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1.
BMC Ophthalmol ; 24(1): 153, 2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38589883

RESUMEN

BACKGROUND: To report a case with bilateral Terson syndrome presented with a unique mushroom-like mass lesion on the optic disc along with proliferative vitreoretinopathy and tractional retinal detachment. CASE PRESENTATION: A 33-year-old man was injured during a traffic accident and had diffuse brain swelling and intraocular hemorrhage. Poor vision in both eyes was noted after the patient regained consciousness. B-scan ultrasonography showed extensive vitreous opacity with a posterior vitreous detachment and without obvious retinal detachment. Vitrectomy was performed in both eyes five months after the accident. After clearing up the vitreous opacity, a peculiar pigmented mushroom-like mass lesion was noted in the posterior pole and had severe adhesion to the underneath optic disc. Extensive multilayered peripapillary epiretinal membrane was found covering the posterior pole and led to tractional retinal detachment around the macula. The mass was presumed to be an organized vitreous hemorrhage originated from the optic disc. The extensive and adherent epiretinal membrane together with the mass lesion were removed as much as possible and silicon oil was injected for tamponade. However, in the right eye, the retina redetached under silicon oil, whereas in the left eye, his vision improved to 20/100. CONCLUSIONS: Terson syndrome usually has a favorable prognosis but may be complicated by proliferative vitreoretinopathy and tractional retinal detachment. Careful monitoring is warranted and early vitrectomy should be considered in cases suspecting additional pathologies.


Asunto(s)
Membrana Epirretinal , Enfermedades Orbitales , Desprendimiento de Retina , Vitreorretinopatía Proliferativa , Masculino , Humanos , Adulto , Desprendimiento de Retina/diagnóstico , Desprendimiento de Retina/etiología , Desprendimiento de Retina/cirugía , Hemorragia Vítrea/diagnóstico , Hemorragia Vítrea/etiología , Vitreorretinopatía Proliferativa/cirugía , Membrana Epirretinal/complicaciones , Membrana Epirretinal/diagnóstico , Membrana Epirretinal/cirugía , Retina/patología , Vitrectomía/efectos adversos
3.
Ophthalmic Plast Reconstr Surg ; 40(2): e58-e62, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38427841

RESUMEN

IgG4-related disease is an uncommon multisystem inflammatory disease characterized by tissue infiltration by IgG4 plasma cells, extensive fibrosis, and sclerosing inflammation. Diffuse orbital involvement extending to the orbital apex and cavernous sinus has been reported, but a solitary well-circumscribed lesion at the apex has not been previously reported. Herein, we report a unique case of IgG4-related orbital disease presenting as a solitary well-circumscribed orbital apex lesion causing subacute visual decline in a 45-year-old male. MRI demonstrated bilateral lacrimal gland and infraorbital nerve enlargement and an 18 × 7 mm left orbital apex lesion demonstrating homogeneous contrast enhancement and isointense signal on T2. He was initially treated with tapering systemic corticosteroid therapy with improvement in his vision; however, he experienced visual deterioration 3 months later with recurrent inflammation. He subsequently commenced high-dose systemic corticosteroid therapy and rituximab infusions with improvement of left visual acuity to 6/7.5 + 2.


Asunto(s)
Enfermedad Relacionada con Inmunoglobulina G4 , Enfermedades Orbitales , Masculino , Humanos , Persona de Mediana Edad , Enfermedad Relacionada con Inmunoglobulina G4/complicaciones , Enfermedad Relacionada con Inmunoglobulina G4/diagnóstico , Inmunoglobulina G , Enfermedades Orbitales/diagnóstico , Enfermedades Orbitales/tratamiento farmacológico , Corticoesteroides , Inflamación
5.
J Fr Ophtalmol ; 47(4): 104105, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38428321

RESUMEN

PURPOSE: To compare the visual outcomes in both eyes of patients who undergo phacoemulsification and trifocal intraocular lens (IOL) implantation and have asteroid hyalosis (AH) or synchysis scintillans (SS) in only one eye. METHODS: A retrospective comparative case series was performed. We evaluated uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), predictability, safety, efficacy, and satisfaction after implantation of the same model of trifocal IOL in both eyes (PhysIOL FineVision Pod-F and Micro-F and Rayner RayOne Trifocal). RESULTS: A total of 164 eyes of 82 patients (41 females, 50%) met the inclusion criteria. There were no statistically significant differences in sphere, cylinder, spherical equivalent, UDVA, UIVA, or UNVA between the groups. Postoperative CDVA was slightly better in the control group (logMAR 0.03) than in the AH/SS group (logMAR 0.04) (P: 0.014). There were no statistically significant differences in predictability, safety index, or efficacy index between the groups. Overall subjective satisfaction was good (98.2%). CONCLUSIONS: Visual outcomes and satisfaction are good after implantation of trifocal IOLs in eyes with AH or SS. Therefore, trifocal IOLs should not be ruled out in these patients when no other vitreoretinal disorder is present.


