Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Central Retinal Artery Occlusion Following Intralesional Triamcinolone Injection for IgG4-related Orbital Disease.","authors":"George Sanchez, Sudarshan Srivatsan, Hee Joon Kim, Robert C Kersten","doi":"10.1097/IOP.0000000000002804","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002804","url":null,"abstract":"<p><p>The risk of blindness associated with periocular and facial injections is well documented. Previous cases describing vision loss following a recent periocular or facial injection have emphasized the importance of facial \"danger zones.\" To date, the literature suggests that nearly half of all cases of central retinal artery occlusion in the setting of a recent periocular or facial injection involve an injection in or around the nose. Here, the authors report the second known case of central retinal artery occlusion following a triamcinolone injection to the lacrimal gland. A 30-year-old female with a diagnosis of IgG4-related disease underwent lacrimal gland debulking with an intralesional steroid injection. She noted OD vision loss immediately after surgery, with posterior segment examination demonstrating retinal whitening with a cherry-red spot and intra-arterial yellow-white plaques. This case serves as a reminder to clinicians regarding the risk of iatrogenic embolism following triamcinolone injections around the face with special attention drawn to the lacrimal gland.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351334","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":"Orbital Pigmented Epithelioid Melanocytoma Tumor Associated With Nevus of Ota (Oculodermal Melanocytosis).","authors":"Juliana Albano de Guimarães,Fernando Chahud,Antonio Augusto V Cruz","doi":"10.1097/iop.0000000000002773","DOIUrl":"https://doi.org/10.1097/iop.0000000000002773","url":null,"abstract":"The authors report a patient with nevus of Ota (oculodermal melanocytosis) who presented with pigmented epithelioid melanocytoma in the right orbit. A 36-year-old female patient attended with proptosis OD and diplopia for 3 months. MRI disclosed an expansive lesion adhered to the right inferior rectus muscle, enlargement of the superior orbital fissure, and filling of the right cavernous sinus. Excision of the orbital mass through a transconjunctival inferior fornix access disclosed a heavily pigmented lesion. Anatomopathological study revealed a diagnosis of pigmented epithelioid melanocytoma. A positron emission tomography scan did not show any metastasis. The patient was submitted to radiotherapy, had an improvement of the proptosis and diplopia, and showed no distant metastases for 3 years now. Pigmented epithelioid melanocytoma belongs to the group of heavily pigmented neoplasms, as do atypical blue nevus, which is characterized by prominent melanin production and a low degree of malignancy.","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264256","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":"Orbital Myeloma and Plasmacytoma: An Australian Study.","authors":"Jessica Xiong,Jessica Y Tong,Jonathan Hyer,Brett O'Donnell,Dinesh Selva,Thomas Hardy,Alan McNab,Timothy J Sullivan,Simon Taylor,Edwin Figueira,Alexandra Allende,Krishna Tumuluri","doi":"10.1097/iop.0000000000002777","DOIUrl":"https://doi.org/10.1097/iop.0000000000002777","url":null,"abstract":"PURPOSEThe purpose of this study was to provide Australian data on the clinical and radiological features and outcomes in patients with orbital plasmacytomas.METHODSMulticentre retrospective review of orbital plasmacytoma and orbital involvement in multiple myeloma (MM) from 2005 to 2022 in Australia.RESULTSTwenty-one participants were identified. The median age was 62 years (range 34-88 years), and 11 (52%) were females. Eighteen (84%) had a known diagnosis of MM prior to their orbital presentation, with all patients eventually being diagnosed with systemic MM. Thirteen (72%) were receiving active treatment for systemic myeloma on presentation, while 3 (17%) were in remission. All but 1 had unilateral orbital involvement (n = 20, 95%). Common presenting symptoms and signs were decreased visual acuity (n = 13, 62%), proptosis (n = 11, 52%), limited motility (n = 15, 71%), and optic neuropathy (n = 5, 24%). Radiologically, 15 (71%) involved the superotemporal orbit, 7 (33%) inferotemporal orbit, and 16 (76%) involved ≥1 extraocular muscle. Sixteen (76%) were biopsied and confirmed orbital plasmacytoma on histopathology. Treatment modalities included intravenous and oral steroids (n = 7, 33%), chemotherapy (n = 9, 43%), radiotherapy (n = 13, 62%), stem cell transplant (n = 3, 14%), and surgical debulking and decompression (n = 3, 14%). Mortality was high, with 15 (71%) having MM-related mortality.CONCLUSIONSThis is the largest cohort of Australian data on orbital plasmacytomas. Most patients have a diagnosis of systemic MM at presentation. It is crucial to recognize and treat these patients early due to a poor systemic prognosis.","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264257","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":"Periorbital Intravenous Lobular Pyogenic Granulomas: A Case Report and Literature Review of This Peculiar Pathology.","authors":"Persiana S Saffari,Ben J Glasgow,Katherine M Lucarelli,Kelsey A Roelofs","doi":"10.1097/iop.0000000000002778","DOIUrl":"https://doi.org/10.1097/iop.0000000000002778","url":null,"abstract":"Intravenous lobular pyogenic granuloma (ILPG) is a seldom-documented pathology in oculoplastic and orbital literature. This study aims to elucidate the clinical presentation and histopathologic findings surrounding periorbital ILPG through a case presentation and literature review. We describe a 42-year-old male with a palpable periorbital subcutaneous nodule that was subsequently diagnosed as ILPG on immunohistochemistry. A literature review was performed by searching articles in the PubMed/MEDLINE database using the keywords \"periorbital intravenous lobular pyogenic granuloma,\" \"periorbital intravenous pyogenic granuloma,\" or \"periorbital intravenous capillary hemangioma.