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1.
Scanning ; 2022: 8149247, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36082172

RESUMO

Objective: To observe the orbital volume changes and the analysis of surgical effect of Graves orbitopathy (GO) after endoscopic medial wall decompression combined with muscle cone fat. Methods: Twenty-two patients (30 eyes) with Graves orbital disease who visited the Department of Ophthalmology of Ningbo Medical Center from December 2019 to September 2021 were retrospectively collected. All patients were diagnosed as nonorganic active stage before operation, and all of them received endoscopic transethmoidal decompression of the medial orbital wall combined with intramuscular orbital fat decompression due to decreased vision, visual field defect or color vision disorder, and concomitant proptosis. Regular follow-up after operation. The curative effect is judged according to the degree of improvement of visual acuity, color vision, degree of correction of exophthalmos, diplopia, and other complications at 9 months after operation. Orbital CT combined with computer aided measurement software (Mimics 21) was used to measure the changes of orbital volume before and after exophthalmos surgery. The relationship between the value and eyeball regression is analyzed. Results: Preoperative exophthalmos ranged from 17.4 mm to 27.6 mm, with an average of (22.08 ± 2.86) mm. The postoperative exophthalmos was 14-25 mm, with an average of (19.52 ± 3.10) mm. Among them, 7 eyes (23.3%) had exophthalmos regression less than 1 mm, 6 eyes (20%) had a regression of 1-2 mm, 7 eyes (23.3%) had a regression of 2-3 mm, 5 eyes (16.7%) had a regression of 3-4 mm, and 5 eyes (16.7%) had a regression of 4-5.3 mm. The exophthalmos after operation was significantly lower than that before operation, and the difference was statistically significant (t = 9.909, P < 0.05). The preoperative orbital volume was 18.6 cm3-25.3 cm3 with an average of (22.39 ± 1.91) cm3. The postoperative orbital volume was 19.8 cm3-26.6 cm3, with an average of (23.89 ± 1.90) cm3.The orbital volume change range is 0.1 cm3-3.8 cm3, and the average orbital volume change is (1.51 ± 1.00) cm3. Compared with preoperative orbital volume, the difference was statistically significant (t = -8.074, P < 0.05). Conclusion: Endoscopic decompression of the medial orbital wall through the ethmoid approach combined with decompression of the orbital fat within the muscle cone can effectively correct the exophthalmos while decompressing the orbital apex, and it is minimally invasive and has no facial scars. It has the advantages of extremely low incidence of postoperative diplopia and eye shift. There is a significant correlation between orbital volume changes and the regression of exophthalmos, which can provide reference for clinical guidance of surgical methods and prediction of surgical results.


Assuntos
Exoftalmia , Oftalmopatia de Graves , Descompressão Cirúrgica/efeitos adversos , Descompressão Cirúrgica/métodos , Diplopia/complicações , Diplopia/cirurgia , Exoftalmia/etiologia , Exoftalmia/cirurgia , Oftalmopatia de Graves/complicações , Oftalmopatia de Graves/diagnóstico por imagem , Oftalmopatia de Graves/cirurgia , Humanos , Vértebras Lombares/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
2.
Rom J Ophthalmol ; 66(2): 168-172, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935074

