Kelly H Yom, Brittany A Simmons, Liuska M Pesce, Laura L Warner, Laura J Fuhrmeister, Pavlina S Kemp, Keith D Carter, Erin M Shriver
PURPOSE: To characterize the size of extraocular muscles (EOMs) in a pediatric population with thyroid dysfunction using orbital echography. METHODS: Patients under age 18 with thyroid dysfunction who presented to an academic ophthalmology department from 2009 to 2020 and received orbital echography were included in this IRB-approved retrospective study. Data collected included age, clinical activity score (CAS), thyroid stimulating immunoglobulin (TSI), and extraocular recti muscle thickness on echography...
April 2024: Orbit
Angela J Oh, Connie M Sears, Akhila A Vadivelan, Brigitte N Gomperts, Noah Federman, Jonathan Said, Kelsey A Roelofs
An 8-year-old female presented to the oculoplastics clinic with 3 months of left upper eyelid fullness and edema. Examination showed a mass in the left anterior superior orbit with erythema. Imaging demonstrated a well-circumscribed superolateral orbital mass that was T1 hypointense and T2 hypo-to-iso intense with contrast enhancement. An incisional biopsy was performed via an upper lid crease incision. Histopathology showed aggregates of histiocytic cells with fibrosis and infiltration of eosinophils...
February 19, 2024: Orbit
Soham S Pal, Md Shahid Alam
Eccrine spiradenoma is a rare sweat gland tumor and usually presents as a solitary, painful nodule. A solitary spiradenoma involving the eyelid is quite rare. A 39-year-old Indian female presented with a gradually increasing, painless, nodular upper eyelid mass for the past 4 years. On examination, a non-tender approximately 4 × 3 mm cystic mass was noted, which was not adherent to underlying structures. The mass was excised in toto, and the histopathological examination was suggestive of eccrine spiradenoma with a low Ki-67 index...
February 19, 2024: Orbit
Panida Potita, Vannakorn Pruksakorn, Panudda Srichomkwun, Kanaungnit Kingpetch, Preamjit Saonanon
PURPOSE: This study was designed to evaluate the effect of selenium supplementation in inactive moderate-severe Graves' orbitopathy (GO) patients. METHODS: This study was a single-center, placebo-controlled, double-masked, randomized trial. Inactive moderate-severe GO participants were randomized to receive six months of 200 micrograms/day of selenium supplementation or placebo. Thorough eye exams, clinical activity score (CAS), Graves' Ophthalmopathy quality of life questionnaire (GO-QOL), and serum selenium level were evaluated at baseline and 6 months after the interventions...
February 19, 2024: Orbit
Fabliha A Mukit, Cynthia M Noguera, Natalie Sullivan, Barbara D Smith, James C Fleming, Brian T Fowler
The incidence of penetrating orbital injuries from writing instruments continues to rise in the pediatric population. Such injuries can cause significant visual morbidity and have a lifelong psychosocial impact. While the description of graphite pencil-related orbital trauma management is well demonstrated with over 40 reported cases, a lack of consistent management protocol for colored pencil-related injuries. Here, we report an inadvertent penetrating orbital colored pencil injury with progressive mechanical ptosis and pre-septal cellulitis necessitating urgent orbitotomy, debridement, and washout to reduce inflammatory and infectious burden...
February 7, 2024: Orbit
Ourania Fydanaki, Haytham Rezq, Anastasios E Sepetis, Varajini Joganathan
An 82-year-old male presented with generalised Pityriasis rubra pilaris (PRP) managed initially by dermatology team. The patient did not respond to first- and second-line treatment, including oral acitretin, steroid creams, and methotrexate, and developed bilateral cicatricial ectropion, for which he was referred to oculoplastic team for surgical management. A head injury resulting in subacute subdural haematoma, managed with a week course of low dose oral dexamethasone, resulted in the improvement of his skin condition and complete resolution of the cicatricial ectropion within a few weeks...
