Large-Scale Transient Transfection of Suspension-Adapted Chinese Hamster Ovary Cells for the Production of the Trimeric SARS-CoV-2 Spike Protein.

The production and purification of the secreted ectodomain of SARS-CoV-2 spike protein (S protein) were performed by transiently transfecting suspension-adapted Chinese hamster ovary cells (ExpiCHO). The method involved the separate addition of plasmid DNA expressing the S protein and polyethyleneimine to a suspension culture at a density of 5 × 106 cells/mL; and the subsequent addition of dimethyl sulfoxide at 2% (v/v). The transfected ExpiCHO cells were cultivated at 31 °C with agitation by orbital shaking under 5% CO2. On day six post-transfection, the culture was centrifuged, and the supernatant was filtered to remove cells and cell debris. Finally, the secreted recombinant S protein was recovered from the supernatant by a single step of affinity chromatography to the Twin-Strep-Tag of the recombinant S protein.

The "d-p orbital hybridization"-guided design of novel two-dimensional MOFs with high anchoring and catalytic capacities in Lithium - Sulfur batteries.

The energy system of lithium-sulfur batteries is quite promising, however, lithium-sulfur batteries still suffer from considerable problems, such as the abominable shuttle effect of polysulfides (LiPSs), the low conductivity of the solid-phase products, the slow redox kinetics during charging and discharging, and the volume expansion. Herein, the hybridization pattern between the d-orbitals of various transition metal atoms and the p-orbitals of sulfides is revealed grounded in the theory of density function, which explains the high adsorption strength of two-dimensional metal-organic frameworks (MOFs) with LiPSs and accelerates the screening of high-performance anchoring and catalytic materials. The results elucidate that the coordinated transition metal-organic frameworks (Mo-NH MOF) monolayers increase the capacity of LiPSs to anchor by forming more π-bonds from the hybridization of the S p orbitals and Mo d orbitals. Notably, Mo-NH MOF exhibits bifunctional catalytic activity for sulfur reduction as well as Li2S decomposition reactions during charging and discharging, which improves the conversion efficiency of redox reactions. As a result, new MOF materials featuring unique active centers and the potential mechanism by which the active centers modulate the performance of the substrate materials are revealed, and this finding may accelerate the development of high-performance Li-S batteries.

Run-time motion and first-order shim control by expanded servo navigation.

PURPOSE: To provide a navigator-based run-time motion and first-order field correction for three-dimensional human brain imaging with high precision, minimal calibration and acquisition, and fast processing. METHODS: A complex-valued linear perturbation model with feedback control is extended to estimate and correct for gradient shim fields using orbital navigators (2.3 ms). Two approaches for sensitizing the model to gradient fields are presented, one based on finite differences with three additional navigators, and another projection-based approximation requiring no additional navigators. A mechanism for noise decorrelation of the matrix and the data is proposed and evaluated to reduce unwanted parameter biases. RESULTS: The rigid motion and first-order field control achieves robust motion and gradient shim corrections improving image quality in a series of phantom and in vivo experiments with varying field conditions. In phantom scans, magnet drifts, forced gradient field perturbations and field distortions from shifts of a second bottle phantom are successfully corrected. Field estimates of the magnet drifts are in good agreement with concurrent field probe measurements. For in vivo scans, the proposed method mitigates field variations from torso motions while being robust to head motion. In vivo gradient field precisions were 30 nT / m $$ 30\;\mathrm{nT}/\mathrm{m} $$ along with single-digit micrometer and millidegree rigid precisions. CONCLUSION: The navigator-based method achieves accurate, high-precision run-time motion and field corrections with low sequence impact and calibration requirements.

Orbital dermoid cyst in children: A case report.

