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1.
Arq. bras. oftalmol ; 84(5): 503-505, Sept.-Oct. 2021. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1339210

RESUMO

ABSTRACT Isolated superior oblique myositis is a rare variant of idiopathic orbital myositis. We are reporting for the first time the case of a 19-year-old woman who had isolated superior oblique myositis with sinusitis that mimics a subperiosteal abscess. Despite the typical history of upper respiratory tract infection and laboratory test results and initial radiological findings suggestive of orbital cellulitis secondary to sinusitis, the initial response to systemic steroid with subsequent imaging changes and the relapse after cessation of steroid therapy helped us reach the diagnosis.


RESUMO A miosite oblíqua superior isolada é uma variante muito rara da miosite orbital idiopática. Trata-se do primeiro relato de uma mulher de 19 anos como um caso de miosite oblíqua superior isolada com sinusite que mimetiza abscesso subperiosteal. Apesar da história típica de infecção do trato respiratório superior, exames laboratoriais e achados radiológicos iniciais sugestivos de celulite orbital secundária à sinusite, a resposta inicial ao esteróide sistêmico com subsequentes alterações de imagem e recaída, após a cessação do esteróide, nos ajudou a alcançar o diagnóstico.

2.
Eur J Ophthalmol ; : 11206721211033465, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34269096

RESUMO

INTRODUCTION: The ocular presentation of paraneoplastic pemphigus (PNP) has rarely been reported in the literature. In this report, we describe a 61-year-old male presenting with eruptive skin lesions associated with underlying non-Hodgkin's lymphoma who had rapid progressive corneal perforation with secondary endophthalmitis in the setting of PNP. CASE DESCRIPTION: A 61-year-old male presented to the emergency department complaining of skin eruption mimicking Stevens-Johnson syndrome, which was later found to be related to PNP. Initially, the patient complained of progressive ocular surface dryness in both eyes. Meanwhile, he developed mild pain in the right eye associated with blurry vision in both eyes and was managed with lubricants and topical antibiotics. A few days later, he was found to have corneal perforation with features suggestive of left endophthalmitis with possible early panophthalmitis. Intravenous antibiotic was administered, and primary evisceration of the left globe was performed. Histopathology revealed acute necrotizing keratitis and endophthalmitis. Vitreous analysis showed numerous gram-negative bacilli and a positive culture of Morganella morganii. The patient continued to be managed with frequent lubrications and punctual plugs in the fellow eye during the follow-up period. CONCLUSION: We describe the first case of endophthalmitis developing secondary to PNP-induced corneal melting and perforation. Anticipating unusual infectious sequelae in the setting of PNP might be warranted to actively detect and successfully manage dry eye disease before devastating complications develop.

3.
Int J Surg Case Rep ; 85: 106185, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34252644

RESUMO

INTRODUCTION AND IMPORTANCE: Primary mucinous adenocarcinoma (PMA) of the skin is a rare condition that is usually seen in elderly patients, most commonly involves the periorbital region as a slow growing mass. Histopathological and immunohistochemical (IHC) stains are of paramount importance for the diagnosis of these lesions, which are usually misdiagnosed either as benign or metastatic mucinous adenocarcinomas. CASE PRESENTATION: We herein report a rare presentation of PMA in a 70-year-old male patient who presented with an upper eyelid residual lesion after being incompletely excised elsewhere as an epidermal cyst and was successfully managed by complete surgical excision with frozen section control of the margins and no evidence of recurrence. DISCUSSION: PMA is a rare sweat gland malignancy that involves the eyelid in 41.9% in the head and neck area and is a disease of the elderly with median age of 60 years and variable reported racial and gender predilection. Diagnosis of PMA is challenging both clinically and histopathologically, which was the case in our patient's initial incomplete excision with the presumed diagnosis of a benign epidermal cyst. Proper final tissue diagnosis and surgical management in our patient ensured his favorable outcome. CONCLUSION: Accurate diagnosis of PMA requires a high index of clinical suspicion and accurate histopathological diagnosis aided by proper IHC markers.

