Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery最新文献

{"title":"Oral mucous membrane tarsal patch grafting: broadening indications and long-term outcomes.","authors":"Anthony Yao, Swati Singh, Bhupesh Bagga, Bhupendra Patel, Raman Malhotra","doi":"10.1080/01676830.2024.2429570","DOIUrl":"10.1080/01676830.2024.2429570","url":null,"abstract":"<p><strong>Purpose: </strong>We present the surgical technique of localised excision of tarsal epithelium and replacement with oral mucous membrane tarsal patch grafting (MMTPG), to highlight novel indications of this technique for tarsal surface abnormalities beyond the lid margin.</p><p><strong>Methods: </strong>Retrospective case series of patients who underwent MMTPG for refractory tarsal conjunctival disease in three centers, with outcome measures of corneal epitheliopathy, visual acuity (VA), and symptomatic improvement.</p><p><strong>Results: </strong>8 eyes of 8 patients were included, with surgical indications of medically recalcitrant Vernal Keratoconjunctivitis (VKC) (1), Giant Papillary Conjunctivitis (GPC) (1), or tarsal scarring in the setting of Ocular Cicatricial Pemphigoid (OCP) (2), Stevens-Johnson Syndrome (SJS) (2), advanced Meibomian Gland Dysfunction (MGD) (1) and Ligneous Conjunctivitis (LC) (1). Following MMTPG there were no recurrences of corneal epithelial defects or local tarsal conjunctival pathologies during the follow-up period (mean 28 months). Five eyes demonstrated an improvement in visual acuity of ≥2 Snellen chart lines. Symptomatic improvement was noted in all 8 eyes, and medication requirement was reduced.</p><p><strong>Conclusion: </strong>This report provides a novel conceptual insight to the successful use of MMTPG, highlighting its use in a range of conditions in therapeutically resistant cases.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"454-459"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tocilizumab - a disease-modulating treatment for thyroid associated ophthalmopathy?","authors":"K Farde, F Träisk","doi":"10.1080/01676830.2025.2452181","DOIUrl":"10.1080/01676830.2025.2452181","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze Tocilizumab (TCZ, an interleukin 6 inhibitor) as a second-line treatment for thyroid-associated ophthalmopathy (TAO).</p><p><strong>Methods: </strong>In this retrospective observational study, the charts of patients with moderately severe to severe TAO who received intravenous Tocilizumab as a second-line treatment 2020-2023 were reviewed.</p><p><strong>Results: </strong>Twenty-three patients were enrolled in the study. At the follow-up visit 24 weeks after the initiation of treatment, 14 out of 22 patients (63.6%, one missing data) had a reduction of proptosis of 2 mm or more. The mean proptosis decreased from 21.07 (±3.23) to 19.18 (±2.52) mm in the right eye (RE) and from 20.61 (±3.12) to 19.95 (±2.81) mm in the left eye (LE). Twenty patients (87%) also showed a reduction of the clinical activity score (CAS) of at least two points with a mean decrease from 5.22 (±1.53) pre-treatment to 2.09 (±1.38) post-treatment points. The median patient total follow-up time after treatment was ten (range 6-26) months. The comparisons reached strong significance between pre-treatment and 24 weeks, as well as pre-treatment and final visit assessments for both proptosis and clinical activity scores. Serum TRAb levels also dropped significantly, and only two patients needed re-treatment with TCZ. Improvement of diplopia did not reach statistical significance.</p><p><strong>Conclusions: </strong>Intravenous Tocilizumab as a second-line treatment for TAO led to a significant improvement of proptosis and CAS at 24 weeks follow-up, with a sustained effect over time.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"415-419"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periocular manifestations of blepharocheilodontic syndrome and their management: case series and literature review.","authors":"Amitouj S Sidhu, Thomas G Hardy, Ryan B Nugent, Rodrigo P Teixeira, Krishna Tumuluri","doi":"10.1080/01676830.2024.2415999","DOIUrl":"10.1080/01676830.2024.2415999","url":null,"abstract":"<p><strong>Purpose: </strong>Blepharocheilodontic (BCD) syndrome is a rare condition with eyelid ectropion, euryblepharon, lagophthalmos, congenital cleft lip/palate, and oligodontia. BCD syndrome is an autosomal dominant inherited disorder and has multiple associations with systemic diseases. We present three new cases of BCD syndrome and a literature review of the periocular manifestations of BCD and their management.</p><p><strong>Methods: </strong>A multi-institutional retrospective case series of patients with BCD syndrome. Clinical characteristics, imaging findings, surgical management, and outcomes were analysed. Further, a comprehensive review of the literature identified all previously published cases of BCD syndrome.</p><p><strong>Results: </strong>Three cases of BCD syndrome in children with autosomal dominant inheritance were included. Periocular manifestations in BCD syndrome include lower lid ectropion, euryblepharon, and lagophthalmos. Systemic manifestations including cleft lip or palate and dental abnormalities were also observed. Multiple surgical procedures including lateral canthoplasty, tarsorrhaphy, and midface augmentation may be necessary for correction of eyelid malposition and achieving cosmetic and functional improvements.