Dermoid cysts represent the most frequent type of orbital cystic lesions observed in children. While superficial orbital dermoid cysts manifest early in life as slowly growing masses, deep dermoid cysts typically remain clinically undetectable until adolescence or adulthood, at which point they enlarge and induce proptosis. Imaging studies play a pivotal role in precisely determining location and size, excluding intracranial and intraorbital extensions, and facilitating the planning of management strategies for complex cases. We present a case of a 5-year-old boy admitted for slowly developing of ocular motility limitation of the right eye, observed by the parents. The imaging revealed a well-circumscribed extraconal cystic mass, with radiological characteristics primarily suggesting a dermoid cyst. The cyst was surgically excised without complications, and the histopathological examination of the operative specimen confirmed our diagnosis.

Guardians of the ocular surface: lessons learned from a challenging case of Langerhans cell histiocytosis with eyelid involvement

ABSTRACT Langerhans cell histiocytosis comprises a heterogeneous range of clinical manifestations secondary to clonal proliferation of histiocytes, characterized by the accumulation of these cells in various organs and tissues. The ophthalmological component commonly involved is the orbit. Herein, we report a rare case of Langerhans cell histiocytosis with eyelid involvement, which resulted in severe ocular surface complications, which subsequently significantly impacted the patient's quality of life. This case report highlights the fact that despite being rare, Langerhans cell histiocytosis should be included in the differential diagnosis of eyelid lesions. Furthermore, a multidisciplinary approach with a systemic overview is crucial for managing the ocular complications.

Innovative hybrid approach: digital and analog fabrication of orbital prosthesis for post-COVID-19 mucormycosis defects using photogrammetry technique.

In addition to anatomical loss, removal of the full or portion of the orbit results in a facial deformity and psychological distress for the patient. This article details a practical case of prosthetic rehabilitation using digital workflow for an orbital deformity caused by post-COVID-19 Mucor mycosis. The main goal of this case study was to create a maxillofacial orbital prosthesis that is well-retained, simple to use, and accurate in terms of appearance. The study addresses the problems involved in fabricating the orbital prosthesis, particularly the unique dimensions and form of the defect, replicating the natural skin tone, and accomplishing retention by the most prudent and patient-friendly approach. Through this article, a digitised algorithm, using photogrammetry technique for facial scan, is suggested for fabricating the prosthesis.

The Role of Radiotherapy in Indolent Ocular Adnexal and Orbital Lymphomas.

BACKGROUND: This study evaluates the oncological outcomes and toxicities of indolent ocular adnexal and orbital lymphomas (OOLs) treated with radiotherapy (RT) ± systemic therapy. METHODS: A retrospective analysis of 44 patients with indolent OOLs treated with RT was conducted. RESULTS: Most patients (87%) had early-stage disease. Treatment involved RT alone (34%) or RT + systemic therapy (66%). The median RT dose was 30 Gy, with a median follow-up of 45 months. Local and systemic recurrence rates were 4% and 9%, respectively. Five-year overall and disease-free survival (DFS) rates were 96.2% and 83.6%. Early-stage patients showed similar DFS rates regardless of whether they received RT alone or RT plus systemic therapy. No grade 3 RT-related toxicity occurred, but systemic therapy led to grade 3 toxicity in 17% of patients. CONCLUSIONS: RT is essential for treating indolent OOLs, and combination with systemic therapies does not enhance outcomes for early-stage patients.

Stereotactic Radiosurgery for Choriocarcinoma Brain Metastases: Illustrative Case Presentation and Systematic Review.

