Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 19 de 19
Filtrar
Más filtros










Base de datos
Intervalo de año de publicación
1.
Can J Ophthalmol ; 2023 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-37088101

RESUMEN

OBJECTIVE: To describe clinical features and management of toxic keratoconjunctivitis associated with punctal and (or) canaliculus stenosis (toxic soup syndrome). DESIGN: Retrospective observational case series. METHODS: Electronic medical record database search for the keywords "toxic soup syndrome" and retrospective chart review were performed. Thirty-five eyes of 25 patients were seen at a tertiary cornea clinic between January 2017 and December 2021. Sex, age, distance-corrected visual acuity, topical medications, symptoms, clinical signs, and outcomes after medical and surgical interventions were analyzed. The main outcome measured was improvement in ocular surface signs and symptoms after interventions. RESULTS: Overall, 35 eyes of 25 patients with a mean age of 66.8 ± 12.8 years, of which 72% were female, were included. The primary complaint was hyperemia and epiphora in all patients. Rosacea or meibomian gland disease were present in all patients, 7 (28%) had glaucoma, and 7 (28%) developed limbal stem cell deficiency. Twenty-two patients (88%) were using topical medications on presentation. All eyes had either punctal plugs, cauterized puncta, or punctal and (or) canaliculus stenosis. Management of all patients consisted of suspension of all preserved topical medications and institution of some type of anti-inflammatory therapy. Nineteen patients (76%) improved after improvement of lacrimal drainage. One patient with severe resistance in the canaliculus required ongoing preservative-free topical steroids. CONCLUSIONS: Chronic drug-induced or pooled inflammatory mediators causing toxic conjunctivitis may be aggravated by punctal and (or) canaliculus stenosis, leading to toxic soup syndrome. Clearance of punctal obstruction leads to improvement in most patients.

2.
Ophthalmic Plast Reconstr Surg ; 37(3S): S19-S22, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33009327

RESUMEN

PURPOSE: To report the etiology, management, and possible risk factors for diplopia after canalicular bypass surgery. METHODS: A multicenter retrospective, noncomparative case series of patients who developed diplopia following canalicular bypass surgery were assessed. RESULTS: Twenty-four cases of diplopia were identified across 12 institutions. Tubes were inserted as a primary procedure with external dacryocystorhinostomy (DCR) (1; 4%) or without DCR (10; 42%) or as a secondary procedure after external (8; 33%) or endonasal (5; 21%) DCR. Factors predisposing to local damage were noted in 17 (71%): these factors included preexisting autoimmune/inflammatory condition (7 cases), medial canthal tumor resection (5 cases), preoperative radiotherapy (2 cases), 2 drug treatments (topical and systemic), and 1 local surgery. Horizontal diplopia was due to restriction of abduction and first noted at a median of 3.5 months (mean: 17.8 months, range: 1 day to 112 months) and persisted in 23 (96%) cases with a mean restriction of -2, affecting primary gaze in 4 patients and activities of daily living in 13 (42%). Seventeen patients received various treatments: 10 were operated on resulting in cure in 1 and improvement in 9. A stable degree of diplopia persisted in all but one patient. CONCLUSIONS: Restriction of abduction causing horizontal diplopia is a rare complication with canalicular bypass surgery and a notably high proportion occurred after tube placement without DCR; carunculectomy was not ubiquitous. Although in some the diplopia may be improved with intervention, the chance of cure is low. This complication should probably be included during informed consent for canalicular bypass tubes.


Asunto(s)
Dacriocistorrinostomía , Obstrucción del Conducto Lagrimal , Conducto Nasolagrimal , Actividades Cotidianas , Diplopía/etiología , Humanos , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento
3.
Can J Ophthalmol ; 55(3): 245-252, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31901307