Asunto(s)
Lentes Intraoculares , Enfermedades Orbitales , Facoemulsificación , Femenino , Humanos , Facoemulsificación/efectos adversos , Implantación de Lentes Intraoculares/efectos adversos , Estudios Retrospectivos , Satisfacción del Paciente , Lentes Intraoculares/efectos adversos , Refracción Ocular , Trastornos de la Visión , Diseño de Prótesis , Seudofaquia/complicaciones , Seudofaquia/cirugía
6.
Korean J Ophthalmol ; 38(2): 113-121, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38351484

RESUMEN

PURPOSE: To investigate cases of vitreous opacity (VO) similar to asteroid hyalosis (AH) after intravitreal brolucizumab injection. METHODS: A retrospective chart review was conducted to identify cases showing VO similar to AH among patients who received intravitreal brolucizumab injections at our retinal clinic from January 2022 to January 2023. RESULTS: A total of 220 brolucizumab injections were administered at our hospital. VO, showing yellow-white brilliant reflective particles, was found in six patients (2.7%). When VO occurred, all patients complained of floaters, although none of them complained of other symptoms including decreased visual acuity, pain, or conjunctival redness. The mean number of brolucizumab injections was 2.57 ± 2.38. No significant visual impairment was observed while VO was present. VO improved in all cases, and four cases improved without any treatment. The mean interval from onset to disappearance of VO was 8.0 ± 3.1 weeks. CONCLUSIONS: VO, similar to AH, can occur with a relatively high probability after intravitreal brolucizumab injections. Patients complained of severe floaters, but VO was not accompanied by other symptoms including vision impairment, injection, and pain. The VO disappeared after approximately 4 to 14 weeks. In case that other inflammatory findings are not severe, close follow-up without treatment may be sufficient. If a patient complains of floaters after an intravitreal brolucizumab injection, close fundus observation is necessary to evaluate the VO.


Asunto(s)
Anticuerpos Monoclonales Humanizados , Enfermedades Orbitales , Trastornos de la Visión , Humanos , Estudios Retrospectivos , Inyecciones Intravítreas , Dolor , Inhibidores de la Angiogénesis
9.
Radiologie (Heidelb) ; 64(3): 204-214, 2024 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-38363324

RESUMEN

CLINICAL/METHODICAL ISSUE: Inflammatory orbital processes on imaging are often misinterpreted as tumors. STANDARD RADIOLOGICAL METHODS: Imaging comprises computed tomography (CT) and magnetic resonance imaging (MRI). ACHIEVEMENTS: Clinical and laboratory data play a crucial role in diagnosing many inflammatory orbital diseases. Radiological imaging provides a supporting but relevant role. PRACTICAL RECOMMENDATIONS: Clinical examination, including specialized ophthalmological examinations, laboratory diagnostics, and MRI are important in the diagnosis of inflammatory orbital diseases.


Asunto(s)
Enfermedades Orbitales , Tomografía Computarizada por Rayos X , Humanos , Imagen por Resonancia Magnética , Enfermedades Orbitales/diagnóstico por imagen , Diagnóstico Diferencial
10.
Int Ophthalmol ; 44(1): 38, 2024 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-38332455