4.
Arq Bras Oftalmol ; 84(5): 503-505, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34320108

RESUMO

Isolated superior oblique myositis is a rare variant of idiopathic orbital myositis. We are reporting for the first time the case of a 19-year-old woman who had isolated superior oblique myositis with sinusitis that mimics a subperiosteal abscess. Despite the typical history of upper respiratory tract infection and laboratory test results and initial radiological findings suggestive of orbital cellulitis secondary to sinusitis, the initial response to systemic steroid with subsequent imaging changes and the relapse after cessation of steroid therapy helped us reach the diagnosis.


Assuntos
Miosite , Celulite Orbitária , Sinusite , Abscesso/diagnóstico por imagem , Abscesso/etiologia , Adulto , Feminino , Humanos , Músculos Oculomotores/diagnóstico por imagem , Sinusite/complicações , Sinusite/diagnóstico por imagem , Adulto Jovem
5.
Can J Ophthalmol ; 2021 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-34324876

RESUMO

OBJECTIVE: The study aims to describe the clinical and histopathologic features of different types of dacryops and their clinical diagnostic challenges. METHODS: This is a retrospective cohort study of all surgically excised cases of dacryops in 2 tertiary eye hospitals in Riyadh, Saudi Arabia. RESULTS: The study included 58 dacryops specimens from 55 patients with an average age of 41.2 years (range, 4-78 years). The most common location was the upper lid (60.3%), whereas the least expected location was the caruncle (6.9%). The most common site of dacryops occurrence was in the accessory lacrimal gland (55.2%), the main lacrimal gland (32.8%), and then ectopic dacryops (12%). All patients presented with lid swelling alone except for 3 patients who experienced secondary mechanical ptosis. On physical examination, conjunctival scarring existed in 4 patients (6.9%). Preoperative diagnosis of dacryops was accurate in 44.8% of the cases. Dacryops of the main lacrimal gland was accurately diagnosed clinically in all cases compared with other locations, which was statistically significant (p < 0.001). The causes of inaccurate clinical diagnoses were hidrocystoma (26.9%), inclusion cyst (11.5%), and dermoid cyst (7.7%), whereas the remaining cases were diagnosed as cysts without a specific subtype (53.9%). Recurrence of the lesion was observed in 2 cases (3.5%). No clinical or histopathologic factors were associated with a risk of recurrence. CONCLUSION: Dacryops can represent a diagnostic challenge to ophthalmologists. Familiarity with clinical presentations and findings is required to diagnose dacryops outside the main lacrimal gland.

6.
Int J Surg Case Rep ; 79: 70-72, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33434772

RESUMO

INTRODUCTION AND IMPORTANCE: Choristomas are benign growth of normal tissue in abnormal location and in the ophthalmic practice, they are more commonly found in the epibulbar region. Intraocular choristoma has been reported in different ocular structures but it is very rare especially in association with microphthalmos. CASE PRESENTATION: We present a 13-month-old child with bilateral microphthalmia with the left side being more significantly smaller than the right that required enucleation for introducing a larger silicone implant. The histopathological examination revealed an intraocular choristoma consisting of chondroid and adipose tissue with surrounding fibrosis. Other areas in the globe were also underdeveloped and dysplastic including the optic nerve, which was replaced by dense wavy collagen fibers and fibrovascular tissue. DISCUSSION: Even though choristomas are benign, they may be extensive interfering with visual development especially the ones involving the epibulbar area. Systemic disease can have choristomas as an ocular feature such as in Goldenhar-Gorlin syndrome. Choristomas inside the eye are rare and they commonly involve the uveal tissue and the optic nerve head mostly in the form of ectopic glandular tissue and choroidal osseous choristoma. Our case is unique in its intraocular retrolental location, composition of chondroid tissue and fat, in addition to the fact that it was found within a microphthalmic globe with other interesting histopathological findings. CONCLUSION: We report a case of an incidental finding of intraocular choristoma with associated microphthalmia, genetic testing may be useful for establishing a genetic etiology in such cases even in the absence of dysmorphic features.

