Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Bilateral V600-E Mutant Ganglioglioma of the Optic Nerve and Entire Optic Pathway: Case Report and Literature Review.","authors":"Antonio Augusto Velasco Cruz, Márcia C Todo, Fernando Chahud, Gustavo S Boasquevisque, Luciano Neder, Elvis T Valera","doi":"10.1097/IOP.0000000000002928","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002928","url":null,"abstract":"<p><p>A 2-year-old male patient was presented with a bilateral optic nerve tumor diagnosed as a glioma, which extended to his entire optic pathways bilaterally. Previous treatment with conventional chemotherapy was unsuccessful. As his OS had no light perception, a biopsy of the optic nerve was performed through a transconjunctival approach. Histopathological examination of the specimen was compatible with ganglioglioma, an extremely rare neoplasm of the optic nerve. Genome sequencing of the tumor specimen revealed a BRAF V600E point mutation with activation of the MAPK/ERKkinase signaling pathway. The tumor was significantly reduced 3 months after targeted therapy.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Perforator Island Flaps for the Reconstruction of Mid-Facial and Periorbital Large and Deep Defects.","authors":"Antonio Augusto Velasco E Cruz, Juliana Albano de Guimarães, Sarah Soares Brassaloti, Roque Souza Lima, Mariana Nadais Aidar","doi":"10.1097/IOP.0000000000002925","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002925","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a single-hospital experience with the reconstruction of broad and deep periorbital defects with perforator island flaps (PIFs).</p><p><strong>Methods: </strong>Twenty cases of reconstruction of complex defects in the periocular region using PIF were selected and revised. All cases were performed in the university hospital of the University of São Paulo, Ribeirão Preto, Brazil, from September 2018 to July 2024. Data collected included intraoperative and postoperative photographic documentation, lesions diagnoses, defect sizes and locations, PIF sizes and axes of mobilization, postoperative follow-up duration, and complications.</p><p><strong>Results: </strong>All patients underwent periorbital reconstruction with PIF after tumor resection. In 7 cases, the defects involved the lower lid cheek junction, and in 10 cases, they extended into the medial canthus, including 3 cases of orbital exenteration. The lateral periorbital region was affected in 2 patients. The mobilization of the flaps was from the lower cheek toward the lower eyelid in 7 patients, toward the medial canthal area in 10 patients, and horizontally to cover defects in the medial and temporal regions in 2 cases. The size of the resultant defect averaged 7.9 cm2. The mean follow-up time was 40 months. The flap remained viable in 100% of cases.</p><p><strong>Conclusion: </strong>PIFs are a versatile option for reconstructing large periorbital defects and extended exenterations, and this technique should be included in the repertoire of procedures for managing mid-facial tumors.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Canalicular Pseudoepitheliomatous Hyperplasia: New Disease Description, Clinical Spectrum, Proposed Management, and Outcomes.","authors":"Anannya Abhyankar Joshi, Lavanya Maddi, Nandini Bothra, Mohammad Javed Ali","doi":"10.1097/IOP.0000000000002948","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002948","url":null,"abstract":"<p><strong>Purpose: </strong>To define the clinical entity of \"isolated canalicular pseudoepitheliomatous hyperplasia.\"</p><p><strong>Methods: </strong>A retrospective interventional case series that included biopsy-proven cases of pseudoepitheliomatous hyperplasia of the canaliculi. Dacryoendoscopy was performed before the surgical procedure to determine the extent of the lesion. A punctoplasty was performed to access the lesion, followed by an excision biopsy. Parameters assessed include patient demographics, clinical presentation, imaging features, operative techniques, histopathological features, and outcomes.</p><p><strong>Results: </strong>Four canaliculi of 3 patients presented with canalicular mass lesions with secondary acquired lacrimal drainage obstructions. Epiphora without discharge was the universal presentation. On examination, an elevated pinkish mass lesion was noted to arise from the vertical canalicular walls, filling up the punctal opening without disturbing the integrity of the outer and inner punctal rims (3/4 canaliculi). The surface of the lesion showed either a speckled pigmentation or a membrane-like grayish appearance. One canaliculus presented with noninflammatory and diffuse canalicular swelling clinically mimicking canaliculops. Dacryoendoscopy revealed that the lesion was arising from the vertical canaliculus, not extending beyond the ampulla. A rectangular punctoplasty approach provided good access to achieve complete excision of the lesion. Histopathology confirmed the diagnosis of canalicular pseudoepitheliomatous hyperplasia.