February 6, 2024: Orbit
Abdelrahman M Elhusseiny, Jamal O Azhari, Tom Kornhauser, David A Kilgore, David K Wilson, Kevin J Bielamowicz, Kandi A Stallings-Archer, John D Pemberton
Langerhans cell histiocytosis (LCH) is a condition characterized by clonal proliferation of the phagocytic cells derived from the bone marrow. In this article, we present an exceedingly rare case of congenital/neonatal LCH in a 3-week-old girl who initially presented with an isolated swelling of the eyelid, initially misdiagnosed as a chalazion. Subsequently, a biopsy was performed, and histopathological evaluation confirmed the diagnosis of LCH. A staging work-up revealed no evidence of multisystem involvement, and thus, local steroid injection was performed as the initial treatment for the residual lesion...
January 30, 2024: Orbit
Charlotte L Marous, Edward J Wladis
No abstract text is available yet for this article.
January 24, 2024: Orbit
Kasturi Bhattacharjee, Obaidur Rehman, Vatsalya Venkatraman, Dipankar Das, Shyam Sundar Das Mohapatra, Rahul Gogoi, Deepak Soni
PURPOSE: Description of clinical features, radiological characteristics, and management strategies in primary orbital intraosseous venous malformation (OIVM) with pertinent literature review. METHODS: A retrospective analysis including clinical, radiologic, operative, and histopathological data of six cases of histopathologically proven OIVM was done. A comprehensive literature review was conducted using online databases and augmented with manual search to identify reported cases of OIVM...
January 23, 2024: Orbit
Md Shahid Alam, Ruchi Pherwani, Subramanian Krishnakumar
No abstract text is available yet for this article.
January 18, 2024: Orbit
Elana Meer, Meleha Ahmad, Jacob Lifton, Arman Mosenia, Davin C Ashraf, Seanna Grob, M Reza Vagefi, Bryan J Winn, Robert C Kersten
PURPOSE: This study evaluates surgical outcomes and complication rates of frontalis suspension with expanded polytetrafluoroethylene (ePTFE). METHODS: This retrospective cohort study reviewed all patients undergoing frontalis suspension surgery using ePTFE as the sling material from January 1 2012 to March 3 2020 by a single surgeon at a single academic center. Two different surgical techniques were evaluated in the placement of the sling material. Demographic, clinical, and operative data were extracted...
January 18, 2024: Orbit
Ahmed Magid Wanas, Clarice Giacuzzo, Seyed Ghazi-Nouri, Lee Teak Tan
Hypokalaemic periodic paralysis (HPP) is an uncommon complication of corticosteroid therapy, which may also be seen in thyrotoxicosis. It was mostly described in the Asian population, and it is rare in other ethnic groups. We present the case of a poorly controlled thyrotoxic Caucasian male with thyroid eye disease (TED) who suffered an acute quadriplegic episode caused by severe hypokalaemia and was admitted to the intensive care unit (ITU) within 24 hours of initiating intravenous methylprednisolone (IVMP) infusion...
January 8, 2024: Orbit
Allan Z Nghiem, Blanca Sanz-Magallon Duque de Estrada, Reem Farwana, Sarah F Osborne
PURPOSE: This study reports the experience of pediatric preseptal and orbital cellulitis at a London tertiary centre during a 6-year period and highlights the role of orbital surgeons in the management of subperiosteal abscess (SPA). METHODS: A retrospective review was conducted of all pediatric patients hospitalised for preseptal and orbital cellulitis. RESULTS: A total of 201 children including 152 cases of preseptal cellulitis and 49 cases of orbital cellulitis were admitted at a London tertiary centre over the study period...