7.
Int J Surg Case Rep ; 79: 73-75, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33434773

RESUMO

INTRODUCTION AND IMPORTANCE: Dyschromatosis symmetrica hereditaria (DSH) are rare autosomal dominant pigmentary genodermatosis characterized by reticular hyper- and hypopigmented skin macules on the dorsal aspect of the extremities and freckle-like spots on the face, sparing the palms and soles. Cutaneous hemangiomas were not reported in the literature with DSH. We describe for the first time to the best of our knowledge a case of DSH with histopathologically confirmed eyelid hemangioma. CASE PRESENTATION: A 25-year-old female was diagnosed with DSH in her childhood by a dermatologist then later developed cutaneous lupus erythematosus (CLE). Four years later she presented to our clinic with right lower eyelid painless mass. The histopathological examination showed inflamed epidermis overlying a mixed capillary and cavernous hemangioma. The patient had complete healing of the skin post-operatively with excellent cosmetic result. DISCUSSION: DSH is usually isolated, however, acral hypertrophy, psoriasis, dental anomalies, aortic valve sclerosis, dystonia and intracranial hemangiomas have been reported in association with the disease. The types of the hemangiomas reported were not specified with lack of tissue diagnosis. Our case is unique because of the late occurrence of this eyelid skin hemangioma, the concomitant CLE, the history of hyperthyroidism, and the positive family history of consanguinity. CONCLUSION: The pathogenesis of DSH is not well understood, however the previously reported intracranial hemangiomas and the currently reported skin vascular lesion would raise the role of inheritance and variable expression of such an association especially with concomitant CLE. This may warrant further studies on the etiology of DSH.

8.
Am J Case Rep ; 22: e929363, 2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33497371

RESUMO

BACKGROUND Massive retinal gliosis (MRG) is a rare benign intraocular tumor that results from the proliferation of well-differentiated glial cells in response to long-standing pathological processes, including glaucoma, trauma, chronic inflammation, vascular disorders, and congenital anomalies. This lesion is considered to be nonneoplastic and occurs ≥10 years after the predisposing insult. It usually affects children and can mimic other conditions, including uveal melanomas, vasoproliferative tumors of the retina, astrocytic hamartomas, and retinal hemangioblastomas. CASE REPORT We present a case of infant MRG with severe left eye microphthalmia. An 11-month-old boy was presented by his parents in the Oculoplastic Unit of a teaching university hospital with bilateral incomplete cryptophthalmos and small globes. An enucleation of the left globe was carried out to stimulate orbital bone growth and to improve the cosmetic outcome. The histopathological examination revealed a microphthalmic globe with sclerocornea and disorganized intraocular anterior segment structures. The retina was dysplastic with proliferating spindle-shaped glial cells showing fibrillar eosinophilic cytoplasm and filled most of the vitreous cavity. The glial origin of the cells was confirmed by the immunohistochemical markers (glial fibrillary acidic protein and synaptophysin), supporting the diagnosis of MRG. The optic nerve was markedly hypoplastic. CONCLUSIONS MRG is a rare intraocular tumor that is clinically difficult to diagnose. A definite diagnosis can be made only on the basis of a histopathological examination and immunohistochemical markers.


Assuntos
Microftalmia , Doenças Retinianas , Criança , Proteína Glial Fibrilar Ácida , Gliose , Humanos , Lactente , Masculino , Retina
9.
Ophthalmic Plast Reconstr Surg ; 37(4): 329-333, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33156145

RESUMO

PURPOSE: To shed light upon the possible role of the levator aponeurosis (LA) developmental fibrotic changes as an added etiology for simple congenital ptosis, which causes limitation of the levator function (LF). METHODS: This retrospective cohort study included patients with simple congenital ptosis who underwent skin approach LA resection as a primary intervention with an intraoperative photographic documentation of LA fibrotic changes. Preoperative demographics and clinical data were reviewed. The effect of LA fibrotic changes on the LF was assessed in different LA fibrotic changes with or without levator palpebrae superioris (LPS) muscle fatty infiltration. RESULTS: A total of 56 eyelids of 49 patients with a mean age (±SD) 6.7 (±3.2) years were enrolled in this study. The fibrotic changes of LA were observed as a sheet of fibrosis (19 eyelids) or fibrous bands (23 eyelids). Fatty infiltration of LPS was noticed in 28 eyelids, either with or without fibrotic changes of LA. Preoperative LF was diminished in LPS fatty infiltration compared with LA fibrotic sheets (P = 0.026). Postoperative LF improved significantly in both LA fibrotic sheets and LA fibrotic bands (9.4 ± 2.5 mm and 9.6 ± 2.8 mm, respectively) compared with LPS with fatty infiltration (6.4 ± 1.8 mm) (P = 0.004). CONCLUSIONS: Although our data are inconclusive due to lack of embryologic studies, the observed LA fibrotic changes may suggest a complex pathogenesis of simple congenital ptosis. The meticulous observation of the LA and the releasing of any adhesion or band to the surrounding structures could improve postoperative LF.


