinical presentation and disease course is crucial. The purpose of this study was to analyse demographics, clinical presentation, disease course and treatment of aminobisphosphonate-associated orbital/ocular inflammation in a large series of patients.A retrospective study of patients with aminobisphosphonate-associated orbital/ocular inflammation

2019 Acta ophthalmologica

14. Prospective study on ocular motility limitation due to orbital muscle entrapment or impingement associated with orbital wall fracture. Full Text available with Trip Pro

Prospective study on ocular motility limitation due to orbital muscle entrapment or impingement associated with orbital wall fracture. The recommended urgent surgical management of ocular motility restriction due to orbital muscle entrapment or impingement associated with orbital wall fracture needs to be elucidated.To evaluate the importance of the time from injury to surgery for the outcome in ocular motility and diplopia, the time lapse of ocular motility, diplopia and hypesthesia (...) recovery.Patients with entrapment or impingement of orbital contents due to orbital wall fracture were followed up prospectively over 1year regarding ocular motility, diplopia, hypesthesia and cosmetic deformity.21 patients (10 entrapments and 11 impingements) were included and treated surgically. The median time from injury to surgery was 36 (8-413)h for the entrapment group and 168 (48-326)h for the impingement group. The median time from study inclusion to surgery was 0 (0-1) days for the entrapment group

2017 Injury

15. Can the onset of orbital cancer be the result of a prosthetic eye? Full Text available with Trip Pro

Can the onset of orbital cancer be the result of a prosthetic eye? Orbital exenteration is a disfiguring procedure performed for unresponsive orbital infections and control of recurrent benign tumours and malignancies arising from the eyelids (basal cell carcinoma, squamous cell carcinoma, conjunctival malignant melanoma), lachrymal glands (adenoid cystic carcinoma) or surrounding sinuses. In extremely rare cases the use of a prosthetic eye after enucleation can lead to anophthalmic socket (...) tumours. We report the case of a 54-year-old man who had left eye enucleation due to recurring events of retinal detachment and who developed an invasive fast growing epidermoid carcinoma 30 years later. We review the literature to evaluate the rarity of the occurrence, time of onset after enucleation, treatments and outcomes. Our case illustrates the management of the pathology and emphasises the necessity of careful examination of the anophthalmic socket and the ocular prosthesis to identify any

2017 Acta Otorhinolaryngologica Italica

16. Radiologic Parameters of Orbital Bone Remodeling in Thyroid Eye Disease. Full Text available with Trip Pro

Radiologic Parameters of Orbital Bone Remodeling in Thyroid Eye Disease. To radiologically examine for the presence of bony remodeling of the orbit in thyroid eye disease (TED).Computed tomography (CT) scans of 248 orbits of 124 patients with TED and 185 orbits of 138 controls were retrospectively reviewed, and the following parameters measured: the angle of the inferomedial orbital strut (AIOS), the angle of the medial wall (AMW), and the diameters of the extraocular muscles. The association (...) correlation between AMW and the calculated average cross-sectional area of the medial rectus in TED (r = -0.23, P = 0.01).A difference in the structure of the bony orbit in TED compared to controls may be demonstrated by the AIOS and AMW radiological parameters. This likely represents the presence of bony remodeling in TED, which may be related to the expansion of the intraorbital soft tissue volume.

2017 Investigative Ophthalmology & Visual Science

17. Orbital Decompression for Thyroid Eye Disease Full Text available with Trip Pro

Orbital Decompression for Thyroid Eye Disease Although most cases of thyroid eye disease (TED) can be managed medically, some refractory or severe cases are treated surgically with orbital decompression. Due to a lack of randomized controlled trials comparing surgical techniques for orbital decompression, none have been deemed superior. Thus, each case of TED is managed based on patient characteristics and surgeon experience. Surgical considerations include the extent of bony wall removal

2017 Seminars in plastic surgery

18. Structural-Functional Relationships Between Eye Orbital Imaging Biomarkers and Clinical Visual Assessments Full Text available with Trip Pro

Structural-Functional Relationships Between Eye Orbital Imaging Biomarkers and Clinical Visual Assessments Eye diseases and visual impairment affect millions of Americans and induce billions of dollars in annual economic burdens. Expounding upon existing knowledge of eye diseases could lead to improved treatment and disease prevention. This research investigated the relationship between structural metrics of the eye orbit and visual function measurements in a cohort of 470 patients from (...) a retrospective study of ophthalmology records for patients (with thyroid eye disease, orbital inflammation, optic nerve edema, glaucoma, intrinsic optic nerve disease), clinical imaging, and visual function assessments. Orbital magnetic resonance imaging (MRI) and computed tomography (CT) images were retrieved and labeled in 3D using multi-atlas label fusion. Based on the 3D structures, both traditional radiology measures (e.g., Barrett index, volumetric crowding index, optic nerve length) and novel

2017 Proceedings of SPIE--the International Society for Optical Engineering

19. An Eye Popping Case of Orbital Necrotizing Fasciitis Treated with Antibiotics, Surgery, and Hyperbaric Oxygen Therapy Full Text available with Trip Pro

An Eye Popping Case of Orbital Necrotizing Fasciitis Treated with Antibiotics, Surgery, and Hyperbaric Oxygen Therapy BACKGROUND Necrotizing fasciitis (NF) of the orbit is a rare and deadly condition that requires prompt surgical and medical management to decrease morbidity and mortality.  CASE REPORT Here we present an interesting case of an individual who developed fulminant NF of the left orbit requiring emergent surgical intervention, antibiotics, and subsequent hyperbaric oxygen therapy (...) in an attempt to save the eye.  CONCLUSIONS With an early and aggressive multifaceted approach using antibiotics, surgery, and hyperbaric oxygen it may be possible to preserve eye structure and function. Without treatment NF is a rapidly progressive condition and can result in significant morbidity.

2017 The American journal of case reports

20. Rectal Cancer in the Eye: A Case Report of Orbital Metastasis Full Text available with Trip Pro

Rectal Cancer in the Eye: A Case Report of Orbital Metastasis Orbital metastasis from colorectal cancer is extremely rare. In this case report, we describe a 48-year-old woman who presented with recurrent severe headaches and new onset constipation with no known history of cancer. After vigilant workup, imaging, and biopsies, she was diagnosed with orbital metastasis from a primary rectal carcinoma. She was started on chemotherapy and radiation therapy. Her chemotherapy regimen consisted

2017 Cureus

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