</p><p><strong>Conclusions: </strong>BCD syndrome presents with a spectrum of periocular manifestations requiring multidisciplinary management. Children that present with cleft lip and palate, dental, and eyelid abnormalities should be suspected to have BCD syndrome. Surgical management of the eyelid in BCD remains challenging. Ophthalmologists should be aware of BCD syndrome and its systemic associations.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"471-477"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic dacryocystitis due to <i>Mycobacterium abscessus</i>.","authors":"Maria M Solbes-Gochicoa, Marissa K Shoji, Jimmy S Chen, Eman Al-Sharif, Don O Kikkawa, Bobby S Korn, Catherine Y Liu","doi":"10.1080/01676830.2024.2412121","DOIUrl":"10.1080/01676830.2024.2412121","url":null,"abstract":"<p><p>Dacryocystitis, inflammation and infection of the lacrimal sac, is most commonly caused by infection from Staphylococcus and Streptococcus species. This report highlights a rare case of chronic dacryocystitis due to the atypical pathogen <i>Mycobacterium abscessus</i>. A 62-year-old woman presented with several months of left medial canthal pain, tenderness, and discharge. Exam demonstrated a left tender medial nodule, and imaging showed left lacrimal sac dilation and fluid collection consistent with dacryocystitis. She underwent external dacryocystorhinostomy with drainage and culture of the abscess, which was positive for <i>M. abscessus</i>. Her post-surgical treatment required an extended course of antibiotics, including omadacycline and azithromycin, with slow but progressive symptomatic improvement. This case is only the second reported case of dacryocystitis due to <i>M. abscessus</i> and suggests a role for culturing lacrimal sac abscesses intraoperatively due to the need for extended antibiotic therapy for atypical infections that may have high antibiotic resistance.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"433-438"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of management and characteristics of orbital and preseptal cellulitis in adult patients with and without diabetes mellitus: a retrospective cohort study.","authors":"Ava Niknahad, Alison B Gibbons, Setu Mehta, Heya Lee, Aishah Ahmed, Meron Haile, Anjana Srikumar, Rachel Stemme, Akanksha Suresh, Samir Al-Ali, Justin C Zhong, Fasika Woreta, Emily Li, Fatemeh Rajaii","doi":"10.1080/01676830.2025.2534564","DOIUrl":"https://doi.org/10.1080/01676830.2025.2534564","url":null,"abstract":"<p><strong>Purpose: </strong>To examine how type 2 diabetes mellitus influences the presentation and management of preseptal and orbital cellulitis.</p><p><strong>Methods: </strong>A retrospective study at a tertiary care center identified patients presenting with preseptal and orbital cellulitis between 2000 to 2022. Data collected included demographics, presentation, management, and follow-up characteristics.</p><p><strong>Results: </strong>Of the 382 patients, 187 (49.0%) had preseptal cellulitis and 195 (51.0%) had orbital cellulitis. Diabetes was present in 19.8% and 23.6% of patients with preseptal and orbital cellulitis, with similar mean A1C levels (8.24 versus 7.96, <i>p</i> = .410). In the preseptal cellulitis cohort, diabetic patients were more likely to be admitted (56.8% versus 35.3%, <i>p</i> = .045). In the orbital cellulitis cohort, diabetic patients had longer hospital stays (median 6.0 versus 4.0 days, <i>p</i> = .004), longer intravenous antibiotics duration (median 4.0 days, <i>p</i> = .005), and received steroids later (median day 2.0 versus 1.0, <i>p</i> = .018). Patients with diabetes presented with worse visual acuity (median 0.40 versus 0.18 logMAR, <i>p</i> = .005) and a higher rate of relative afferent pupillary defect (47.2% versus 18.5%, <i>p</i> = .001). Extraocular movement (EOM) restriction was significantly more common in diabetic patients at follow-up (47.6% vs. 14.1%, <i>p</i> < .0001). The overall readmission rate was higher in diabetic patients (19.6% vs. 8.7%, <i>p</i> = .043).</p><p><strong>Conclusions: </strong>Patients with diabetes and preseptal cellulitis had a higher inpatient admission rate and longer duration stays than patients without diabetes. Patients with diabetes and orbital cellulitis had longer hospital stays, longer intravenous antibiotics duration, worse visual acuity at diagnosis, and a higher EOM restriction rate at follow-up compared to patients without diabetes.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between quantified magnetic resonance imaging (MRI) findings and \"MRI score\" in Graves' ophthalmopathy.","authors":"Satoshi Ueki, Takumi Mashio","doi":"10.1080/01676830.2025.2528979","DOIUrl":"https://doi.org/10.1080/01676830.2025.2528979","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the correlation between a magnetic resonance imaging (MRI) score, we proposed in a previous report, and conventional quantitatively evaluated MRI findings, and to evaluate the clinical utility of the MRI score in patients with Graves' ophthalmopathy (GO).</p><p><strong>Methods: </strong>Using ImageJ, we retrospectively re-analyzed magnetic resonance images of 25 patients with GO who were evaluated in the previous study. The signal intensity and area measured by ImageJ were normalized for each affected extraocular muscle (EOM) in each patient (normalized quantified inflammation and enlargement). Furthermore, the ratio of the value for the affected EOM to the normal values was calculated in each patient (quantified inflammation and enlargement compared to normal values). We analyzed the correlations between MRI scores and quantitative MRI finding before and after 6 g of intravenous methylprednisolone (IVMP).