Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Are Considered Ectopic Orbital Meningiomas Really Ectopic?","authors":"Laura Ninet, Romain Appay, Julien Bertin, Thierry David, Florian Dalmas","doi":"10.1097/IOP.0000000000002946","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002946","url":null,"abstract":"<p><p>We presented a case of a 74-year-old woman with a medial orbital mass. MRI revealed a subtle tumoral extension from the skull base to the orbit. A biopsy was performed by a retrocaruncular approach. The histologic examination confirmed grade 1 orbital meningioma. The extension from the skull base through the ethmoid sinus to the medial orbit might explain some orbital meningiomas considered as \"ectopic.\" A very slight extension might not be easily identified on MRI.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975240","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":"\"Real Life\" Utility of the Graves' Ophthalmopathy-Quality of Life in a Multidisciplinary Thyroid Eye Disease Service.","authors":"Simrun Virdee, Malik Moledina, Vickie Lee","doi":"10.1097/IOP.0000000000002950","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002950","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to describe the correlation of demographic and clinical factors with the Graves' ophthalmopathy-quality of life (GO-QOL) visual function (VF) and appearance (A) scores in a cohort attending a metropolitan multidisciplinary thyroid eye disease (TED) service.</p><p><strong>Methods: </strong>This is a cross-sectional retrospective study of 152 consecutive TED patients who completed the GO-QOL questionnaire. Clinical parameters, including endocrine diagnosis and status, TED activity and severity, Gorman diplopia score, and TED treatments were recorded at the time of completing each questionnaire and retrospectively analyzed.</p><p><strong>Results: </strong>A total of 257 GO-QOL questionnaires were completed over 32 months, with 59 patients providing sequential responses. The mean age was 50.0 ± 13.1 years, 77.0% (117/152) were female and 52.0% (79/152) were Caucasian. Graves' disease was present in 86.2% (131/152) of participants, and 91.4% (139/152) were euthyroid at the time of the questionnaire. The mean time since TED onset was 2.5 years (range: 0.25-180 months). The mean ± standard deviation GO-QOL scores in the mild, moderate-to-severe, and sight-threatening disease cohorts for VF were 92.2 ± 15.2, 70.9 ± 28.6, and 56.6 ± 29.6, respectively, and for A were 79.1 ± 22.3, 48.2 ± 29.7, and 66.1 ± 35.3, respectively. VF and A scores were inversely correlated with clinical activity scores. Both scores improved postimmunosuppression but only A scores improved following decompression and rehabilitation surgery. Females and younger patients had lower A but not VF scores. East Asians and Caucasians had higher VF and A scores than African-Caribbeans.</p><p><strong>Conclusion: </strong>The GO-QOL's granularity highlights the diverse functional and psychosocial experiences of TED patients, underscoring the need to integrate this valuable but underutilized tool into routine clinical practice.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975235","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":"PD-1 Inhibitors for Periocular Squamous Cell Carcinoma With Perineural Spread to the Orbit and Skull Base.","authors":"Tracy J Lu, Janet Fan, Luana Guimaraes de Sousa, Oded Sagiv, Sharia Hernandez, Lorena Bolanos Gomez, Neal Akhave, Renata Ferrarotto, Bita Esmaeli","doi":"10.1097/IOP.0000000000002944","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002944","url":null,"abstract":"<p><strong>Background: </strong>Periocular squamous cell carcinoma with perineural spread and orbital and skull base involvement is challenging to treat, as complete surgical resection is usually not feasible and radiotherapy carries a high risk of ocular toxic effects. PD-1 inhibitors have emerged as an alternative treatment for such cases.</p><p><strong>Methods: </strong>A retrospective study of all consecutive patients with periocular squamous cell carcinoma and perineural spread to the orbit treated with PD-1 inhibitors was carried out. Patients who had concurrent radiotherapy were excluded. The main outcome measure was treatment response.</p><p><strong>Results: </strong>Most patients had recurrent squamous cell carcinoma that had been heavily treated with Mohs surgery, radiotherapy, chemotherapy, or a combination of these modalities before referral with perineural spread to the orbit and skull base. All patients had V1 involvement; other cranial nerves involved were III (n = 1), V2 (n = 1), V3 (n = 1), VI (n = 1), VII (n = 2), and VIII (n = 1). The PD-1 inhibitors cemiplimab and pembrolizumab were used in 9 patients and 1 patient, respectively. The treatment duration ranged from 2 to 24 months (median, 19 months). Six patients had a partial response, and 4 had a complete response. With a median follow-up time of 16 months, all patients were without evidence of progressive disease at last contact.</p><p><strong>Conclusion: </strong>Treatment with PD-1 inhibitors can lead to meaningful responses in patients with periocular squamous cell carcinoma with perineural spread to the orbit and skull base and avoids the need for radiotherapy, which is toxic to the eye. Careful long-term follow-up is needed to assess long-term response durability.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039118","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":"Atypical Optic Nerve Sheath Meningioma With Postbiopsy Ophthalmic Artery Occlusion.","authors":"Maryam Eghtedari, William G Mitchell, Thomas G Hardy","doi":"10.1097/IOP.0000000000002938","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002938","url":null,"abstract":"<p><p>The authors present the case of a 44-year-old female with progressive optic neuropathy secondary to an atypical posterior intraconal tumor who underwent incisional biopsy complicated by severe postoperative vision loss secondary to ophthalmic artery occlusion. Histology showed a fibroblastic meningioma WHO grade 1. Here, the authors discuss the clinical and radiologic findings, in particular, the exophytic \"globular\" configuration of the tumor, and perform a review of the literature.