\" The literature review identified 6 patients presenting with similar subcutaneous nodules that were diagnosed as periorbital ILPGs. All patients, including the one in this study, were treated with local excision. Only 1 patient (1/7; 14.3%) noted pain while 5 experienced swelling or fluctuance (5/7; 71.4%). In patients with documented pathology reports, all ILPGs involved the angular vein (6/6; 100%). Of the 3 patients who had follow-ups at 2 to 7 years postexcision, none had recurrence. Histopathologic findings demonstrate an intravascular lobular tumor composed of capillaries with endothelial cells and pericytes. Marked reactivity to anti-Wilms tumor type 1 (WT-1) and anti-Smooth muscle actin was noted in the capillary structure. ILPG can be included on the differential for well-circumscribed, subcutaneous periocular masses. While the etiology of periorbital ILPG is unknown, most cases are managed with surgical excision, and recurrence appears to be uncommon. In sharing these cases and histopathologic underpinnings of periorbital ILPG, we endeavor to describe this peculiar pathology for oculoplastic and reconstructive surgeons.","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264258","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":"Do Botulinum Toxin Injections for Upper Face Rejuvenation and Lateral Canthal Rhytids Have Unintended Effects on Tear Production?","authors":"Anthony Yao,Raman Malhotra","doi":"10.1097/iop.0000000000002785","DOIUrl":"https://doi.org/10.1097/iop.0000000000002785","url":null,"abstract":"PURPOSETo report the influence of botulinum toxin A (BoNTA) injections on basal tear production, as measured by Schirmer's test with anesthesia in patients seeking eyelid surgery.METHODSA retrospective cohort of patients requesting esthetic eyelid surgery reviewed by a single clinician between January 2021 to April 2024, assessed with Schirmer's test with anesthesia. Demographic data, history of BoNTA treatment in the periocular region, ocular surface disease index dry eye symptom frequency, and requirement for ocular lubricants were recorded. Patients with no history of BoNTA were designated as group 1. Patients with a positive recent history of periocular BoNTA were designated as group 2. The proportions of eyes with Schirmer's test with anesthesia (basal tear production) test result <5 mm (\"low\"), 5 to 9 mm (\"borderline\"), and ≥10 mm (\"normal\") were compared between groups.RESULTSSeven hundred twenty-two eyes (361 patients) were assessed, of which 670 eyes (335 patients) met the inclusion criteria. Mean age was 55.1 (range, 17-93) years, with 71.3% female. Schirmer's data in group 1 were \"low\" at 32.9%, \"borderline\" at 26.4%, and \"normal\" at 40.7%. In contrast, group 2 had significantly lower results (P ≤ 0.05), with readings \"low\" at 48.3%, \"borderline\" at 26.7%, and \"normal\" at 25.0%. However, there were no significant differences between groups in ocular surface disease index symptom frequency scores or ocular lubricant requirements.CONCLUSIONSPatients who had received BoNTA injections had significantly lower basal tear production compared with patients who had never received BoNTA. Esthetic BoNTA treatment may be associated with an unintended effect of decreased basal tear production and subsequent risk of dry eye.","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264255","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":"Primary Treatment of Eyelid Conjunctival Melanoma with Immunotherapy: A Case Report.","authors":"Madison E Weiss, Brittany M Perzia, John H Sinard, Thuy T Tran, Michelle M Maeng","doi":"10.1097/IOP.0000000000002776","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002776","url":null,"abstract":"<p><p>Conjunctival melanoma is a rare, life- and sight-threatening ocular malignancy sharing molecular features with cutaneous and mucosal melanoma. Despite current clinical approaches, high recurrence rates and frequent metastases pose significant challenges in management. Immune checkpoint inhibitors such as ipilimumab and nivolumab have revolutionized cutaneous melanoma treatment, but their efficacy in conjunctival melanoma remains largely unexplored. Herein, the authors present the case of metastatic palpebral conjunctival melanoma in a 59-year-old male successfully treated with a first-line combination of ipilimumab and nivolumab without adjuvant therapies or local surgeries. Local disease resolution was achieved after only 7 months of treatment, and the immune checkpoint inhibitor regimen was well-tolerated with limited systemic adverse effects and no ocular side effects.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140705","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 Algorithmic Role of Critical Radiographic Features in the Treatment of Angioinvasive Fungal Sinusitis.","authors":"Alexis Kassotis, Allison Coombs, Nahill Matari, Angela Lignelli, Michael Kazim","doi":"10.1097/IOP.0000000000002783","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002783","url":null,"abstract":"<p><strong>Introduction: </strong>Angioinvasive fungal sinusitis (AIFS) is a rapidly progressive, highly morbid infection. It can be challenging to obtain an early diagnosis, but intervention in the acute period is crucial for prognosis. Previous literature has identified numerous radiographic features with high sensitivity and specificity for AIFS, even in early disease. Bedside nasal endoscopy can substantiate the diagnosis but can also yield false negative results. Initially, these patients may present to the ophthalmologist. Thus, to avoid visual and potentially life-threatening complications, subtle clinical signs in conjunction with suspicious radiographic features must be promptly recognized by the ophthalmologist and escalated appropriately. We review, for the benefit of the ophthalmic community, the salient radiographic features of AIFS and integrate them into a decision-making algorithm for diagnostic workup and management.