RESUMEN

BACKGROUND: Thyroid eye disease (TED) is an orbit-associated autoimmune inflammatory disorder intricately linked to immune dysregulation. Complete pathogenesis of TED remains elusive. This work aimed to mine pathogenesis of TED from immunological perspective and identify diagnostic genes. METHODS: Gene expression microarray data for TED patients were downloaded from Gene Expression Omnibus, immune-related genes (IRGs) were from ImmPort database, and TED-related transcription factors (TFs) were from Cirtrome Cancer database. Differential analysis, Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed. Regulatory networks of TFs and IRGs were constructed with Cytoscape. Diagnostic biomarkers in TED were identified through LASSO. Immune cell infiltration analysis was performed using CIBERSORT. RESULTS: Twenty-three immune-related DEmRNAs were revealed and were primarily enriched in humoral immune response, positive regulation of inflammatory response, IL-17, and TNF pathways. Co-expression regulatory network included four TFs and 16 immune-related DEmRNAs. Seven diagnostic genes were identified, with Area Under the Curve (AUC) of 0.993 for training set and AUC value of 0.836 for validation set. TED patients exhibited elevated infiltration levels by macrophages M2, mast cells, and CD8 T cells among 22 immune cell types, whereas macrophages M2 and mast cells resting were significantly lower than normal group. CONCLUSIONS: The seven feature genes had high diagnostic value for TED patients. Our work explored regulatory network and diagnostic biomarkers, laying theoretical basis for TED diagnosis and treatment.


Asunto(s)
Enfermedades Autoinmunes , Oftalmopatía de Graves , Enfermedades Orbitales , Humanos , Oftalmopatía de Graves/diagnóstico , Oftalmopatía de Graves/genética , Área Bajo la Curva , Biomarcadores
11.
J Fr Ophtalmol ; 47(2): 104070, 2024 Feb.
Artículo en Francés | MEDLINE | ID: mdl-38310692

RESUMEN

INTRODUCTION: Rosai-Dorfman disease (RDD) is a sinus histiocytosis with massive lymphadenopathy. This rare condition is a benign disease of unknown etiology. Bilateral orbital localization of RDD is rare. OBSERVATION: The authors report the case of a 6-year-old child who presented with bilateral orbital-palpebral masses associated with chronic cervical lymphadenopathy. There were no laboratory signs of inflammation. Serological and tuberculosis screening tests were negative. Histopathological examination of a lymph node biopsy established a diagnosis of Rosai-Dorfman disease. The patient underwent surgical excision of the orbital lesions followed by long-term corticosteroid therapy. A favorable course was observed, with no sign of recurrence after one year of follow-up. CONCLUSION: Rosai-Dorfman disease is very rare in its bilateral orbital presentation. Histopathological diagnosis remains challenging. In Africa, the presence of chronic oculo-palpebral tumor associated with or without cervical lymphadenopathy must raise the suspicion of Rosai-Dorfman disease after ruling out tuberculosis and lymphoma.


Asunto(s)
Histiocitosis Sinusal , Linfadenopatía , Enfermedades Orbitales , Tuberculosis , Humanos , Niño , Histiocitosis Sinusal/diagnóstico , Histiocitosis Sinusal/complicaciones , Histiocitosis Sinusal/patología , Enfermedades Orbitales/diagnóstico , Enfermedades Orbitales/complicaciones , Biopsia , Tuberculosis/complicaciones
12.
JNMA J Nepal Med Assoc ; 62(270): 148-151, 2024 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-38409977

RESUMEN

Orbital tuberculosis is a rare form of extrapulmonary tuberculosis involving orbital soft tissue, periosteum, bones and lacrimal glands. This is a case report of a 6-year-old male child who presented with swelling of the right upper eyelid. He had normal visual acuity without signs of diplopia or ophthalmoplegia. The tuberculin skin test was reactive and the computed tomography scan showed peripherally enhancing collection with bony erosion and intracranial extension in the extraconal space of the superolateral right orbit. Orbital exploration was done which showed caseous material. The histological examination revealed necrotizing granulomatous tissue. The caseous material on Ziehl Neelsen staining confirmed acid-fast bacilli causing a tubercular abscess. The child is currently on anti-tubercular therapy planned for 12 months. Orbital tuberculosis might or might not be in association with pulmonary tuberculosis and should always be taken into consideration while dealing with chronic inflammatory orbital disease and an orbital mass. Keywords: case reports; orbit; tuberculosis.