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736095","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":"Basal Cell Carcinoma in Lacrimal Sac: An Exceptional Histopathological Finding.","authors":"Gonzalo Roig-Ferreruela, Elena Arias-García, Cristina Martínez-Gil, Luis Alfaro-Ferreres, Rafael Araújo-Miranda, Salvador García-Delpech, Raúl Martínez-Belda","doi":"10.1097/IOP.0000000000002942","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002942","url":null,"abstract":"<p><p>The authors report a case of a 49-year-old patient who presented with affection in the lacrimal sac. He had undergone multiple dacryocystorhinostomy surgeries, yet his symptoms failed to improve. However, histopathological examination revealed an unusual diagnosis: basal cell carcinoma. This is a completely atypical discovery and is rarely described in the literature in the lacrimal sac. The fact that this unusual location together with its difficult diagnosis given the similarity to the symptoms of a lacrimal duct obstruction makes this a particularly noteworthy case.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736103","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":"Reconstruction of Bilateral Upper Eyelid Colobomas Using a Vertical Temporal Advancement Flap.","authors":"Asem T Mustafa, Kenneth V Cahill, Llwyatt K Hofer, Jill A Foster","doi":"10.1097/IOP.0000000000002937","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002937","url":null,"abstract":"<p><p>A male infant born at full term presented with bilateral upper eyelid colobomas, absent upper puncta, and fusion of the eyelids to the globes. He was admitted for management of bilateral exposure keratopathy and a central corneal ulcer in the right eye. Further examination revealed multiple congenital abnormalities, such as penile torsion, unusual hair growth pattern on the forehead, bifid nasal tip, and hypertelorism. Genetic testing confirmed a diagnosis of Manitoba oculo-tricho-anal syndrome. Because conservative management of the ocular surface was insufficient, bilateral upper eyelid reconstruction surgery was performed 5 days after birth using a vertical temporal advancement flap. At 6-month follow-up, there was excellent eyelid movement and closure with no corneal exposure. This case report describes the clinical findings of a rare bilateral upper eyelid defect and shares an innovative reconstructive technique that readers could mimic if presented with similar congenital upper eyelid defects.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736105","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":"Evaluation of Research Productivity Among Academic Oculoplastic Surgeons Using the Relative Citation Ratio.","authors":"Matthew N Henderson, Lucy S Guan, Oliver Guyer, Catherine J Hwang, Julian D Perry","doi":"10.1097/IOP.0000000000002940","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002940","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate research productivity among oculoplastic surgeons and provide relative citation ratio (RCR) benchmark data for the field.</p><p><strong>Methods: </strong>In this cross-sectional bibliometric analysis, fellowship-trained academic oculoplastic surgeons at Accreditation Council for Graduate Medical Education-accredited institutions were individually indexed using the National Institutes of Health iCite database. Publication count, mean RCR (mRCR) score, and weighted RCR score were collected for each author between February and May 2023 and included PubMed-listed articles from 1980 to 2022. Data were compared by gender, career duration, academic rank, and acquisition of a doctor of philosophy.</p><p><strong>Results: </strong>Two hundred ninety-nine academic oculoplastic surgeons from 113 institutions were indexed. These physicians produced highly impactful research with a median publication count of 20 (interquartile range, 8-45), median mRCR of 0.91 (interquartile range, 0.65-1.24), and median weighted RCR of 16.27 (interquartile range, 5.61-41.10). Academic rank and career duration were associated with increased publication count, mRCR, and weighted RCR. Weighted RCR scores were greater among male faculty, but no differences were observed between genders for publication count or mRCR score. Female faculties were underrepresented in more senior academic ranks and earlier career start years.</p><p><strong>Conclusions: </strong>Current academic oculoplastic surgeons have comparable mRCR values relative to the National Institutes of Health-standard RCR value of 1. These benchmark data serve as a more accurate gauge of research impact within the oculoplastic surgery community and can be used to inform self, institutional, and departmental evaluations. In addition, the mRCR may provide an accurate metric for quantifying research productivity among historically underrepresented groups that are disadvantaged by time-dependent factors such as the number of publications.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709956","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":"Characteristics of Upper Eyelid Thickness in Asians.","authors":"Hirohiko Kakizaki, Blanche Xiao Hong Lim, Munekazu Naito, Yasuhiro Takahashi","doi":"10.1097/IOP.0000000000002939","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002939","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines the characteristics of upper eyelid thickness in Asians microscopically.