RESUMO

Purpose: To report a case of indirect carotid-cavernous fistula (CCF) in a patient who presented as a case of thyroid-associated orbitopathy (TAO). Case presentation: A 60-year-old female, known case of hypothyroidism, presented with left-sided headache associated with pain, protrusion and redness of left eye, the examination revealing vision of 20/ 80, proptosis, chemosis and severe ophthalmoplegia. All routine investigations were normal, including thyroid hormone levels. MRI brain & orbits showed increase in bulk of all extraocular muscles with tendon sparing. In view of suspicion of TAO, she was initially misdiagnosed and treated with parenteral and oral steroids, which resulted in further worsening of vision. Optical coherence tomography macula of the left eye revealed acute central serous chorioretinopathy that compelled the stoppage of steroids. While reviewing the patient again, dilated cork-screw tortuous episcleral vessels were found in the left eye. Thus, advised Digital subtraction angiography, confirmed as a case of low-flow left Indirect CCF, managed with endovascular embolization therapy improved her ocular symptoms completely in three days. Conclusion: CCF may mimic TAO due to overlapping features. In-view of different treatment protocols for both, it is critically important to look for atypical features in thyroid eye disease and keep CCF as one of the differential diagnoses for accurate management. Abbreviations: CCF = carotid-cavernous fistula, ICA = internal carotid artery, ECA = external carotid artery, TAO = thyroid-associated ophthalmopathy, BCVA = best corrected visual acuity, MRI = magnetic resonance imaging, IVMP = intravenous methylprednisolone, OCT = Optical coherence tomography, CSCR = central serous chorioretinopathy, DSA = digital subtraction angiography, IOP = intraocular pressure, CT = computed tomography.


Assuntos
Fístula Carotidocavernosa , Coriorretinopatia Serosa Central , Embolização Terapêutica , Exoftalmia , Fístula , Oftalmopatia de Graves , Fístula Carotidocavernosa/cirurgia , Fístula Carotidocavernosa/terapia , Embolização Terapêutica/métodos , Exoftalmia/diagnóstico , Exoftalmia/etiologia , Feminino , Fístula/complicações , Fístula/terapia , Oftalmopatia de Graves/complicações , Oftalmopatia de Graves/diagnóstico , Oftalmopatia de Graves/terapia , Humanos , Pessoa de Meia-Idade
3.
Rom J Ophthalmol ; 66(2): 153-157, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935091

RESUMO

Objective: Our aim was to present a rare case of a middle-aged male patient, diagnosed with Graves' orbitopathy, which had an atypical rapid unilateral onset. Initially, the left eye presented exophthalmos, eyelid retraction, corneal ulceration, and pannus formation with an important vascular component due to corneal exposure. The same symptoms developed in the right eye within a short period of time. Methods: A 52-year-old man presented in our department with bilateral proptosis, decrease in visual acuity, and orbital pain, which developed initially in the left eye seven months before the right eye. Slit lamp examination revealed conjunctival hyperemia, purulent discharge, chemosis and inflammation of the caruncle in both eyes. The fluorescein eye stain test was positive due to corneal ulceration with the presence of cells and flare in anterior chamber in the RE (right eye). The LE (left eye) presented a corneal pannus. We documented the changes using a slit lamp biomicroscope, a fundus camera, orbital ultrasonography, and contrast CT (computer tomography) scans. Discussions: The severe Graves' ophthalmopathy represents a challenge both in active or inactive phase. Medical and surgical therapies should be taken into consideration in order to prevent the complications following corneal perforation or optic neuropathy. Also, ophthalmic, and systemic adverse reactions of systemic steroids used in the treatment of Graves' disease are important in the prognosis of the visual outcome. Conclusions: The management of Graves' ophthalmopathy is multidisciplinary and needs a very good therapy adherence in order to achieve a satisfactory prognosis and quality of life.


Assuntos
Úlcera da Córnea , Exoftalmia , Oftalmopatia de Graves , Doenças do Nervo Óptico , Úlcera da Córnea/complicações , Exoftalmia/diagnóstico , Exoftalmia/etiologia , Oftalmopatia de Graves/complicações , Oftalmopatia de Graves/diagnóstico , Oftalmopatia de Graves/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
6.
Pan Afr Med J ; 41: 219, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35721655

RESUMO

Subperiosteal haematoma of the orbit associated with frontal extradural hematoma is very rare. We here report a case treated in our Department with a literature review. The study involved a 15-year-old boy, victim of head injury from white weapon, a week before his admission to the emergency room. He had inflammatory and painful exophthalmos on the left side, associated with left ophthalmoplegia and blindness. Brain scanner showed left frontal extradural hematoma associated with subperiosteal hematoma of the ipsilateral orbit. Frontal craniotomy associated with fracture orbitotomy allowed evacuation of the extradural hematoma, and then, of the subperiosteal hematoma. Patient´s outcome was favorable. Simultaneous occurrence of frontal extradural hematoma and subperiosteal hematoma of the orbit is extremely rare. Generally, attention is drawn by exophthalmos and visual disturbances. Emergency brain scan without contrast agent injection can be used to make a diagnosis. Prognosis depends on visual function, then adequate management helps to safeguard the eye and vision.