BACKGROUND: Choriocarcinoma (CC) is a rare and aggressive form of germ cell tumor. There is limited evidence reporting outcomes in patients with primary CC and brain metastases (BM). To date, only a few single case reports have documented the use of SRS for CC BM. METHODS: We retrospectively assessed patients who were treated with SRS for pure CC BM from 1998-2024. Lesion follow-up sizes and local tumor control status were evaluated after SRS treatment using RECIST criteria. A comprehensive literature search was performed for CC BM in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: In our series, 3 patients with 7 CC BM underwent SRS. Two were male with testicular CC and one was female with gestational CC. The median diameter of the lesions was 8 mm with a median volume of 0.14 cm3 at treatment. The MRIs at 3 and 6 months demonstrated reductions in median diameters to 6 mm and 4 mm, respectively. At the last follow-up visits, one lesion had local progression at 15 months after SRS and one lesion had sustained complete response. Our systematic review yielded 249 articles. After screening, a total of 18 reports were identified for CC BM. Among these, only three single cases documented the use of SRS for CC BM. CONCLUSION: SRS is a feasible and viable approach for CC BM, particularly in cases where immediate surgical management is not necessary. This is yet the largest report evaluating the outcome of CC BM treated with SRS.

Ag Atom Induces Microstrain Environment around Cd Sites to Construct Diatomic Sites for Almost 100% CO2-to-CO Electroreduction.

Deeply understanding how local microstrain environment around diatomic sites influences their electronic state and adsorption is crucial for improving electrochemical CO2 reduction (eCO2R) reaction; however, precise engineering of the atomic microstrain environment is challenging. Herein, we fabricate Ag-CdTMT electrocatalysts with AgN2S2-CdN2S2 diatomic sites by anchoring Ag to the nodes of CdTMT (TMT = 2,4,6-trimercaptotriazine anion) coordination polymers. The Ag-CdTMT catalysts achieve approximately 100% Faradaic efficiency for CO reduction with an industrial level current density (∼200 mA cm-2 in H-cell). The embedded Ag atoms induce the formation of Ag-Cd diatomic sites with local microstrain, stretching Cd-N/S bonds, and reinforcing electron localization at Cd sites. The microstrain engineering and adjacent Ag atoms synergistically reduced Cd 4d-C 2p antibonding orbital occupancy for intensifying *COOH adsorption as the rate-determining step. This study provides novel insights into customizing the electronic structure of diatomic sites through strain engineering.

Therapeutic role of physalin A in the pathogenesis of Graves' orbitopathy.

BACKGROUND: Graves' orbitopathy (GO) is an autoimmune condition that causes serious ocular symptoms; its treatment strategies are limited. Physalin A is a phytosterol that has shown various therapeutic properties, including anti-inflammatory and anti-fibrotic effects. In this study, we investigated whether physalin A could inhibit inflammation, fibrosis, hyaluronan (hyaluronic acid) production, and adipogenesis, which are crucial to the pathogenesis of GO. METHODS: Orbital tissue explants were obtained from patients with GO during orbital decompression surgery and healthy controls. Orbital fibroblasts (OFs) were isolated and treated with different concentrations of physalin A. Using western blot and ELISA analyses, we determined the effects of physalin A on OFs. RESULTS: Physalin A treatment suppressed the production of interleukin (IL)-1ß-induced prostaglandin E2 (PGE2) and pro-inflammatory molecules, including cyclooxygenase (COX)-2, IL-6, IL-8, and intercellular adhesion molecule (ICAM)-1. We discovered that physalin A attenuated hyaluronan production induced by IL-1ß or insulin-like growth factor (IGF)-1. Moreover, physalin A reduced lipid droplet formation and production of peroxisome proliferator activator (PPAR) γ, CCAAT-enhancer-binding protein (C/EBP) α, C/EBP ß, sterol regulatory element binding protein (SREBP)-1, leptin, and adiponectin proteins. Physalin A suppressed the phosphorylation of extracellular signal-related kinase (ERK), nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB), and suppressor of mothers against decapentaplegic (SMAD) 2 signaling protein. CONCLUSIONS: Our study suggests that the major mechanisms by which physalin A suppresses GO include reducing inflammation, fibrosis, hyaluronan production, and adipogenesis in OFs. The findings of this study provide evidence of the therapeutic effect of physalin A in GO.

Orbital Lymphoma Presenting As Recurrent Orbital Cellulitis: A Diagnostic Challenge.