Asunto(s)
Enfermedades Orbitales , Tuberculosis Ocular , Tuberculosis , Masculino , Niño , Humanos , Absceso/diagnóstico por imagen , Absceso/complicaciones , Tuberculosis/complicaciones , Tuberculosis Ocular/complicaciones , Tuberculosis Ocular/diagnóstico , Tuberculosis Ocular/tratamiento farmacológico , Enfermedades Orbitales/diagnóstico , Tomografía Computarizada por Rayos X
15.
Radiologie (Heidelb) ; 64(3): 196-203, 2024 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-38194103

RESUMEN

Orbital tumours include a variety of orbital diseases of different origins. In the case of malignant orbital tumours, early detection is important so that treatment can be initiated promptly. Neuroradiological imaging, in particular magnetic resonance imaging (MRI), plays an important role in the diagnostic of orbital tumours. In adults, lymphoproliferative diseases, inflammations and secondary orbital tumours are most frequently found, whereas in children mostly dermoid cysts, optic gliomas and capillary haemangiomas are found. Optic glioma is a pilocytic astrocytoma and accounts for two thirds of all primary optic tumours. Optic nerve sheath meningiomas mostly affect middle-aged women. In childhood, retinoblastoma is the most common intraocular tumour. This is an aggressive malignant tumour which can occur unilaterally or bilaterally. Based on the imaging findings, differential diagnoses can usually be easily narrowed down using criteria such as age of manifestation, frequency, localisation and imaging characteristics.


Asunto(s)
Neoplasias Meníngeas , Glioma del Nervio Óptico , Neoplasias del Nervio Óptico , Enfermedades Orbitales , Neoplasias Orbitales , Neoplasias de la Retina , Adulto , Niño , Persona de Mediana Edad , Humanos , Femenino , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/terapia , Enfermedades Orbitales/diagnóstico , Neoplasias del Nervio Óptico/diagnóstico por imagen , Neoplasias del Nervio Óptico/terapia
16.
Int J Pediatr Otorhinolaryngol ; 177: 111865, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38262225

RESUMEN

OBJECTIVE: Orbital complications account for approximately 74-85 % of all complications of acute sinusitis, affect the pediatric population more frequently, and can have devastating consequences. In the years following the COVID-19 pandemic (2022, 2023), a high number of children presented to our clinic with orbital complications. 1)Has there been an increase in orbital complications in the post-covid era? 2)To what extent has the use of MRI reduced radiation in pediatric patients? DESIGN: In our retrospective data analysis, all pediatric patients (age 0-16 years) treated at a university ENT clinic during the period 01/2014-06/2023 who presented with an orbital complication of rhinosinusitis were included. The analysis was descriptive. RESULTS: Forty-four children with orbital complications of rhinosinusitis were treated during the study period, 14 females and 30 males. Most patients (n = 23, 52 %) presented during the years of the waning Covid-19 pandemic (01/2022 to 06/2023). MRI was the initial imaging modality (n = 22,50 %); CT was performed in 17 of 44 cases (39 %) when surgery was indicated. The most common germ detected was of the Streptococcus species, and the predominant antibiotic administered was amipicillin/sulbactam. CONCLUSION: The standard operating procedure (SOP) established at our hospital in 2014 was followed in 42/44 cases. Except for 2 cases, CT was performed exclusively when surgery was indicated. Imaging-related radiation could be avoided in 27 patients (61 %). There was a 30 % increase in orbital complications related to sinus infections postpandemically.


Asunto(s)
COVID-19 , Enfermedades Orbitales , 60523 , Sinusitis , Masculino , Femenino , Niño , Humanos , Recién Nacido , Lactante , Preescolar , Adolescente , Enfermedades Orbitales/epidemiología , Enfermedades Orbitales/etiología , Enfermedades Orbitales/terapia , Estudios Retrospectivos , Pandemias , Sinusitis/complicaciones , Sinusitis/diagnóstico por imagen , Sinusitis/epidemiología , Enfermedad Aguda , COVID-19/complicaciones , COVID-19/epidemiología
17.
J AAPOS ; 28(1): 103827, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38253286

RESUMEN

PURPOSE: To determine the postoperative fundus torsion following surgical inferior oblique (IO) weakening in patients with inferior oblique overaction (IOOA). METHODS: In this interventional case series, 37 patients with IOOA ≥ +1 and reliable preoperative fundus photographs were included. IO weakening was accomplished through myectomy or anterior transposition. Fundus photography was repeated at 3 months' follow-up. The primary outcome was change of disk foveal angle (DFA), measured as the angle between the line connecting the center of the fovea and optic disk and horizontal. Success or normal fundus torsion was defined as a postoperative angle of 0° to 8° of extorsion. Residual extorsion was defined as postoperative extorsion of > 8°. Postoperative intorsion was defined as any amount of induced intorsion. RESULTS: Mean age of patients (56% females) was 6.46 ± 6.79 years. At follow-up at least 3 months after surgery, the mean change of DFA was 7.79 ± 6.24° of reduction of extorsion after IO myectomy (P < 0.001) and 6.05 ± 6.07° after IO anterior transposition (P = 0.005). Normal fundus torsion was achieved in 50% of patients after myectomy and 36.4% of patients after anterior transposition. Residual extorsion was observed in 49% of patients; induced intorsion in 5%. CONCLUSIONS: Using objective measurement of fundus photographs, fundus extorsion was decreased in 94.7% of patients after myectomy or anterior transposition.