Assuntos
Doenças Ósseas , Traumatismos Craniocerebrais , Exoftalmia , Hematoma Epidural Craniano , Doenças Orbitárias , Adolescente , Traumatismos Craniocerebrais/complicações , Exoftalmia/etiologia , Hematoma/complicações , Hematoma/cirurgia , Hematoma Epidural Craniano/complicações , Hematoma Epidural Craniano/diagnóstico , Hematoma Epidural Craniano/cirurgia , Humanos , Masculino , Órbita , Doenças Orbitárias/complicações , Doenças Orbitárias/etiologia
7.
J Feline Med Surg ; 24(6): e116-e123, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35536054

RESUMO

OBJECTIVES: The aim of this multicentre retrospective study was to describe the clinical presentation, imaging findings, diagnosis and outcomes of cats with retrobulbar neoplasia. METHODS: A total of 37 cats that were diagnosed with retrobulbar neoplasia and underwent advanced imaging were recruited from searches of the clinical records of two referral hospitals. All cats had neoplasia confirmed via cytology or histopathology. Data relating to the signalment, presentation, results of investigations, treatment and outcome were recorded. A review of imaging studies was performed where possible. RESULTS: In total, 23 cases (62%) were presented with respiratory signs. Exophthalmos was the most common ophthalmological examination finding, present in 18 cases (49%). Thirty-two cases (86%) had secondary extension of neoplasia to the retrobulbar space (most commonly from the nasal cavities), present in 20 cases (54%), of which 12 were lymphoma. In cases where contrast was administered, 28/35 (80%) had contrast-enhancing masses. Orbital extension was detected in 21 cases (57%), exophthalmos in 22 (59%), globe deformation in 12 (32%) and local lymphadenomegaly in 22 (61%). In total, 36 (97%) retrobulbar tumours were malignant. Thoracic imaging, where it was performed, was concerning for metastasis in 8/25 cases (31%), with abdominal imaging suggestive of metastasis in 5/12 (42%). The most common diagnosis was lymphoma with 19 cases (51%), with nasal lymphoma representing 12 of these, followed by carcinoma in 10 (27%). The median survival time, for cases where death was recorded, was 85 days (range 1-263 days). CONCLUSIONS AND RELEVANCE: To the authors' knowledge, this is the largest study of neoplasia affecting the feline retrobulbar space. Retrobulbar tumours in cats are overwhelmingly malignant, and commonly due to secondary extension of tumours originating elsewhere. Lymphoma, particularly arising from the nasal cavities, was the most common cause. Cats presenting with signs suggestive of retrobulbar disease should be assessed for disease affecting any of the structures of the head.


Assuntos
Carcinoma , Doenças do Gato , Exoftalmia , Linfoma , Abdome , Animais , Carcinoma/veterinária , Doenças do Gato/diagnóstico por imagem , Gatos , Exoftalmia/diagnóstico , Exoftalmia/etiologia , Exoftalmia/veterinária , Linfoma/veterinária , Estudos Multicêntricos como Assunto , Estudos Retrospectivos
8.
Ned Tijdschr Geneeskd ; 1662022 02 16.
Artigo em Holandês | MEDLINE | ID: mdl-35499767

RESUMO

Graves' orbitopathy may cause multiple symptoms, such as proptosis, redness or inflammation of the conjunctiva, excessive tearing, swelling of the eyelids and pain. Smoking, male gender and old age are significant risk factors for a more severe and active disease.