Assuntos
Blefaroplastia , Blefaroptose , Aponeurose , Blefaroptose/etiologia , Blefaroptose/cirurgia , Criança , Pré-Escolar , Fibrose , Humanos , Músculos Oculomotores/cirurgia , Estudos Retrospectivos
10.
Eur J Ophthalmol ; 31(6): 3425-3429, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33233950

RESUMO

OBJECTIVE: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. METHODS: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. RESULTS: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6-118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure (p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium (R: 0.025, p = 0.157). CONCLUSIONS: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.


Assuntos
Dacriocistorinostomia , Obstrução dos Ductos Lacrimais , Ducto Nasolacrimal , Endoscopia , Feminino , Humanos , Intubação , Obstrução dos Ductos Lacrimais/diagnóstico , Ducto Nasolacrimal/diagnóstico por imagem , Ducto Nasolacrimal/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
11.
Am J Case Rep ; 21: e925134, 2020 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-32788569

RESUMO

BACKGROUND Sebaceous gland carcinoma (SGC) is a rare malignant lesion that occurs on the eyelids. It is known to mimic other benign or malignant lesions in clinical presentation, such as a chalazion, basal cell carcinoma, and squamous cell carcinoma. The histopathological diagnosis is the mainstay for diagnosis and is often challenging. CASE REPORT We describe a case of SGC in a 53-year-old woman who presented with a cauliflower-appearing lesion with pearly telangiectatic vessels and raised margins at the lower eyelid margin. Clinically, we suspected a diagnosis of basal cell carcinoma. Upon complete resection of the lesion, the final diagnosis was SGC based on the histopathological features and immunohistochemical staining characteristics of the tissue. CONCLUSIONS Due to the possibility of SGC presenting similarly to other lesions, it is essential for ophthalmologists to have a high index of suspicion in its diagnosis. The early and accurate diagnosis of such lesions is important for appropriate management to prevent metastasis or recurrence related to advanced tumors.


Assuntos
Carcinoma/patologia , Pálpebras/cirurgia , Neoplasias das Glândulas Sebáceas/patologia , Carcinoma/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias das Glândulas Sebáceas/cirurgia
12.
Ann Med Surg (Lond) ; 55: 1-4, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32435472

RESUMO

Extramedullary plasmacytomas (EMPs) are uncommon plasma cell tumors that develop in soft tissue as isolated tumors without osseous involvement while secondary lesions are associated with systemic multiple myeloma (MM). Primary extramedullary lesions are most commonly found in upper respiratory tract, gastrointestinal tract and lymph nodes. They can be found either in patients with history of MM or preceding the manifestation of a systemic disease. Orbital manifestation of the lesion is rare but conjunctival involvement is very unusual. The reported cases in the English-written literature are only five cases. Herein, we report the sixth case of primary EMP in a middle-aged adult who presented with a lesion confined to the conjunctiva, unremarkable present and past medical history, and confirmed tissue diagnosis. In addition, a review and summary of the previously reported cases in the literature is presented. We aim to attract the attention of ophthalmic surgeons to consider plasmacytoma within the differential diagnosis of a conjunctival lesion.