Orbital cellulitis is an infection of the orbital tissue behind the orbital septum. We report a case of a 71-year-old Malay lady, a passive smoker for 20 years, presenting with recurrent orbital cellulitis at the same site. She initially presented with right periorbital swelling, redness, and reduced vision worsening over two weeks, along with a firm swelling over the right temple. CT of the brain and orbit revealed a homogenous mass extending from the right sphenoid bone to the right orbit. The initial diagnosis was right sphenoid meningioma or metastasis. Her symptoms improved after 10 days of intravenous cefuroxime, prescribed for catheter-related phlebitis over her right hand, which developed during the admission. A follow-up MRI of the brain and orbit showed osteomyelitis changes in the right orbit and sphenoid bone. Histopathology revealed chronic inflammation without malignancy, and cultures were negative. The diagnosis was revised to right orbital cellulitis secondary to cranial osteomyelitis. The patient was lost to follow-up but returned three months later with recurrent symptoms, including right periorbital swelling, reduced vision, ophthalmoplegia, and right forehead swelling. She was treated with intravenous ceftriaxone, which resulted in partial symptom resolution. Neurosurgery planned a right craniotomy, but she was undecided and again lost to follow-up due to deteriorating health. Over time, her condition worsened, leading to readmission. A repeated CT scan of the brain and orbit showed a lobulated, enhancing soft tissue lesion in the right periorbital area with intralesional calcification and bony erosion. A biopsy confirmed it as high-grade B-cell lymphoma. The patient succumbed to the illness a few weeks later. This case highlights that orbital lymphoma can manifest as orbital cellulitis. Failure to respond to conventional orbital cellulitis treatment should raise suspicion of a more serious underlying cause. We advocate that clinicians consider orbital lymphoma as a potential diagnosis in elderly patients presenting with recurrent, culture-negative orbital cellulitis.

Isolated Pancreatic Metastasis in a Patient With Orbital Rhabdomyosarcoma: A Report of a Rare Case.

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children and adolescents and its occurrence in adults is extremely rare. There are three major subtypes of RMS of which alveolar RMS (ARMS) has the worst prognosis and tends to metastasize to unusual locations such as the pancreas. We present a case of a 19-year-old male with a rapidly enlarging right orbital mass, the imaging of which revealed it to be an infiltrative lesion with extension into the nasal cavity, ethmoid sinuses, and intracranial involvement. Histopathology confirmed the diagnosis of ARMS. A staging CT scan showed an enlarged and hypoenhancing pancreas; the histopathology test confirmed ARMS metastasis. It is important to consider pancreatic involvement in patients with ARMS, as it may be misinterpreted with other pathologies such as pancreatitis and pancreatic lymphoma. Metastasis to the pancreas can significantly alter the clinical approach and staging, underscoring the need for accurate diagnosis and staging in these patients.

Rehabilitation of Acquired Maxillary Defect With Patient-Specific Implants Post-mucormycosis Resection: A Case Report.

The outbreak of COVID-19 swept massive masses causing rhinocerebral mucormycosis, a fatal mycotic infection, and high mortality among humans. ​It affects individuals with weakened immune systems, resulting in severe ulcers on the palate or perforation of the palate, accompanied by blackish necrotic tissue and exposure of underlying bone.​ Some of the key symptoms include rhinorrhea, facial swelling, pain in the orofacial region, varying degrees of fever, headaches, blurred vision due to proptosis, and involvement of the contents of the orbit. The impairment is enormous and thus needs a surgical resection of the palate and associated structures, leaving the patient with both compromised function and psychological impairment. This case report presents a new digital technique for the rehabilitation of acquired maxillary defects with patient-specific implants.

Rare skin manifestation of juvenile dermatomyositis: peri-orbital oedema and facial swelling.