Assuntos
Exoftalmia , Oftalmopatia de Graves , Doenças do Aparelho Lacrimal , Exoftalmia/complicações , Exoftalmia/etiologia , Oftalmopatia de Graves/diagnóstico , Oftalmopatia de Graves/etiologia , Humanos , Inflamação/complicações , Masculino
10.
BMC Ophthalmol ; 22(1): 232, 2022 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-35606735

RESUMO

BACKGROUND: Intramuscular haemangiomas are rare, benign vascular tumours that represent < 1% of all haemangiomas. When involving the extraocular muscles, haemangiomas are extremely rare, with only nine cases reported in the literature; to date there are no reported cases of extraocular muscle haemangiomas extending into the brain. CASE PRESENTATION: A 6-year-old boy with a two-week history of a painless swelling and erythema on the upper eyelid. On examination, the patient had restricted extraocular motility in all directions of gaze. In addition, the eye appeared proptotic, with chemosis and hyperaemia of the conjunctiva. Visual acuity and intraocular pressure were normal. Orbital computed tomography imaging showed a mass in the left superior rectus, with heterogeneous enhancement following contrast administration. Incisional biopsy revealed an intramuscular haemangioma of the superior rectus muscle with capillary-type vessels. The patient received an intralesional steroid, which improved the condition for a few months; however, the lesion later recurred and included an intracranial extension. CONCLUSION: This case represents the first reported case of intracranial extension of intramuscular haemangioma of extraocular muscle.


Assuntos
Exoftalmia , Hemangioma , Criança , Exoftalmia/etiologia , Hemangioma/diagnóstico , Humanos , Masculino , Recidiva Local de Neoplasia , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/patologia , Tomografia Computadorizada por Raios X
12.
Jpn J Ophthalmol ; 66(3): 314-319, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35438395

RESUMO

PURPOSE: Chronic progressive external ophthalmoplegia (CPEO) is a mitochondrial disease characterized by slowly progressive ptosis and limitations in ocular motility. Although exophthalmos is not considered to be a common feature of CPEO, this study focused on the incidence of exophthalmos in patients with CPEO. STUDY DESIGN: Retrospective observational case series METHODS: We reviewed the clinical charts of patients who received a diagnosis of CPEO sometime during the period between January 2010 and December 2018. CPEO was diagnosed on the basis of detection of a deletion of mitochondrial DNA (mtDNA) from saliva, buccal mucosa, or extraocular muscle specimens obtained during strabismus surgery. Horizontal MRI/CT images or Hertel ophthalmometry was used in determining exophthalmos. RESULTS: Seven patients (4 males) were identified. The mean age at diagnosis was 32.6 years (range 13-53 years). mtDNA deletion mutations were detected in the buccal mucous membrane DNA in 5 patients and in the saliva and extraocular muscle DNA in 2 patients. MRI/CT was recorded in 6 patients, four of whom showed exophthalmos (cases 1-4), and case 5 was determined as exophthalmos on the basis of a Hertel ophthalmometer reading. Exophthalmos was bilateral in 4 of the patients (cases 1, 2, 4, and 5) and unilateral in 1 patient (case 3). Exophthalmos was the chief concern of 2 of the patients; however, it was not clinically significant in the other patients. CONCLUSIONS: Although exophthalmos may not be recognized by either the patient or the clinician, it may be one of the common features of CPEO. A large multiethnic study should be performed.


Assuntos
Exoftalmia , Oftalmoplegia Externa Progressiva Crônica , Adolescente , Adulto , DNA Mitocondrial/genética , Exoftalmia/diagnóstico , Exoftalmia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculos Oculomotores , Oftalmoplegia Externa Progressiva Crônica/complicações , Oftalmoplegia Externa Progressiva Crônica/diagnóstico , Oftalmoplegia Externa Progressiva Crônica/genética , Estudos Retrospectivos , Adulto Jovem
13.
Zh Vopr Neirokhir Im N N Burdenko ; 86(2): 103-108, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35412719