13.
Int Ophthalmol ; 40(8): 2041-2045, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32367161

RESUMO

PURPOSE: To present the differentiating clinical findings between intratarsal keratinous cyst (IKC) and chalazion. METHOD: A retrospective review of medical records of all patients who presented between 2010 and 2018 at King Abdulaziz University Hospital with proven histopathological diagnosis of IKC was done. Complete ophthalmologic evaluation at presentation, surgical procedures performed, complications, histopathological findings, response to treatment and follow-up were recorded. RESULTS: Twelve patients were found to have IKC. All patients presented with an eyelid mass with no signs of local inflammation. All lesions were fixed to the tarsus with freely mobile overlying skin, which was found to be slightly pale compared to the surrounding skin in six patients. On palpation, IKC had well-defined boarders. Isolation with clear surgical plane for cyst excision was achieved in nine patients as they were superficially involving the tarsus. When IKC involved the deep part of the tarsus, bluish/ whitish nodules were seen upon eyelid eversion. Six patients were misdiagnosed and surgically treated as a chalazion elsewhere prior to presentation to us with recurrence. CONCLUSION: Differentiating IKC from chalazion can be challenging. Careful clinical evaluation helps reaching the right diagnosis and providing the correct treatment, which involves complete excision of IKC to prevent recurrence.


Assuntos
Calázio , Doenças Palpebrais , Calázio/diagnóstico , Calázio/cirurgia , Doenças Palpebrais/diagnóstico , Doenças Palpebrais/cirurgia , Humanos , Queratinas , Recidiva Local de Neoplasia , Estudos Retrospectivos
14.
Ophthalmic Plast Reconstr Surg ; 36(1): 38-44, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31593049

RESUMO

PURPOSE: To assess the effect of releasing the central attachment between the Whitnall's ligament (WL) and the levator palpebrae superioris muscle on the postoperative levator function (LF), eyelid lag, and degree of lagophthalmos. METHODS: This retrospective case-control study included patients with moderate and severe simple congenital ptosis who underwent skin approach levator aponeurosis resection (LR) as a primary procedure with a minimum of 6-month follow up. Patients were divided into 2 groups; the first group underwent LR without WL release (control group) while the second group underwent LR with WL release. Preoperative demographics and clinical data were reviewed. Postoperative LF, eyelid lag, and degree of lagophthalmos as well as surgical outcomes were compared and analyzed in both groups. RESULTS: A total of 81 patients (88 eyelids) were included in this study. There were 50 males (61.7%). The mean age was ±SD 12.0 ± 9.5 years. The first group included 43 eyelids while the second had 45 eyelids. There was no statistical difference in demographics and preoperative data between both groups. The postoperative LF was higher in the second group (10.7 ± 2.1 mm) with less consecutive eyelid lag compared with the control group (7.8 ± 1.9 mm) (p < 0.001). The control group had acquired more postoperative lagophthalmos compared with the second group (p < 0.001). Complete surgical success was achieved in 82.2% in the second group compared with 60.5% in the control group (p = 0.024). CONCLUSIONS: Releasing the central attachment between WL and levator palpebrae superioris muscle has achieved an improvement in LF with minimal postoperative eyelid lag, lagophthalmos, and corneal complications.Releasing the central attachment between levator palpebrae superioris muscle and Whitnall's ligament during levator aponeurosis resection allows better levator excursion and minimizes postoperative lagophthalmos, eyelid lag, and corneal complications.


Assuntos
Blefaroplastia , Blefaroptose , Doenças Palpebrais , Adolescente , Adulto , Blefaroptose/cirurgia , Estudos de Casos e Controles , Criança , Pré-Escolar , Doenças Palpebrais/cirurgia , Pálpebras/cirurgia , Humanos , Masculino , Músculos Oculomotores/cirurgia , Estudos Retrospectivos , Adulto Jovem
15.
Saudi J Ophthalmol ; 33(3): 209-213, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31686960

RESUMO

Purpose: To study different tarsal cysts that share similar presentations and are commonly misdiagnosed clinically as a chalazion. Methods: A retrospective review of medical charts of all consecutive patients who presented eyelid tarsal-related pathology that needed surgical excision between 2010 and 2016 to a tertiary hospital was done. The data collected included preoperative, intraoperative and postoperative observations. Complete ophthalmologic examination at presentation, surgical procedures needed, complications, histopathological findings, response to treatment and follow-ups were recorded. Results: Out of 850 patients who had an eyelid tarsal-related pathology, ten patients were found to have an eyelid cystic lesion related to the tarsus. All patients presented with an eyelid mass with no sign of local inflammation. All lesions were fixed to the tarsus with freely mobile overlying skin. Five patients had a recurrent lesion that was misdiagnosed and surgically treated as a chalazion. All patients underwent a surgical removal of these cysts, and a histopathological examination was performed. An intratarsal keratinous cyst was found in six patients and epithelial inclusion cyst was in one patient. Two patients found to have cystic structure lined by double cuboidal epithelium with numerous goblet cells consistent with benign lacrimal duct cyst (Dacryops). Conclusion: Cysts related to the tarsal plate could have similar presentations. Careful clinical evaluation and histopathological examination play an important role in giving the right diagnosis and in providing the appropriate management.