RESUMEN

OBJECTIVE: The management of advanced basal cell carcinoma (BCC) in the periocular region remains a clinical challenge. Vismodegib (ErivedgeTM) has been approved in 2013 by Health Canada for adult patients with "histologically confirmed metastatic BCC or locally advanced BCC inappropriate for surgery or radiation." An expert consensus was sought to create a standardised approach in the use of this novel treatment. METHODS: Fourteen practicing oculoplastic surgeons across Canada were involved in formulating and reviewing guidelines until consensus was reached. A consultancy meeting was followed by further ratification of guidelines over email. Two voting surveys were performed of the group to objectively assess agreement over each statement within the guidelines. Ratification continued until at least two-thirds of the group agreed on every guideline statement. RESULTS: The guidelines summarize 21 statements in a major and minor criteria format. A multidisciplinary team review is suggested for each patient with the involvement of recommended specialists. The internal survey revealed 100% agreement over 9 statements, 91.7% agreement over 8 statements, 83.3% agreement over 4 statements, and 2 statements had 66.7% and 58.7% agreement each. All statements with less than 91.7% agreement were surveyed again, and they were kept, modified, or removed on the basis of a consensus of over 66.7%. CONCLUSIONS: These guidelines serve to act as a framework for physicians considering vismodegib for the medical management of patients with advanced or metastatic periocular BCC. Future applications, including neoadjuvant uses of the drug, may become apparent through further research.


Asunto(s)
Antineoplásicos , Carcinoma Basocelular , Neoplasias Cutáneas , Adulto , Anilidas , Antineoplásicos/uso terapéutico , Canadá , Humanos , Piridinas , Resultado del Tratamiento
4.
J AAPOS ; 23(3): 182-185, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30974170

RESUMEN

This case highlights the management of orbital rhabdomyosarcoma in a child with Li Fraumeni syndrome (LFS). Treatment with chemotherapy and eventual orbital exenteration enabled margin-free control of the tumor. Radiation therapy was avoided to reduce the risk of inducing additional malignancy. Reactive orbital hyperostosis was observed postoperatively and was confirmed with surgical biopsy of the orbital roof. In this case, systemic surveillance imaging, which is necessary in patients with LFS, revealed an adrenal cortical carcinoma.


Asunto(s)
Síndrome de Li-Fraumeni/complicaciones , Órbita/diagnóstico por imagen , Neoplasias Orbitales/complicaciones , Rabdomiosarcoma/complicaciones , Terapia Combinada , Humanos , Lactante , Síndrome de Li-Fraumeni/diagnóstico , Imagen por Resonancia Magnética , Masculino , Neoplasias Orbitales/diagnóstico , Neoplasias Orbitales/terapia , Rabdomiosarcoma/diagnóstico , Rabdomiosarcoma/terapia , Tomografía Computarizada por Rayos X
7.
Ophthalmic Plast Reconstr Surg ; 27(4): 260-2, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21326128

RESUMEN

OBJECTIVE: To determine the indications for ordering orbital imaging and the indications for ordering CT versus MRI by oculoplastic surgeons and to assess the correlation between surgeon's clinical indications for imaging and the radiologist's diagnosis. DESIGN: Retrospective review of imaging requisitions and radiology reports. PARTICIPANTS: Patients of 4 oculoplastic surgeons who required CT or MRI scans. METHODS: Imaging requisitions and radiology reports of patients from 4 oculoplastic surgeons were reviewed to determine the indication for ordering a CT or MRI scan between March 2006 and March 2009. The indications were then compared with the radiologist's diagnosis. RESULTS: A total of 735 patients were included: 449 (61.1%) female and 286 (38.9%) male, with an average age of 50.1 years and an age range of 7 months to 93 years. Of these patients, a total of 632 CT and 223 MRI scans were ordered, 135 of which were follow-up scans. CONCLUSIONS: The most common indication for CT scan was thyroid disease, followed by orbital tumors and then inflammatory disease, while the most common indication for MRI scan was orbital tumors, followed by inflammatory disease and then thyroid disease. CT scans were more commonly ordered than MRI, largely for trauma and to rule out orbital foreign body.


Asunto(s)
Técnicas de Diagnóstico Oftalmológico/estadística & datos numéricos , Imagen por Resonancia Magnética/estadística & datos numéricos , Órbita/patología , Enfermedades Orbitales/diagnóstico , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Derivación y Consulta/estadística & datos numéricos , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/métodos , Procedimientos Innecesarios/estadística & datos numéricos
8.
Ophthalmic Plast Reconstr Surg ; 27(5): e132-4, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21178798

RESUMEN

A 72-year-old man presented with a slowly progressive left hyperglobus, left infraduction deficit, bilateral lower eyelid retraction, and dysphagia. He had a notable chin-down head position, diplopia in primary position, and 3 mm of left proptosis. He had been diagnosed with Graves disease 3 years before presentation. CT scans showed enlargement of the left inferior and medial rectus muscles with associated stranding of the retrobulbar fat and a low-density heterogeneous mass in the left aspect of the neck protruding in the nasopharynx. Biopsies of the orbit and nasopharynx revealed focal areas of amyloid. This represents the first report of bifocal amyloidomas of the orbit and nasopharynx.