Asunto(s)
Oftalmopatías , Trastornos de la Motilidad Ocular , Enfermedades Orbitales , Estrabismo , Femenino , Humanos , Niño , Adolescente , Masculino , Músculos Oculomotores/cirugía , Anomalía Torsional/diagnóstico , Anomalía Torsional/cirugía , Trastornos de la Motilidad Ocular/cirugía , Oftalmopatías/cirugía , Fondo de Ojo , Enfermedades Orbitales/cirugía , Procedimientos Quirúrgicos Oftalmológicos , Resultado del Tratamiento , Estrabismo/cirugía , Estudios Retrospectivos
18.
J Pediatr Hematol Oncol ; 46(2): 69-71, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-38277624

RESUMEN

Raccoon's eyes (periorbital ecchymosis) may present as the first sign in patients with skull base/base/facial fractures and tumors. In childhood, orbital metastases of neuroblastoma should be considered in the absence of trauma history. Herein, we report a 3-year-old girl diagnosed with acute lymphoblastic leukemia who presented with periorbital ecchymosis. To the best of our knowledge, this is the first pediatric patient with acute lymphoblastic leukemia in the literature who presented with raccoon eyes.


Asunto(s)
Neuroblastoma , Enfermedades Orbitales , Leucemia-Linfoma Linfoblástico de Células Precursoras , Preescolar , Femenino , Humanos , Diagnóstico Diferencial , Equimosis/complicaciones , Equimosis/diagnóstico , Neuroblastoma/patología , Enfermedades Orbitales/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones
19.
Ophthalmic Plast Reconstr Surg ; 40(1): 93-98, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37695202

RESUMEN

PURPOSE: Orbital liposarcoma is a challenging tumor to treat due to its rarity and high rate of local recurrence, and the role of radiotherapy and chemotherapy remain unclear. Analysis of big data may improve our overall understanding of orbital disease and role of adjuvant therapies. METHODS: Data were extracted from the Surveillance, Epidemiology and End Results (SEER) Research Plus database from 1975 to 2017. All patients with a diagnosis of liposarcoma (ICD-O3 codes 8850-8858, 8869-8862, 8870, 8880, 8881) were included. Cases were divided into 4 groups by primary site: orbit, retroperitoneum, soft tissue, and other. RESULTS: A total of 16,958 patients were included. Patients with orbital involvement were younger and more likely to be female ( p < 0.05). Among orbital lesions, myxoid liposarcoma was the most common histologic subtype (6/19; 31.6%) followed by well differentiated (5/19; 26.3%). This differed from the distribution of histologic subtypes encountered elsewhere, for which well-differentiated liposarcoma was the most common (retroperitoneum 979/3,136; 31%, soft tissue 3,493/11,671; 30%, and other sites 497/2,132; 23%, p < 0.05). Dedifferentiated histologic subtype was the second most common subtype found in the retroperitoneum (946/3,136; 30%), whereas it was less common in the orbit (2/19; 11%) and soft tissue (1,396/11,671; 12%) ( p < 0.001). Patients with orbital liposarcoma had similar disease-specific mortality compared with soft-tissue location ( p = 0.825) and lower disease-specific mortality compared with retroperitoneal location ( p < 0.001). When all locations were combined, patients with well-differentiated liposarcoma had the lowest disease-specific mortality. CONCLUSIONS: Patients with orbital liposarcoma tend to be younger, female, and have a better prognosis than those with retroperitoneal disease, likely due to the lower incidence of dedifferentiated histologic subtype.


Asunto(s)
Lipoma , Liposarcoma , Enfermedades Orbitales , Adulto , Humanos , Femenino , Masculino , Liposarcoma/epidemiología , Pronóstico , Terapia Combinada , Lipoma/patología
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