Juvenile dermatomyositis (JDM) is an auto-immune disease characterised by muscle weakness and typical skin findings. Although peri-orbital oedema and facial swelling are compatible cutaneous findings in JDM, they are extremely rare. A 7-year-old boy who presented with peri-orbital oedema and facial swelling without muscle weakness is reported. In addition, he had cholestasis and marked cytopenia, which are uncommon in JDM, and malignancy and metabolic disorders were primarily considered in the aetiology. He had no musculoskeletal complaints other than elevated muscle enzymes on presentation but developed muscle weakness during follow-up, and a muscle biopsy was compatible with inflammatory myopathy. He responded favourably to conventional treatment and there were no physical limitations or skin findings by the 14th month of follow-up. Although patients presenting with typical clinical features are easy to diagnose, atypical skin findings are challenging for the clinician. In the presence of atypical skin and clinical findings in addition to muscle enzyme elevation, JDM should be considered in the differential diagnosis.Abbreviations: AHCE: asymptomatic hyper-CKemia; AST: aspartate aminotransferase; C: complement; CK: creatine kinase; IVIG: intravenous immunoglobulin; IIM: idiopathic inflammatory myopathy; JDM: juvenile dermatomyositis; LDH: lactate dehydrogenase; MAA: myositis-associated antibodies; MDA5: melanoma differentiation-associated gene 5; MRC: Medical Research Council; MRI: magnetic resonance imaging; MSA: myositis-specific antibodies; MTX: methotrexate NXP2: nuclear matrix protein 2; STIR: short tau inversion recovery; US: ultrasound.

Orbital masses as a rare presentation of Rosai-Dorfman disease: Clinicopathologic characterization of five cases.

Rosai-Dorfman disease (RDD) is a rare, non-Langerhans cell histiocytosis. Most cases present with marked, non-tender lymphadenopathy due to the proliferation of atypical histiocytes. A minority of cases involves extranodal sites and can present as bone lesions, skin rashes, pulmonary nodules, and rarely orbital masses. Orbital involvement in RDD is rare and may infrequently present as an isolated tumor mass without lymphadenopathy. This study aims to better characterize this uncommon presentation of this rare disease. Five cases of orbital RDD were identified from the last 18 years and the clinical characteristics of each case were compared with histopathological findings. Three men and two women ages 12-36 presented with complaints of eye swelling and/or vision changes. One patient had a history of neurofibromatosis type I and inflammatory pseudotumors while the other four had no signs of systemic disease or other sites of extranodal involvement at the time of presentation. Masses ranged in size from 1.0 cm to 3.5 cm and primarily involved the superior orbit. Resected lesions all displayed characteristic findings of admixed atypical histiocytes, lymphocytes, and plasma cells with a fibrotic background. Emperipolesis was seen in all cases. Immunostaining for S100 and CD68 was diffusely positive in the histiocyte population. Clinical follow-up was obtained for 4 of 5 patients: all four were disease-free at 1 to 15 years after resection. RDD should be considered in the differential for patients with orbital masses, even in the absence of lymphadenopathy or signs of systemic disease.

Laser Scanning Morphometric Measurements of the Main Orbital Communications in Dry Human Skulls.

BACKGROUND AND OBJECTIVES: This research investigated the morphometric dimensions of the optic foramen (OF), superior orbital fissure (SOF) and inferior orbital fissure (IOF), using indirect measurement techniques such as laser scanning, making it likely the first study of its kind. This study aimed to identify the morphometric variability of the main orbit communications and to highlight the differences between genders. MATERIALS AND METHODS: The anthropometric study was conducted on sixty dry skulls (120 orbits) of adults aged between 20 and 70 years. Measurements of orbital communications were made using the RS6 laser scanner. The orbital parameters that were investigated are as follows: length and width of the SOF and IOF, and height and width of the OF. RESULTS: In males, the average height of the OF was 8.27 mm and 8.13 mm in females, while the average width of the OF was 6.34 mm in males and 5.83 mm in females. The SOF average length was 21.09 mm in males and 17.58 mm in females. The widths of the SOF in the three thirds (anterior, middle and posterior) in males were 5.14/4.77/7.11 mm and 2.28/3.48/5.80 mm in females. The average length of the IOF was 33.05 mm in males and 32.30 mm in females. The widths of the IOF in the three thirds (anterior, middle and posterior) were 5.61/3.92/4.70 mm in males and 7.24/4.68/4.08 mm in females. CONCLUSIONS: The OF height and width were higher in males compared to females. The SOF length and width were higher in males compared to females. The IOF length was higher in males for the right orbit and higher in females for the left orbit. The IOF width for both orbits was higher in females in the anterior and middle third, and higher for males in the posterior third. Evaluation of dry skulls using laser scanning is reliable and recommended for data accuracy. Laser scanning can become a usable method for all indented and hard-to-reach regions of the cranial skeleton.