</p><p><strong>Materials and methods: </strong>Histological evaluations of 20 upper eyelids (10 right and 10 left) from 14 Japanese cadavers (age range, 36-97, years; average, 68.9 years) were performed. Specimens were fixed in 10% formalin, stained with Masson trichrome and Elastica van Gieson, and analyzed for anterior protrusion of preaponeurotic fat and skin and subcutaneous tissue thickness at 10 mm from the eyelid margin. Statistical analyses included 1-way ANOVA and the Tukey multiple comparison test, with significance set at p < 0.05.</p><p><strong>Results: </strong>Upper eyelid thickness was classified into 3 types: very thick, moderately thick, and thin types. The very thick type (7 eyelids in 6 cadavers) showed significant anterior protrusion of preaponeurotic fat beyond the superior tarsal edge, pushing the orbicularis oculi muscle anteriorly, with thick subcutaneous tissue. The moderately thick type (5 eyelids in 4 cadavers) exhibited preaponeurotic fat fully reaching the septum-aponeurosis junction with minimal anterior muscle displacement, with less thick subcutaneous tissue. The thin type (8 eyelids in 6 cadavers) demonstrated preaponeurotic fat failing to reach the septum-aponeurosis junction, with thinner subcutaneous tissue. Subcutaneous tissue was significantly thicker in very thick types compared with moderately thick types (p = 0.002) and thin types (p = 0.000). It was similar in the moderately thick type and the thin type (p = 0.356). Skin thickness did not differ significantly between groups (p = 0.078).</p><p><strong>Conclusions: </strong>Upper eyelid thickness in Asians is primarily influenced by the anterior protrusion of preaponeurotic fat and subcutaneous tissue thickness, with significant variations across the 3 identified types.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710014","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":"A Large Retrospective Study on Long-Term Complications From Osseointegrated Orbitofacial Prosthetic Implants.","authors":"Bethany M Erb, Grace Wilton, Gregory Gion, Megan Thomas, Kenneth E Morgenstern, Cat N Burkat","doi":"10.1097/IOP.0000000000002932","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002932","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate long-term complications of osseointegrated orbitofacial prosthetic implantation following exenteration.</p><p><strong>Methods: </strong>This retrospective review included 40 patients who received orbital reconstruction with osseointegrated orbitofacial prosthetics between 2008 and 2024. Patient demographics, exenteration indication, orbitofacial radiation exposure, osseointegration approach, and postoperative complications were recorded. Collection and evaluation of protected patient health information were Health Insurance Portability and Accountability Act compliant. This manuscript adheres to the tenets of the Declaration of Helsinki.</p><p><strong>Results: </strong>A total of 134 implants were placed after orbital exenteration (average per orbit: 3). Most patients (75.0%, n = 30) had no implant failure/replacement within the follow-up period (range: 5 months to 16 years). Ten of the 134 placed implants failed (7.46%). Nine patients (22.5%) had an implant replaced within 5 years of implantation, and 1 patient (2.5%) had an implant replaced after 16 years. Implant failure was most often due to peri-implant bone instability (n = 6, 60.0%). Implants placed in the inferolateral orbital rim were most likely to fail (30%, n = 3). One failed implant (10%) was associated with a patient history of radiation treatment. General orbitofacial prosthetic discomfort (n = 22, 55%) was the most cited patient concern. Other common long-term complications included peri-implant discharge (n = 15, 37.5%), malodor (n = 15, 37.5%), and soft tissue dermatitis (n = 13, 32.5%).</p><p><strong>Conclusions: </strong>There are long-term complications associated with osseointegrated orbitofacial prosthetics. There are practical perioperative and intraoperative opportunities to improve the outcome of osseointegrated orbitofacial prosthetic rehabilitation. Postoperative daily implant hygiene is critical for successful long-term rehabilitation.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657959","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":"Significant Periocular Swelling as a Sign of Systemic Amyloidosis.","authors":"Elana Meer, Davin Ashraf, Melike Pekmezci, Nancy S Wong, Sandy W Wong, Seanna Grob","doi":"10.1097/IOP.0000000000002933","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002933","url":null,"abstract":"<p><p>We report a case of a 66-year-old woman with 8 years of progressive bilateral periorbital fullness, eyelid edema, and skin laxity. She had a history of thyroid cancer, smoldering myeloma, and systemic amyloidosis. The exam demonstrated significant bilateral periorbital fullness with mild limitation of extraocular motility in all directions bilaterally without double vision. The patient also reported regions of skin excess and edema throughout her body, not just isolated to her eyelids. Progressive dyspnea on exertion, lower extremity edema, and cough lead to cardiac workup, resulting in a diagnosis of cardiac amyloidosis. Given persistent and progressive eyelid swelling, MRI of her orbits was obtained, which demonstrated thickening of the extraocular muscles. Orbitotomy with biopsy of the right medial rectus muscle along with periocular eyelid skin was performed with pathology consistent with orbital and periocular amyloidosis. Amyloidosis is a rare cause of orbital-mass lesions and may appear clinically similar to IgG4-related disease, lymphoma, and thyroid eye disease. This case highlights the importance of considering amyloidosis, especially in the setting of plasma cell dyscrasia, with presentation with persistent periocular edema and cutis laxa.</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":"143625570","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}