RESUMO

OBJECTIVE: To demonstrate own experience in 3D modeling for planning of minimally invasive approach to the orbit and anterior skull base. MATERIAL AND METHODS: A 17-year-old patient admitted to the Department of Pediatric Neurosurgery with complaints of decreased visual acuity of the left eye, lacrimation and exophthalmos. MRI revealed a tumor of the left orbit. We have preoperatively modeled frontoorbital region, anterior skull, as well as eyeball and tumor within the same model. Considering young age and potentially favorable prognosis of disease, we preferred a minimally invasive intervention (microsurgical resection of tumor through minimally invasive frontoorbital access). RESULTS: Total resection of tumor was followed by examination of anterior skull base. There was postoperative regression of visual disturbances, lacrimation and exophthalmos. Sutures were removed after 5 days, and the patient was discharged. CONCLUSION: Minimally invasive frontoorbital access is adequate for approach to the orbit, anterior and middle cranial fossa, adequate resection of orbital tumor and examination of anterior skull base. 3D modeling is an additional preoperative tool to improve the quality of preoperative planning and facilitate intraoperative navigation.


Assuntos
Exoftalmia/cirurgia , Órbita/cirurgia , Neoplasias Orbitárias/cirurgia , Adolescente , Criança , Fossa Craniana Média , Exoftalmia/diagnóstico por imagem , Exoftalmia/etiologia , Humanos , Imageamento Tridimensional , Procedimentos Cirúrgicos Minimamente Invasivos , Procedimentos Neurocirúrgicos , Órbita/diagnóstico por imagem , Neoplasias Orbitárias/diagnóstico por imagem
14.
World Neurosurg ; 162: 85-90, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35331947

RESUMO

OBJECTIVE: The endoscopic endonasal approach (EEA) was originally performed to treat thyroid orbitopathy and proptosis. Since then, this approach also has been used to treat other causes of proptosis. This review systematically identifies surgical outcome and complication rates in patients without thyroid proptosis who underwent endoscopic endonasal orbital decompression. METHODS: Databases were searched using the following search terms: orbital disease, surgical decompression, and endoscopic endonasal approach. Two independent reviewers screened all abstracts and titles for relevance and all articles passing this screen were subjected to full-text review. To assess risk of bias, we used ROBINS-I (Risk Of Bias in Non-randomized Studies-of Interventions). RESULTS: Eight studies with a total of 74 patients with nonthyroid proptosis were included. Pre- and postoperative eye examination was performed in all studies, but the extent of examination was varying. With a mean age of 35.7 years, most patients were adolescent, and most pathologies induced unilateral proptosis Complications to EEA for orbital decompression were transient diplopia (5 patients/6.8%), transient facial dysesthesia (2 patients/2.7%), ptosis (1 patient/1.4%), infarction (1 patient/1.4%), sinus obstruction (1 patient/1.4%), and enophtalmos (1 patient/1.4%). The authors reported successful reduction of proptosis in all but 2 patients (97.2%), and only 2 authors reported a need for secondary decompression. CONCLUSIONS: Medial orbital decompression using EEA is a feasible approach for orbital decompression in patients with nonthyroid proptosis. While being comparable in primary outcome to transorbital approaches, the EEA seems superior in terms of complication rates.


Assuntos
Exoftalmia , Oftalmopatia de Graves , Adolescente , Adulto , Descompressão Cirúrgica/efeitos adversos , Endoscopia/efeitos adversos , Exoftalmia/etiologia , Exoftalmia/cirurgia , Oftalmopatia de Graves/cirurgia , Humanos , Órbita/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
15.
J Cyst Fibros ; 21(5): 878-880, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35246383

RESUMO

In cystic fibrosis (CF) patients, Ear Nose Throat (ENT) pathology is often undiagnosed despite its high prevalence and its possible life-threatening complications. We present the case of an ethmoidal mucocele leading to ocular manifestations in a 2-year-old girl with cystic fibrosis with no previous serious complications. She progressively developed non-axial proptosis, limitation of the adduction and exotropia of her left eye. Paranasal sinus magnetic resonance image (MRI) showed a left ethmoidal mucocele causing displacement of the ocular globe, compression of the medial rectus and the optic nerve. Eye fundus revealed disc edema and diffuse vascular congestion. Endoscopic sinus surgery was performed to remove the mass. The mucocele was drained and the discharge was sent for microbiology assessment. Escherichia coli (E. coli) was found in the culture and treated with cefotaxime and dexamethasone with complete resolution of non-axial proptosis and disc edema.