Asunto(s)
Amiloidosis/complicaciones , Enfermedad de Graves/etiología , Neoplasias Nasofaríngeas/complicaciones , Neoplasias Orbitales/complicaciones , Anciano , Humanos , Masculino
10.
Orbit ; 27(4): 259-65, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18716963

RESUMEN

PURPOSE: To introduce a novel technique for measuring ocular surface dimensions using digital photography and computerized image analysis in the context of ptosis repair surgery. METHODS: Digital photographs and patient questionnaires on dry eye symptoms were obtained from 31 patients before and after ptosis repair. Patients were examined preoperatively and at 1 and 6 weeks postoperatively. Adobe Photoshop 7.0 (Adobe Systems Incorporated, 345 Parkl Avenue, San Jose, CA 95110-2704, USA) was used to digitally measure palpebral fissure height, fissure width, and ocular surface area (OSA). Similar digital measurements were obtained on 30 control subjects as well. Digital calculations of OSA for control, preoperative, and postoperative groups were compared with other published techniques. RESULTS: Graphical comparison between our method of measuring OSA and the mathematical estimations proposed by previous studies suggests that our method is more precise in measuring OSA, and that it is also better able to identify individual variations of OSA from general population trends. CONCLUSION: Digital ocular photography combined with computerized image analysis is a fast, easy to use, and reliable method of measuring ocular surface dimensions. In addition to ptosis surgery, this method can be used in other ocular surface studies.


Asunto(s)
Segmento Anterior del Ojo/anatomía & histología , Procesamiento de Imagen Asistido por Computador/métodos , Fotograbar/métodos , Blefaroplastia , Blefaroptosis/cirugía , Síndromes de Ojo Seco/diagnóstico , Humanos , Estudios Prospectivos , Encuestas y Cuestionarios
11.
Can J Ophthalmol ; 42(6): 826-31, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18033326

RESUMEN

BACKGROUND: The purpose of this study was to evaluate surgical waiting times experienced by intraocular and periocular cancer patients in Toronto and to assess the period of greatest delay between certain stages of ocular cancer care. METHODS: A retrospective chart review was performed on cases of adult patients who underwent surgery between January 2002 and December 2004 for malignant or premalignant tumours of the eye and ocular adnexa. Waiting time intervals were calculated between 5 time points: initial presentation to referring physician or optometrist, date of referral to oculoplastics or ocular oncology, initial assessment, consent date, and surgery date. Total surgical waiting time was the period between the initial presentation and surgery date. RESULTS: The mean total surgical waiting time was 85.93 (standard error [SE] 212.70) days. The 5% trimmed mean total waiting time was 51.07 days. The longest mean total waiting time averaged 94.16 (SE 18.69) days for patients with orbital or lacrimal tumours. For all patients, the interval of greatest delay was between initial assessment and consent (according to means) or between referral and initial assessment (according to 5% trimmed means). For patients with lid, brow, or conjunctival tumours the interval of greatest delay was between referral and initial assessment, and for those with orbital, lacrimal, or intraocular tumours it was between initial assessment and consent. INTERPRETATION: By measuring the period between consent and surgery, the Ontario government is not measuring the interval of greatest delay in ocular cancer care. The wait-time registry may benefit from including data from patients with periocular tumours.


Asunto(s)
Neoplasias del Ojo/cirugía , Procedimientos Quirúrgicos Oftalmológicos/estadística & datos numéricos , Listas de Espera , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Conjuntiva/cirugía , Atención a la Salud/estadística & datos numéricos , Neoplasias de los Párpados/cirugía , Femenino , Humanos , Enfermedades del Aparato Lagrimal/cirugía , Masculino , Persona de Mediana Edad , Ontario , Neoplasias Orbitales/cirugía , Estudios Retrospectivos
12.
Ophthalmic Plast Reconstr Surg ; 23(5): 367-71, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17881986

