RESUMO
Injectable dermal fillers continue to increase in popularity in aesthetic medicine. Although rare, vision loss secondary to filler injections is a devastating complication associated with a poor visual prognosis. The mechanism for vision loss is thought to be related to retrograde embolization of the dermal filler from peripheral vessels in the face into the ophthalmic arterial system. Early recognition and prompt management are essential if vision is to be salvaged. The use of retrobulbar hyaluronidase is still contentious, however when administered by a specialist, this treatment gives the best chance at visual recovery and should be considered for all cases.
Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Humanos , Preenchedores Dérmicos/efeitos adversos , Injeções , Transtornos da Visão , Artéria Oftálmica , Ácido Hialurônico , Técnicas Cosméticas/efeitos adversos , HialuronoglucosaminidaseAssuntos
Fenda Labial , Fissura Palatina , Perfuração da Córnea , Displasia Ectodérmica , Fenda Labial/complicações , Fenda Labial/diagnóstico , Fenda Labial/cirurgia , Fissura Palatina/complicações , Fissura Palatina/diagnóstico , Fissura Palatina/cirurgia , Displasia Ectodérmica/complicações , Displasia Ectodérmica/diagnóstico , Displasia Ectodérmica/cirurgia , Anormalidades do Olho , Pálpebras/anormalidades , Humanos , LactenteAssuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Glaucoma/diagnóstico , Glaucoma/terapia , Equipe de Assistência ao Paciente/organização & administração , Assistência Centrada no Paciente/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Oftalmologistas/organização & administração , Optometristas/organização & administração , Seleção de Pacientes , Estudos Retrospectivos , Adulto JovemRESUMO
Desmoplasia is the formation of a dense collagenous stroma around a neoplasm. It occurs in a variety of malignancies including squamous cell carcinoma (SCC). While desmoplasia is uncommonly seen in cutaneous SCC, it is an independent risk factor for recurrence and metastasis. We report a case series of desmoplastic SCC in the periorbital region. Seven cases were identified: the median age was 68, four were men. The mean follow-up was 48 months. Two patients (29%) had aggressive local recurrence: one required salvage surgery including orbital exenteration, parotidectomy, and neck dissection to excise involved parotid and cervical lymph nodes; the other required repeat excision and adjuvant radiotherapy. Desmoplastic SCC is an uncommon but highly aggressive subtype. In the periorbital region, due to the high risk of orbital invasion, it is potentially sight and life-threatening.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Orbitárias/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cirurgia de Mohs , Recidiva Local de Neoplasia/patologia , Neoplasias Orbitárias/diagnóstico , Neoplasias Orbitárias/terapia , Radioterapia Adjuvante , Estudos RetrospectivosRESUMO
AIM: An exponential rise in patients requiring intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment has occurred over recent years. We addressed this in Palmerston North by establishing a senior nurse-led macular review clinic. We aimed to determine the current intravitreal service accessibility and compared it to results from 2012. METHODS: Chart analysis. RESULTS: Planned follow-up was aimed for 42 days, near the end of the anti-VEGF therapeutic effect. It occurred on average at 45.05 (12 to 127) days after initial treatment induction and 40.7 (14 to 77) days for subsequent follow-ups. Treatment was started on average 29.8 (0 to 139) days after the decision was made. Further injections occurred on average 25.7 (0 to 104) days after the retreatment decision. These findings were similar to 2012 where initial follow-up occurred on average 42 (29 to 89) days following treatment, initial treatment 30 (0 to 78) days after treatment decision and retreatment at 34 (6 to 89) days. CONCLUSION: Instituting the senior nurse-led macular review clinic has enabled timely review of patients despite significant increases in those requiring treatment and surveillance. The average follow-up appointment delay is within the four week guideline set by NICE.