</p><p><strong>Conclusion: </strong>The present study described the clinical spectrum, anterior segment optical coherence tomography, dacryoendoscopy, surgical technique, histopathology, and outcomes of a previously not-recognized entity-\"isolated canalicular pseudoepitheliomatous hyperplasia.\" The study is the first step in further characterizing the clinical and radiological aspects of isolated canalicular pseudoepitheliomatous hyperplasia and improving the surgical techniques.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproducibility of the Unaided Subjective Assessment of Orbital Computed X-Ray Tomographic Features in Thyroid Eye Disease.","authors":"Isobel Landray, James Carpenter, Kaveh Vahdani, Katherine Miszkiel, Lakshmi A Ratnam, Geoffrey E Rose","doi":"10.1097/IOP.0000000000002929","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002929","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the reproducibility of subjective interpretation of computed x-ray tomography for 8 features associated with thyroid eye disease.</p><p><strong>Methods: </strong>Patients with confirmed thyroid eye disease had 3 distinct orbital computed x-ray tomography sections presented as anonymized montages to 3 masked observers (#1 orbital radiologist, #2 general radiologist, and #3 orbital surgeon). Eight features were graded: superior orbital fissure clarity, degree of orbital fat prolapse through the superior orbital fissure, loss of fat space at the apex, muscle enlargement, increase in orbital fat volume, vascular congestion, superior ophthalmic vein size, and lamina papyracea bowing. Thirty montages were randomly triplicated within the completed image-testing-file.</p><p><strong>Results: </strong>Each observer provided 3296 assessments of montages from 146 patients (68% female). Observer #2 had the highest rate of \"indeterminate\" gradings (13.3%), while #1 had the lowest (6.7%). For intraobserver agreement, the kappa statistics were \"substantial\" to \"almost perfect\" for apical crowding, muscular enlargement, and medial bowing, whereas orbital fat expansion and vascular congestion showed only \"slight\" to \"moderate\" agreement. Excluding superior ophthalmic vein size (where indeterminacy was too great for statistical analysis), there was a wide and statistically significant interobserver variation for the other 7 features, with no consistent ranking of observer scores.</p><p><strong>Conclusions: </strong>Subjective interpretation of computed x-ray tomography images for patients with thyroid eye disease has high variability, particularly for interobserver comparisons. Only the assessment of apical crowding, muscular enlargement, and bowing of the lamina papyracea showed fairly consistent intraobserver gradings. The results suggest that variability in the interpretation of such images might only be improved with the use of objective measures applied to the computed x-ray tomography images.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy for Advanced Conjunctival Squamous Cell Carcinoma: Treatment Failures.","authors":"Amee D Azad, Jia Jia Zhang, Kevin S Emerick, Sophia Z Shalhout, Howard L Kaufman, David M Miller, Nahyoung G Lee, Michael K Yoon, Suzanne K Freitag, Anna M Stagner, Natalie Wolkow","doi":"10.1097/IOP.0000000000002935","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002935","url":null,"abstract":"<p><strong>Purpose: </strong>To review the treatment response of advanced conjunctival squamous cell carcinoma (SCC) to systemic immune checkpoint inhibitor (ICI) therapy at a single institution.</p><p><strong>Methods: </strong>A retrospective review of patients treated at a single institution from 2015 to 2024 was conducted to identify those with advanced conjunctival SCC who had been treated with ICI therapy. Advanced disease included patients with orbital invasion of tumors, unresectable disease, or metastatic disease. Computed tomography imaging and tumor mutational burden data were evaluated for all patients.</p><p><strong>Results: </strong>Five patients with advanced conjunctival SCC were treated with ICIs. All patients had the American Joint Committee on Cancer stage cT3N0M0. All patients had best corrected visual acuity in the affected eye of 20/30 or better at presentation. All patients progressed while on ICIs, with 3 ultimately requiring exenteration at a median time of 6 months from initial diagnosis. One patient had progressive metastatic disease, and one had direct intracranial extension. All patients had low tumor mutational burden.