January 2, 2024: Orbit
Hamad M Alsulaiman, Reem Alanazi, Sahar Elkhamary, Azza Maktabi, Hind Alkatan, Rawan N Althaqib, Osama Sheik, Silvana A Schellini
A systematic literature review revealed 88 Rosai-Dorfman Disease (RDD) cases affecting the orbit. We present a review of the literature on orbital RDD in addition to two brothers with isolated bilateral extra-nodal orbital RDD cases associated with G-6PD deficiency. The disease manifested as asymmetric extensive orbital and paranasal sinus infiltration, with orbital bone destruction. Orbital mass debulking and steroids improved the condition in both patients. This is the most extensive case series of orbital RDD reported, including clinical manifestation, imaging, pathologic results, management, and outcome...
December 20, 2023: Orbit
Jessica X L Li, Jessica Y Tong, Krishna Tumuluri
Orbital Apex Syndrome (OAS) complicating Herpes Zoster Ophthalmicus (HZO) is associated with significant visual impairment. We present four patients with HZO OAS, to highlight clinical features and outcomes in order to promote earlier recognition and management of this potentially sight-threatening complication. CT and MRI imaging findings included expansion and enhancement of extraocular muscles and intraconal fat and involvement of the orbital apex and cavernous sinus. All patients received systemic steroid and antiviral therapy, but a standardised dosage and duration of treatment remains to be defined...
December 18, 2023: Orbit
Tatsuya Yunoki, Mitsuya Otsuka, Hitoshi Yamazaki, Atsushi Hayashi
PURPOSE: This study aimed to examine the changes in lower eyelid position after blepharoptosis surgery and the factors that influence the outcome. METHODS: We conducted a retrospective study of 155 eyes of 89 patients who underwent blepharoptosis surgery between June 2019 and October 2022. The margin reflex distance (MRD)-1 and MRD-2 were examined preoperatively and 3 months postoperatively in two groups: one with lower scleral show (LSS) ( n  = 37) and one without LSS ( n  = 118)...
December 15, 2023: Orbit
Silvana A Schellini, Daniela Santos Souza, Amanda A M P Almeida, Rodolfo A Schellini, Lucieni C B Ferraz
Primary sebaceous carcinoma of the lacrimal gland (PSCLG) is the rarest lacrimal gland (LG) tumor, often belatedly diagnosed, worsening the prognosis. We present a 68-year-old man with a large, indurated mass in the left orbital outer quadrant, visible at the conjunctival upper temporal fornix, extending to the lower fornix, with left gaze restriction. The lesion was not related to the eyelid or other periocular tissues. Excisional biopsy revealed the PSCLG diagnosis. There are only eight others previous PSCLGs...
December 15, 2023: Orbit
Cameron Yang, Derrick Wang, Lynn Schoenfield, Sruti S Akella
No abstract text is available yet for this article.
December 13, 2023: Orbit
Rachana Haliyur, Jane S Kim, Smriti Mohan, Seth Iskowitz, Nikhil Bommakanti, Jayapalli Rajiv Bapuraj, Jeremy Adler, Victor M Elner, Hakan Demirci
Both granulomatous polyangiitis (GPA) and Crohn's disease (CD) can cause orbital inflammation though rarely coincide and can often be differentiated by presenting features and histological findings. Here, we report the clinical and therapeutic course of a 14-year-old White male with binocular diplopia caused by orbital myositis. Imaging and biopsy obtained at presentation revealed necrosis and necrotizing granulomatous vasculitis suspicious for GPA. He subsequently developed gastrointestinal symptoms and terminal ileitis consistent with CD...
December 13, 2023: Orbit
Seyed Mohsen Rafizadeh, Hadi Ghadimi, Nasim Zarei Vesal, Zohreh Nozarian, Mojgan Nikdel
Adenoid cystic carcinoma (ACC) is the most common malignant neoplasm involving the lacrimal glands, with high rates of recurrence and metastasis. During the pregnancy, reports of recurrence of ACC of the salivary glands and trachea have previously been published, but no lacrimal gland ACC recurrence has been reported. We present a 35-year-old woman with lacrimal gland ACC who was initially treated by surgical resection and adjunctive radiotherapy, but her cancer recurred during pregnancy, with rapid progression to cavernous sinuses and brain...
December 2023: Orbit
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