Assuntos
Fibrose Cística , Exoftalmia , Mucocele , Doenças dos Seios Paranasais , Cefotaxima , Criança , Pré-Escolar , Fibrose Cística/complicações , Fibrose Cística/diagnóstico , Fibrose Cística/patologia , Dexametasona , Escherichia coli , Seio Etmoidal/patologia , Seio Etmoidal/cirurgia , Exoftalmia/diagnóstico , Exoftalmia/etiologia , Exoftalmia/cirurgia , Feminino , Humanos , Mucocele/complicações , Mucocele/diagnóstico , Mucocele/cirurgia , Doenças dos Seios Paranasais/complicações , Doenças dos Seios Paranasais/diagnóstico , Doenças dos Seios Paranasais/cirurgia
16.
Ann Ital Chir ; 92: 271-279, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35333194

RESUMO

AIM: The main focus of this paper was to describe our experience in the management of primary lesions involving the orbit, analyzing signs and symptoms and illustrating surgical management. MATERIAL OF STUDY: We describe our experience managing 62 consecutive patients diagnosed with orbital tumors confined to the orbital content (not involving skin or bone, with no intracranial invasion) and treated between January 2013 and December 2016. Demographic characteristics, symptoms, clinical findings, histological types and approaches have been recorded. RESULTS: We found that the most common clinical manifestations were exophthalmos/proptosis and ocular movement impairment; the most common histological types were vascular malformation and ocular adnexal lymphomas. DISCUSSION: Primary neoplasms involving orbital contents include a broad spectrum of pathologies difficult to manage without a firm diagnosis, usually histological. Different surgical accesses are described in order to perform incisional biopsy or resection of the mass. CONSCLUSION: In every case, accurate surgical planning is mandatory, in order to prevent functional and/or aesthetic complications. KEY WORDS: Blepharoplasty incision, Intraorbital neoplasia, Lateral orbital tumor, Orbitotomy, Surgical treatment, Transconjunctival approach.


Assuntos
Exoftalmia , Neoplasias Orbitárias , Cirurgiões , Biópsia , Exoftalmia/etiologia , Exoftalmia/cirurgia , Humanos , Órbita/patologia , Órbita/cirurgia , Neoplasias Orbitárias/diagnóstico , Neoplasias Orbitárias/cirurgia
17.
Arch Endocrinol Metab ; 66(2): 191-197, 2022 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-35315985

RESUMO

Objective: Graves' ophthalmopathy (GO) is a vision-threatening finding observed in approximately half of Graves' disease patients. The pathophysiology of GO is unclear, and one of the suspected factors is oxidative stress. In our study, we compared the relationship between proptosis and SH-SS in patients diagnosed with GO. Methods: In this prospective study, 40 recently diagnosed Graves' disease patients with proptosis, 40 recently diagnosed Graves' disease patients without GO and 30 healthy individuals with similar demographic characteristics were included. Serum thiol-disulfide (SH-SS) measurements were performed. Eye examinations were performed by a single ophthalmologist to check for the presence of GO, and proptosis values were recorded with a Hertel exophthalmometer. Results: Total SH values were lower in the group with proptosis than in the other groups (p < 0.05). Total and native SH values were lower in patients without proptosis than in the control group (p < 0.05). Total SH, native SH and SS levels were independently associated with proptosis (p < 0.05). According to this analysis, it was found that increasing SS and decreasing total and native SH levels increased the probability of proptosis by 24.4%, 32.7% and 32.4%, respectively. Conclusion: A decrease in SH, which is a natural antioxidant that protects the body against oxidative stress, and an increase in SS are important signs of oxidative damage. Proptosis and SH-SS are closely related in GO. This may help us detect GO and proptosis in Graves' patients. It can also assist in developing new options for preventing and treating GO.