Angioinvasive Rhino-Orbital-Cerebral Mucormycosis in a Patient with Type 2 Diabetes Mellitus: A Complex and Lethal Cause of Stroke.

Rhino-orbital-cerebral mucormycosis is a rapidly progressive and often fatal fungal infection caused by molds of the order Mucorales, particularly affecting immunocompromised individuals. This infection is notorious for its angioinvasive properties, enabling the fungi to invade blood vessels and leading to tissue necrosis. We report the clinical course of a 59-year-old Caucasian man with poorly controlled type 2 diabetes (HbA1c 16.8%) who presented with unilateral headache, left-sided facial numbness, and incomplete left ocular motor paresis. Initial presentation raised suspicion of orbital phlegmon, leading to antibiotic and later corticosteroid pulse therapy, which worsened the patient's condition. Subsequent imaging demonstrated extensive inflammatory changes, including wall irregularities of the left intracranial internal carotid artery, accompanied by ocular protrusion and periorbital enhancement. New palatal lesions indicated mucormycosis, which was confirmed by molecular analysis of a palatal biopsy, leading to Amphotericin B treatment. Pre-surgery imaging revealed a malignant middle cerebral artery infarction, and the patient died 16 days after symptom onset and 12 days after initial presentation under palliative care due to a poor prognosis. This case of angioinvasive mucormycosis underscores the severe and often fatal course of rhino-orbital-cerebral mucormycosis in an immunocompromised individual. The rapid progression from initially vague and unspecific symptoms to extensive vascular involvement and stroke highlights the critical need for early and accurate diagnosis, as well as prompt intervention to prevent further disease progression. Additionally, this case also illustrates the potential risks associated with corticosteroid therapy in the presence of undiagnosed fungal infections, which can exacerbate the condition and lead to serious complications. Clinicians should maintain a high index of suspicion for mucormycosis in similar clinical scenarios, prioritizing adequate antifungal treatment and careful monitoring to improve patient outcomes. Early interdisciplinary collaboration is essential for the effective management of such complex cases.

Orbital tuberculosis presenting as vision loss and headache: early management is paramount.

Orbital tuberculosis is a rare form of extra pulmonary TB and may arise either by hematogenous route or spread directly from the paranasal sinus. We herein report two cases of orbital TB with a vision threatening complication. Case-1 is a 31-year-old female with a headache, a diminution of vision in the right eye, and pain in ocular movement. On examination, there was no proptosis with RAPD present in right eye and tenderness on palpation. CEMRI revealed a diffuse infiltrating lesion at the orbital apex, suggesting of inflammatory pathology. Case-2 is a 40-year-old male with similar complaints in the left eye, CECT showed edema and swelling in the optic nerve and extraocular muscle of the left eye. A detailed investigation was done, and a diagnosis of orbital tuberculosis was made in both patients. They were started on ATT and oral steroids but lost follow-up initially and due to delayed treatment, it led to irreversible vision loss. A long-term follow-up showed resolution of ocular symptoms with occasional headaches.

Integrated machine learning and Mendelian randomization reveal PALMD as a prognostic biomarker for nonspecific orbital inflammation.