16.
Int J Surg Case Rep ; 50: 130-134, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30118963

RESUMO

INTRODUCTION: Acute dacryocystitis usually presents as a pre-septal cellulitis since the lacrimal sac lies anterior to the orbital septum. Orbital cellulitis secondary to acute dacryocystitis is very rare due to a variety of anatomic barriers to the orbit but can occur and result in abscess formation with risk of visual compromise. PRESENTATION OF CASE: We describe a case of otherwise healthy adult who presented with complete visual loss following orbital cellulitis and abscess formation secondary to acute dacryocystitis. The clinical, radiological, intraoperative and postoperative findings are discussed. DISCUSSION: Typically, orbital cellulitis responds well to systemic antibiotic and surgical drainage without permanent visual loss. There are 7 cases reported in the literature of acute dacryocystitis complicated by permanent visual loss. CONCLUSION: Patients with acute dacryocystitis need to be carefully monitored for signs of orbital cellulitis. Prompt recognition and appropriate treatment of this condition are essential.

17.
J Med Case Rep ; 12(1): 139, 2018 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-29754589

RESUMO

BACKGROUND: Primary orbital peripheral T-cell lymphoma, not otherwise specified is an exceedingly rare disorder with a very poor outcome, and to the best of our knowledge only a few cases have been reported in the English literature. We present the youngest reported case describing the successful outcome after management with a thorough review of the English literature of all the reported cases of primary peripheral T-cell lymphoma, not otherwise specified. CASE PRESENTATION: Our patient is a 3-year-old Syrian boy who presented with gradual progressive orbital swelling. A physical examination showed a left orbital dystopia and a superior medial displacement of the globe. Extraocular motility was limited in upward elevation of his left eye. A computed tomography scan and magnetic resonance imaging of his orbit showed a mass involving the lateral and inferior walls of his left orbit and extending intraconally. A diagnosis of peripheral T-cell lymphoma, not otherwise specified was made by careful histopathological examination and Berlin-Frankfurt-Munster protocol was initiated. A 6-month follow up with orbital magnetic resonance imaging showed no sign of orbital or brain involvement. CONCLUSIONS: Through this report we emphasize two takeaway lessons: (1) always have a high level of suspicion of this entity regardless of the age of the patient; and (2) careful histopathological examination is very important for prompt confirmation of the diagnosis and early commencement of proper treatment.


Assuntos
Detecção Precoce de Câncer , Linfoma de Células T , Distribuição por Idade , Protocolos de Quimioterapia Combinada Antineoplásica , Asparaginase , Pré-Escolar , Daunorrubicina , Humanos , Linfoma de Células T/diagnóstico por imagem , Linfoma de Células T/tratamento farmacológico , Linfoma de Células T/patologia , Imageamento por Ressonância Magnética , Masculino , Órbita/diagnóstico por imagem , Órbita/patologia , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/tratamento farmacológico , Neoplasias Orbitárias/patologia , Prednisona , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vincristina
18.
Saudi J Ophthalmol ; 32(1): 75-78, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29755277

RESUMO

Childhood orbital teratomas are congenital lesions that presents most often at birth with progressive, severe unilateral proptosis. Due to the rarity of such tumors, the diagnosis is often missed with delay in the patient's management. We are presenting a unique case of an immature right orbital teratoma with extensive growth in a full-term newly born baby boy. In this case report, we provide description of the clinical findings, initial misdiagnosis and the eventual management with review of similar reported cases.