</p><p><strong>Results: </strong>The correlation coefficient between the normalized MRI score and normalized quantified inflammation and enlargement was 0.59 before IVMP and 0.69 after IVMP. The correlation coefficient between the MRI score and quantified inflammation and enlargement compared to normal values was 0.58 before IVMP and 0.73 after IVMP. The correlation coefficients for all items were statistically significant (<i>P</i>-value < .05).</p><p><strong>Conclusion: </strong>This study found a high correlation between the MRI score, which is our proposed semiquantitative method for assessing EOM swelling and inflammation, and the results of conventional quantitative evaluation methods. This suggests that the MRI score, which can be more readily used in clinical practice, may be as reliable as quantitative evaluation methods.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"1-5"},"PeriodicalIF":0.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital necrotizing fasciitis due to <i>Prevotella baroniae</i> resulting in acute orbital compartment syndrome.","authors":"Clement C Anozie, Ana P Garcia, Evan M Wong, Noor A Laylani, Tracy J Lu, Saif Aldeen Alryalat, Andrew G Lee, Nadia G Mohyuddin, Amina I Malik","doi":"10.1080/01676830.2025.2526029","DOIUrl":"https://doi.org/10.1080/01676830.2025.2526029","url":null,"abstract":"<p><p>A 44-year-old man with uncontrolled diabetes mellitus (A1C: 9.9%), a well-established risk factor for infection, presented with acute onset of complete vision loss in the right eye (OD) associated with periorbital swelling, pain, and proptosis. Visual acuity was no light perception OD with intraocular pressure of 45 mmHg. Clinical examination revealed significant right sided proptosis and orbital inflammation. Emergent canthotomy and cantholysis were performed. He was then taken to the operating room where biopsy revealed a rapidly progressive orbital necrotizing fasciitis (ONF) involving <i>Prevotella baroniae</i>. Due to clinical worsening despite broad spectrum antibiotics and surgical debridement, the patient ultimately required orbital exenteration. The identification of <i>Prevotella baroniae</i> in the orbit is rare. This case highlights the aggressive nature of ONF and its potential for progression to orbital compartment syndrome, emphasizing the need for high clinical suspicion of these conditions. Timely surgical and medical interventions are imperative for preserving visual function and preventing mortality.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"1-6"},"PeriodicalIF":0.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital lymphoma masquerading as postoperative blepharoplasty changes.","authors":"Tiran Golani, Jonathan Weidenfeld, Ofira Zloto","doi":"10.1080/01676830.2025.2528230","DOIUrl":"https://doi.org/10.1080/01676830.2025.2528230","url":null,"abstract":"","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"1"},"PeriodicalIF":0.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital angioleiomyoma with GJA4 mutation mimicking cavernous venous malformation: a case report and comprehensive review.","authors":"Marie Callet, Arnault Tauziede-Espariat, Augustin Lecler, Sorin Aldea, Pierre Vincent Jacomet, Olivier Galatoire, Mathieu Veyrat","doi":"10.1080/01676830.2025.2515594","DOIUrl":"https://doi.org/10.1080/01676830.2025.2515594","url":null,"abstract":"<p><p>Orbital angioleiomyomas are rare benign tumors that can mimic orbital cavernous venous malformations (OCVM) due to overlapping radiological and histopathological features. We present the case of a 42-year-old woman with an apical orbital angioleiomyoma incidentally discovered during evaluation for migraines. Magnetic resonance imaging revealed a well-defined, gadolinium-enhancing intraconal mass, initially suggestive of OCVM. Surgical excision was performed via an endonasal endoscopic approach, achieving complete removal without recurrence. Histopathological analysis and molecular testing confirmed the diagnosis, identifying a somatic GJA4 (p.Gly41Cys) mutation.This case highlights the diagnostic challenge of distinguishing orbital angioleiomyomas from OCVM and emphasizes the importance of immunohistochemistry and molecular analysis, particularly GJA4 mutation screening, in achieving diagnostic accuracy. The identification of GJA4 mutations may assist clinicians and pathologists in better characterizing true angioleiomyomas, especially in cases where the distinction between OCVM and the cavernous subtype of angioleiomyoma is histologically ambiguous. Angioleiomyomas may be underrecognized in orbital pathology and could represent a subset of lesions previously classified as OCVM or intracranial meningiomas. A comprehensive, multimodal diagnostic approach is essential for appropriate classification and management of these tumors.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"Fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) negative orbital metastasis secondary to breast carcinoma: a diagnostic pitfall\".","authors":"Syed Ahmad, Ahsen Hussain, Derek Wilke","doi":"10.1080/01676830.2025.2530586","DOIUrl":"https://doi.org/10.1080/01676830.2025.2530586","url":null,"abstract":"","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"1-2"},"PeriodicalIF":0.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}