RESUMEN

PURPOSE: To investigate the relationship between adrenergic receptors in Müller muscle and response to phenylephrine testing in patients undergoing ptosis surgery. This study also compares outcomes of Fasanella and Putterman approaches to posterior ptosis repair. METHODS: Prospective analysis of 71 patients undergoing posterior ptosis surgery. Eyelid height was measured before and after phenylephrine. Müller muscle was examined for alpha-1D, alpha-2C, beta-1, and beta-2 receptors. Specimens were graded on receptor staining intensity. Patients were seen 1 week and 6 weeks following surgery. Surgical outcomes were scored on a scale of 1 (most favorable) to 3 (least favorable). RESULTS: Adrenergic receptors were found in decreasing order: alpha-1D, beta-1, alpha-2C, and beta-2. Receptor grade significantly predicted eyelid height for alpha-2C receptors (p = .03). Mean outcome scores for 36 Putterman (1.10) and 35 Fasanella (1.27) procedures were not significantly different. CONCLUSIONS: Alpha 1D, alpha-2C, and beta-2 receptors are documented within human Müller muscle. Human eyelid elevation response to phenylephrine is inversely related to the amount of alpha-2C receptor staining in Müller muscle. Fasanella and Putterman procedures have equal outcomes, independent of adrenergic receptors.


Asunto(s)
Agonistas alfa-Adrenérgicos , Blefaroptosis/metabolismo , Párpados/metabolismo , Músculo Liso/metabolismo , Fenilefrina , Receptores Adrenérgicos/metabolismo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Blefaroplastia , Blefaroptosis/diagnóstico , Blefaroptosis/cirugía , Niño , Femenino , Humanos , Técnicas para Inmunoenzimas , Masculino , Persona de Mediana Edad , Receptores Adrenérgicos alfa 1/metabolismo , Receptores Adrenérgicos alfa 2/metabolismo , Receptores Adrenérgicos beta 1/metabolismo , Receptores Adrenérgicos beta 2/metabolismo
13.
Can J Ophthalmol ; 42(1): 147-8, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17361264

RESUMEN

CASE REPORT: Gaze-evoked amaurosis (GEA) is a transient loss of vision upon eccentric gaze. With return to the primary position of gaze, the process promptly resolves. COMMENTS: We present the first reported case of GEA secondary to an intraorbital foreign body that was resolved surgically in the immediate posttraumatic period.


Asunto(s)
Ceguera/etiología , Cuerpos Extraños en el Ojo/complicaciones , Lesiones Oculares Penetrantes/complicaciones , Órbita/lesiones , Adolescente , Ceguera/diagnóstico , Cuerpos Extraños en el Ojo/diagnóstico por imagen , Cuerpos Extraños en el Ojo/cirugía , Lesiones Oculares Penetrantes/diagnóstico por imagen , Lesiones Oculares Penetrantes/cirugía , Humanos , Masculino , Órbita/diagnóstico por imagen , Órbita/cirugía , Tomografía Computarizada por Rayos X , Agudeza Visual
14.
Can J Ophthalmol ; 41(5): 630-2, 2006 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17016539

RESUMEN

CASE REPORT: An asymptomatic patient was referred for assessment of an intraocular amelanotic mass in her left eye. Examination showed a mass effect in the inferior location at the 5 o'clock position. This abnormality was defined with ultrasound biomicroscopy and standard ultrasound, but because the appearance was not typical of a melanoma or other choroidal infiltrate, magnetic resonance images and computed tomograms of the orbits were obtained, identifying an extraocular mass arising from the zygomatic rim. Results of a biopsy reported an intraosseous hemangioma. COMMENTS: The diagnosis of intraosseous hemangioma, because of its low incidence and unusual manner of presentation, can be challenging. Computed tomography and biopsy are helpful in making a definitive diagnosis.


Asunto(s)
Hemangioma/patología , Neoplasias Orbitales/patología , Cigoma/patología , Anciano , Biopsia , Femenino , Hemangioma/diagnóstico por imagen , Humanos , Neoplasias Orbitales/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Ultrasonografía , Cigoma/diagnóstico por imagen
15.
Ophthalmic Plast Reconstr Surg ; 21(6): 445-7, 2005 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-16304523

RESUMEN

Orbital teratomas are rare embryonic tumors composed of a wide diversity of tissues derived from the three germinal layers. The presenting features include, a healthy newborn with extreme unilateral proptosis; marked stretching of the eyelids over a tense, fluctuating mass, with elongation of the palpebral fissure; enlargement of the bony orbit (two to three times normal size) with subsequent nasal and malar deformities; and transillumination of all or part of the orbital mass. Commonly the eye is normally developed but often vision is not preserved either due to exposure or secondary optic atrophy. The objective in the management of orbital teratoma is to save the eye to encourage orbitofacial development, maintain cosmesis and retain some vision. We report a case of massive congenital orbital teratoma successfully removed by an eyelid-sparing exenteration technique.