19.
Cornea ; 37(4): 416-420, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29504955

RESUMO

PURPOSE: To study the effect of trachoma on meibomian glands using infrared meibography and to correlate the results with tear film parameters. METHODS: This is a prospective cohort study in which 86 eyes of healthy volunteers and 90 eyes with trachoma were included. Clinical assessment was performed including the following: slit-lamp examination looking for signs of sequelae of trachoma, tear breakup time (TBUT), superficial punctate keratopathy (SPK), Schirmer II test (with anesthesia), and meibum score. Noncontact meibography was performed on both upper and lower eyelids separately using the meibograde system, which involved distortion of the meibomian gland, shortening, and dropout. RESULTS: Lid margin abnormalities (telangiectasia, lid margin swelling, and hyperemia) were all significantly higher in the trachoma group. The mean SPK (1.36), meibum score (1.76), meibography dropout, distortion, shortening, and total meibography (8.19 for upper eyelids and 3.81 for lower eyelids) were all significantly higher in the trachoma group (P < 0.001) compared with the normal group were SPK (0.88), meibum score (0.16), and total meibography (1.24 for upper eyelids and 0.92 for lower eyelids). Mean TBUT (4.2 s) was significantly shorter in the trachoma group than in the normal group (10.3 s) (P < 0.001). There was no significant difference between both groups in the Schirmer II test. CONCLUSIONS: Meibography of patients with sequelae of trachoma was in agreement with the histopathologic studies. Upper eyelids were much more affected than the lower eyelids. TBUT, SPK, and meibum score were correlated with the status of meibomian glands and meibography, which were significantly different in the trachoma group.


Assuntos
Doenças Palpebrais/diagnóstico por imagem , Pálpebras/patologia , Glândulas Tarsais/diagnóstico por imagem , Tracoma/diagnóstico por imagem , Idoso , Doenças Palpebrais/patologia , Feminino , Seguimentos , Voluntários Saudáveis , Humanos , Masculino , Glândulas Tarsais/patologia , Pessoa de Meia-Idade , Estudos Prospectivos , Lâmpada de Fenda , Lágrimas/metabolismo , Tracoma/patologia
20.
Ophthalmic Plast Reconstr Surg ; 34(5): 463-466, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29384825

RESUMO

PURPOSES: To study the ophthalmic manifestations of patients with allergic fungal sinusitis (AFS) and evaluate the importance of early diagnosis and management in preventing the possible future complications of AFS. METHODS: Retrospective chart review of 100 patients with the diagnosis of AFS from a single institution was performed. Age, gender, clinical presentation including ophthalmic and radiological findings, immune status, patterns of sinus involvement, medical and surgical intervention needed, laboratory results, and the course of the disease were evaluated. RESULTS: The mean age at presentation was 19.8 years (range, 10-42 years) with no clear gender predominance (52% of patients were female).The most common sinuses involved were ethmoid and maxillary sinuses. All patients underwent functional endoscopic sinus surgery and received systemic and topical steroids. There were no intervention-related complications. Thirty-four of 100 patients had ophthalmic consequences of AFS. The most common ophthalmic presentation was proptosis (n = 21, 61.7%), followed by epiphora (n = 5, 14.7%), visual loss (n = 4, 11.7%), diplopia (n = 3, 8.8%), and dystopia (n = 1, 2.9%) in addition to 1 patient having ptosis beside proptosis. CT scans of these 34 patients showed that 82.3% had nonhomogenous opacification of sinuses, 52% had erosion of lamina papyracea, 17.6% had intraorbital extension, and 8.8% had intracranial extension. CONCLUSIONS: Ophthalmologists may be the first who encounter these patients which necessitates familiarity with AFS presentations and complications. In cases of sudden visual loss, early intervention may prevent permanent vision loss. Functional endoscopic sinus surgery and postoperative systemic and topical steroids resulted in dramatic improvement of ophthalmic symptoms and signs.


Assuntos
Exoftalmia/etiologia , Micoses/complicações , Sinusite/complicações , Transtornos da Visão/etiologia , Adolescente , Adulto , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Criança , Diagnóstico Precoce , Feminino , Humanos , Masculino , Micoses/terapia , Seios Paranasais/cirurgia , Estudos Retrospectivos , Sinusite/microbiologia , Sinusite/terapia , Esteroides/uso terapêutico , Adulto Jovem
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