BACKGROUND: Nonspecific Orbital Inflammation (NSOI) remains a perplexing enigma among proliferative inflammatory disorders. Its etiology is idiopathic, characterized by distinctive and polymorphous lymphoid infiltration within the orbital region. Preliminary investigations suggest that PALMD localizes within the cytosol, potentially playing a crucial role in cellular processes, including plasma membrane dynamics and myogenic differentiation. The potential of PALMD as a biomarker for NSOI warrants meticulous exploration. METHODS: PALMD was identified through the intersection analysis of common DEGs from datasets GSE58331 and GSE105149 from the GEO database, alongside immune-related gene lists from the ImmPort database, using Lasso regression and SVM-RFE analysis. GSEA and GSVA were conducted with gene sets co-expressed with PALMD. To further investigate the correlation between PALMD and immune-related biological processes, the CIBERSORT algorithm and ESTIMATE method were employed to evaluate immune microenvironment characteristics of each sample. The expression levels of PALMD were subsequently validated using GSE105149. RESULTS: Among the 314 DEGs identified, several showed significant differences. Lasso and SVM-RFE algorithms pinpointed 15 hub genes. Functional analysis of PALMD emphasized its involvement in cell-cell adhesion, leukocyte migration, and leukocyte-mediated immunity. Enrichment analysis revealed that gene sets positively correlated with PALMD were enriched in immune-related pathways. Immune infiltration analysis indicated that resting dendritic cells, resting mast cells, activated NK cells, and plasma cells positively associate with PALMD expression. Conversely, naive B cells, activated dendritic cells, M0 and M1 macrophages, activated mast cells, activated CD4 memory T cells, and naive CD4 T cells showed a negative correlation with PALMD expression. PALMD demonstrated significant diagnostic potential in differentiating NSOI. CONCLUSIONS: This study identifies PALMD as a potential biomarker linked to NSOI, providing insights into its pathogenesis and offering new avenues for tracking disease progression.

Orbital Hematoma Treatment-A Retrospective Study.

Background: Bleeding within the orbit in the form of a subperiosteal or retrobulbar hematoma is a relatively common complication of trauma and surgery. It affects up to 30% of patients fractures involving the orbital bones. Most cases do not require surgical intervention because they do not cause retinal ischemia or optic nerve neuropathy. The above symptoms occur in only 0.5-1% of patients developing Orbital Compartment Syndrome (OCS). Due to the short period (60-100 min) of time in which the optic nerve and retina can tolerate increased intraocular pressure, it seemed reasonable to evaluate and standardize the surgical management protocol for this rare complication. Objective: The aim of this retrospective study was to retrospectively analyze cases of inframammary haematomas with clinically relevant correlations. Methods: Eighteen patients treated at the Department of Maxillofacial Surgery due to OCS, in Lodz and Poznan, Poland, between 2009 and 2022, were included. APTT, INR, systemic diseases, cause, location and size of hematoma, presence and number of fractures, visual disturbances and pupillary response on the day after surgery and one month after, the type of intervention and time between admission to the hospital and surgery were evaluated. Results: Statistically significant correlations were obtained between the size of the hematoma and the patients' age, the degree of visual disturbance and the weakening of pupillary constriction, severe initial symptoms and poor postoperative outcomes at both postoperative periods studied, immediate and distant poor outcome after decompression surgery and good postoperative outcome persisting one month after. Conclusions: The results obtained in the study and the surgical protocol proposed by the authors are in line with the current state of knowledge regarding orbital hematomas. Some of the correlations described in the literature (such as OCS and anticoagulant treatment) were not demonstrated, but this is probably due to the small study group. Maintaining the 100 min limit as a standard was possible only in early postoperative diagnoses (only 1 of the patients was operated on up to 100 min after the appearance of symptoms). In other cases, the specialized diagnosis took an average of 2785 ± 4020 min or 46 ± 67 h.