</p><p><strong>Conclusions: </strong>Unlike prior reports demonstrating complete treatment response while on ICI therapy in patients with advanced conjunctival SCC, the current study demonstrates that 5 of 5 patients had disease progression while on ICI therapy. All patients also had low tumor mutational burden. Tumor mutational burden may be important in predicting disease response to ICI in patients with conjunctival SCC; however, given the small number of patients with conjunctival SCC treated with ICI to date, more data are needed to understand the role of ICIs in conjunctival SCC.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiologic Images of Subperiosteal Glass Beads.","authors":"Stephanie Thermozier, Kevin Heinze, Pete Setabutr","doi":"10.1097/IOP.0000000000002936","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002936","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermoid Cyst of Conjunctival Origin Attached to the Tarsus in a Pediatric Patient.","authors":"David L Swain, Alden Gregston, Alan D Proia, Sara F Grace, Laura B Enyedi","doi":"10.1097/IOP.0000000000002835","DOIUrl":"10.1097/IOP.0000000000002835","url":null,"abstract":"<p><p>Dermoid cysts of cutaneous origin are common orbital lesions, whereas dermoid cysts of conjunctival origin are rare. The authors present a case of a dermoid cyst of conjunctival origin that was attached to the tarsus in a pediatric patient. A 2-year-old boy presented to the clinic with an approximately 2 cm in diameter mobile nodule in the upper eyelid on the temporal side that distorted the eyelid architecture with temporal ptosis. During surgical excision, the lesion was firmly adherent to the tarsal plate. The mass was a conjunctival dermoid cyst lined by nonkeratinizing squamous epithelium with goblet cells and hair follicles on histological examination. This case represents the first report of a conjunctival dermoid cyst attached to the tarsus.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e69-e71"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Hemifacial Spasm as the Presenting Sign of Cerebral Glioblastoma.","authors":"Agni Kakouri, Ying Chen, Timothy J McCulley","doi":"10.1097/IOP.0000000000002838","DOIUrl":"10.1097/IOP.0000000000002838","url":null,"abstract":"<p><p>The authors report a rare case of a 58-year-old female with mild right-sided hemifacial spasms and eyelid myokymia and a concomitant high-grade glial mass. This report outlines the clinical presentation, diagnostic approach, and management of right hemifacial spasms and eyelid myokymia. The patient had a 5-month history of gradually worsening right hemifacial spams accompanied by mild right lower eyelid twitching. Given the persistence and exacerbation of these symptoms, alongside episodes of dysphagia, an MRI was performed. Imaging revealed a heterogeneous, peripherally enhancing mass with central necrosis at the lateral aspect of the left precentral gyrus and posterior aspect of the left middle and inferior frontal gyri consistent with high-grade glial mass. The patient subsequently underwent an awake craniotomy with resection of a temporal lobe tumor. These initial episodes of isolated facial spasms may be attributed to epilepsia partialis continua, often indicative of subcortical lesions that can compress the motor cortex. Eyelid myokymia and hemifacial spasms, though common, present significant diagnostic and management challenges. Due to high rate of underdiagnosis or misdiagnosis of these conditions, increased clinical awareness and knowledge are essential for effective patient management.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e71-e73"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soft-Tissue Chondroma of the Eyelid.","authors":"Lea M Carter, Rami N Al-Rohil, Alan D Proia","doi":"10.1097/IOP.0000000000002824","DOIUrl":"10.1097/IOP.0000000000002824","url":null,"abstract":"<p><p>A woman in her early 20s underwent excision of a 6-mm diameter, tender, mobile mass in the temporal left upper eyelid associated with eyelid swelling and blurred vision. Surgery disclosed a large tarsal lesion that appeared to be a cyst but was found to be a soft-tissue chondroma featuring an island of hyaline cartilage surrounded by dense tarsal fibrous connective tissue containing smaller foci of myxoid cartilage. The woman reported that a nodule had been present at this site since childhood. The soft-tissue chondroma has not recurred after 1.5 years. This case represents one of the few known reports of a soft-tissue chondroma in the eyelid.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e56-e58"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Transition: Building on a Foundation of Success.","authors":"Michael Kazim","doi":"10.1097/IOP.0000000000002943","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002943","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":"41 2","pages":"121"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}