Assuntos
Exoftalmia , Doença de Graves , Oftalmopatia de Graves , Dissulfetos , Exoftalmia/diagnóstico , Exoftalmia/etiologia , Doença de Graves/complicações , Doença de Graves/tratamento farmacológico , Humanos , Estudos Prospectivos , Compostos de Sulfidrila
18.
Neurol India ; 70(1): 337-339, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35263908

RESUMO

Background: Hydatid cyst is a parasitic infection caused by Echinococcus granulosus and human is an accidental host. Liver and lungs are the most widely recognized organ of association but relatively low in other organs. Orbital involvement of the hydatid cyst is rare. Case Description: The case was a 47-year-old lady presented in the late stage of disease when corneal ulcer had developed and with complete vision loss along with headache, proptosis, and pain in the left eye. Cystic lesion in the retro-orbital region of the left eye was revealed by Computed tomography scan and magnetic resonance imaging. The patient underwent surgery. Hundreds of daughter cysts were seen intraoperatively and cyst wall sent for histopathological examination to confirm the diagnosis. The patient was further treated with albendazole for 3 months. Conclusion: Although hydatid cyst is uncommon, it ought to be considered in the differential diagnosis of cystic lesion of orbital locale, more so in the endemic territories.


Assuntos
Equinococose , Echinococcus , Exoftalmia , Albendazol/uso terapêutico , Animais , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Exoftalmia/etiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade
19.
BMJ Case Rep ; 15(2)2022 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-35140092

RESUMO

A male in his early teens presented with redness of the right eye following a fall. This redness was progressive and increased suddenly over the week prior to presentation. Fundus evaluation revealed an exudative retinal detachment, and a bruit was audible over the right eye. A digital subtraction angiogram revealed the cause to be a ruptured persistent trigeminal artery aneurysm causing a carotid-cavernous fistula like haemodynamic situation with a massively dilated superior ophthalmic vein. Curative embolisation was done using both vertebrobasilar and carotid approach, and the aneurysm as well as the fistula was occluded using detachable coils and n-butyl cyanoacrylate glue. Patient made a complete recovery in his proptosis and chemosis over 8 weeks, with significant improvement of his visual acuity. The key to successful outcome in this case was a complete occlusion with thrombosis of the fistula bed that can only be achieved using a combination of coils and liquid embolic agents.


Assuntos
Fístula Carotidocavernosa , Seio Cavernoso , Embolização Terapêutica , Exoftalmia , Adolescente , Angiografia , Fístula Carotidocavernosa/diagnóstico por imagem , Fístula Carotidocavernosa/terapia , Exoftalmia/etiologia , Humanos , Masculino
20.
Medicina (Kaunas) ; 58(2)2022 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-35208640

RESUMO

Carcinosarcomas are biphasic tumors comprising carcinoma and sarcoma components that occur in many tissues but are rarely found in the orbit. A 70-year-old male presented to the ophthalmic clinic with progressive proptosis, having decreased vision in the left eye for 8 months. On examination, severe exophthalmos and lagophthalmos with limited extraocular movement were noted. Orbital computed tomography scans revealed a large, well-defined, heterogeneously enhanced mass in the left retrobulbar orbital cavity. The tumor was completely resected, and the pathological examination revealed a carcinosarcoma. The prognosis was excellent without local recurrence at 48 months postoperatively. Thus, when considering treatment for effective management of such tumors, tumor resection followed by radiotherapy or chemotherapy is highly recommended.


Assuntos
Carcinossarcoma , Exoftalmia , Idoso , Carcinossarcoma/diagnóstico por imagem , Carcinossarcoma/radioterapia , Carcinossarcoma/cirurgia , Exoftalmia/etiologia , Humanos , Masculino , Órbita/diagnóstico por imagem , Órbita/cirurgia , Prognóstico , Tomografia Computadorizada por Raios X
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