Asunto(s)
Evisceración Orbitaria/métodos , Neoplasias Orbitales/congénito , Teratoma/congénito , Femenino , Estudios de Seguimiento , Humanos , Recién Nacido , Imagen por Resonancia Magnética , Neoplasias Orbitales/diagnóstico , Neoplasias Orbitales/cirugía , Teratoma/diagnóstico , Teratoma/cirugía , Tomografía Computarizada por Rayos X
16.
Pediatr Dev Pathol ; 8(1): 98-104, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-15803216

RESUMEN

We present a unique case of a perivascular epithelioid cell tumor (PEComa) in the orbit of a 9-year-old female patient. The entity of PEComas has been described only recently. Characteristic histologic features and an immunohistochemical profile of negativity for epithelial markers and positivity for melanogenesis-related markers define the tumors. In children and young adults, this tumor has a predilection for the falciform ligament and ligamentum teres of the liver. It is associated with, but not exclusive to, tuberous sclerosis. To the best of our knowledge, this is the first reported case of a PEComa of the orbit in a child or adult. The main differential diagnoses for this melanin pigment-producing lesion include melanoma and pigmented paraganglioma. The histologic features, immunohistochemical profile, ultrastructural studies, and molecular studies led us to favor a diagnosis of PEComa. The prognosis of this entity is undetermined due largely to the small number of reported cases.


Asunto(s)
Carcinoma/patología , Células Epitelioides/patología , Neoplasias Orbitales/patología , Antígenos de Neoplasias , Biomarcadores de Tumor/análisis , Carcinoma/química , Carcinoma/cirugía , Niño , Supervivencia sin Enfermedad , Células Epitelioides/química , Femenino , Humanos , Técnicas para Inmunoenzimas , Antígeno MART-1 , Antígenos Específicos del Melanoma , Proteínas de Neoplasias/análisis , Neoplasias Orbitales/química , Neoplasias Orbitales/cirugía , Resultado del Tratamiento
18.
Am J Ophthalmol ; 134(3): 433-4, 2002 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-12208256

RESUMEN

PURPOSE: To report a case of bacillary angiomatosis of the lower eyelid, conjunctiva, and anterior orbit. DESIGN: Interventional case report. METHODS: A 76-year-old immunocompromised male patient developed a firm vascularized nodule in his left lower eyelid and anterior orbit. RESULTS: An excisional biopsy was performed. Histopathologic examination revealed an abnormal vascular proliferation and a mixed inflammatory infiltrate. A Warthin-Starry stain showed numerous bacilli. These findings are characteristic of bacillary angiomatosis. A serologic specimen was positive for antibodies to Bartonella Quintana. CONCLUSION: The lower lid and anterior orbit are rare locations for bacillary angiomatosis. Our case brings to attention the increasing importance of Bartonella infection as a causative agent of ophthalmic diseases.


Asunto(s)
Angiomatosis Bacilar/microbiología , Bartonella quintana/aislamiento & purificación , Enfermedades de la Conjuntiva/microbiología , Infecciones Bacterianas del Ojo/microbiología , Enfermedades de los Párpados/microbiología , Enfermedades Orbitales/microbiología , Anciano , Angiomatosis Bacilar/tratamiento farmacológico , Angiomatosis Bacilar/patología , Antibacterianos/uso terapéutico , Enfermedades de la Conjuntiva/tratamiento farmacológico , Enfermedades de la Conjuntiva/patología , Doxiciclina/uso terapéutico , Quimioterapia Combinada/uso terapéutico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Infecciones Bacterianas del Ojo/patología , Enfermedades de los Párpados/tratamiento farmacológico , Enfermedades de los Párpados/patología , Humanos , Huésped Inmunocomprometido , Masculino , Enfermedades Orbitales/tratamiento farmacológico , Enfermedades Orbitales/patología , Rifampin/uso terapéutico
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...