</p><p><strong>Methods: </strong>A literature search was conducted using a comprehensive keyword search in the Pubmed and Embase databases. English studies from 1988 to 2022 describing the radiographic features of AIFS queried. Literature on the newly described entity, COVID-19 COVID-19-associated mucormycosis was included. The authors collected the most frequently reported indicators of AIFS.</p><p><strong>Results: </strong>The authors review 4 radiographic findings that are frequently associated with AIFS, including in the early stages of disease: 1) loss of contrast enhancement in the nasal turbinate and maxilla (i.e., \"black turbinate and maxillary sign\"), (2) periantral involvement seen as changes in density, fat stranding or obliteration of the anterior, retromaxillary, or retroantral fat planes on CT, (3) Tissue invasion without bony erosion, (4) Hypointense T2W sinonasal secretions on MRI in the setting of acute sinusitis. The authors additionally propose an algorithm that suggests surgical exploration for patients with clinical concern for AIFS and these radiographic features, even if bedside nasal endoscopy is inconsistent with AIFS.</p><p><strong>Conclusion: </strong>The radiographic signs highlighted herein should heighten suspicion for AIFS in the appropriate clinical setting, prompting urgent surgical exploration regardless of nasal endoscopy findings.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140706","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":"Treatment of Eyelid Entropion: A Historical Review.","authors":"Philip L Custer","doi":"10.1097/IOP.0000000000002784","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002784","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to review the long history of entropion, with emphasis on its significance to the specialty of ophthalmology, and the numerous methods developed to treat cicatricial and involutional forms of the condition.</p><p><strong>Methods: </strong>An extensive medical literature review was performed, identifying publications containing information on entropion and associated conditions. Foreign language manuscripts were translated using online resources.</p><p><strong>Results: </strong>A total of 920 manuscripts published between 1505 and 2023 were reviewed. While the majority were written in English, 38.5% were foreign language works. For much of history, both cicatricial and involutional entropion were managed by shortening the anterior lamella. Horizontal eyelid margin or posterior tarsal incisions were often added for cicatricial disease. Later, different tissues were grafted into the defects created by these incisions. A variety of measures were used to temporize in patients with involutional entropion. Surgical treatment of this condition evolved to include methods of suture rotation, orbicularis weakening or redirection, tarsal stabilization, lid margin shortening, and eyelid retractor repair.</p><p><strong>Conclusions: </strong>Entropion and its management are described throughout recorded history. For much of this time, cicatricial entropion was the most common form of the disease, in great part secondary to the prevalence of trachoma. The social impact of these conditions was a primary factor in the establishment of ophthalmology as a medical specialty and the creation of dedicated eye hospitals. Publications describing the treatment of involutional entropion appear with increasing frequency after the mid-19th century. Arguably, more procedures have been described for entropion than for any other ophthalmic condition.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140707","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":"Inadvertent Orbital Mitomycin C Injection as a Cause of Ptosis and Ophthalmoplegia from Orbital Necrosis.","authors":"Ryan H Mason, Kenneth Chang, Georges Nassrallah, David B Yan, Dan D DeAngelis","doi":"10.1097/IOP.0000000000002775","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002775","url":null,"abstract":"<p><p>Mitomycin C is an alkylating agent with the ability to suppress fibroblast proliferation and activity, making it a powerful antifibrotic. It has therefore become popular in glaucoma filtering surgeries, used both intraoperatively during bleb formation and postoperatively as an adjunct to bleb needling. This report presents a rare but serious risk of bleb needling with Mitomycin C at the slit lamp, where inadvertent movement of the patient resulted in an orbital injection. The patient quickly developed focal tissue inflammation and necrosis, presenting one day after the procedure with complete ptosis, ophthalmoplegia, and a palpable orbital mass. After appropriate imaging and an excisional biopsy to exclude infectious, infiltrative, and neoplastic causes, this was managed with close observation and continued improvement, and resolution of most orbital sequelae.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140704","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":"Reply Re: \"Proptosis Regression After Teprotumumab Treatment for Thyroid Eye Disease\".","authors":"Tatiana R Rosenblatt, Carolina A Chiou, Michael K Yoon, Natalie Wolkow, Nahyoung Grace Lee, Suzanne K Freitag","doi":"10.1097/IOP.0000000000002786","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002786","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140715","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}