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1.
Int J Med Sci ; 21(9): 1604-1611, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39006846

RESUMO

Purpose: To investigate morphological and hemodynamic characteristics of the ophthalmic artery (OA) in patients with white matter hyperintensity (WMH), and the association of the presence and severity of WMH with OA characteristics. Methods: This cross-sectional study included 44 eyes of 25 patients with WMH and 38 eyes of 19 controls. The Fazekas scale was adopted as criteria for evaluating the severity of white matter hyperintensities. The morphological characteristics of the OA were measured on the basis of three-dimensional reconstruction. The hemodynamic parameters of the OA were calculated using computational fluid dynamics simulations. Results: Compared with the control group, the diameter (16.0±0.27 mm vs. 1.71±0.18 mm, P=0.029), median blood flow velocity (0.12 m/s vs. 0.22 m/s, P<0.001), mass flow ratio (2.16% vs. 3.94%, P=0.012) and wall shear stress (2.65 Pa vs. 9.31 Pa, P<0.001) of the OA in patients with WMH were significantly decreased. After adjusting for confounding factors, the diameter, blood flow velocity, wall shear stress, and mass flow ratio of the OA were significantly associated with the presence of WMH. Male sex and high low-density protein level were associated with moderate-to-severe total WMH, and smoking was associated with the moderate-to-severe periventricular WMH. Conclusions: The diameter, blood flow velocity, mass flow ratio, and wall shear stress of the OA were independently associated with the presence of WMH. Atherosclerosis might be involved in the common mechanism of the occurrence of WMH and the OA changes.


Assuntos
Hemodinâmica , Artéria Oftálmica , Substância Branca , Humanos , Masculino , Feminino , Artéria Oftálmica/diagnóstico por imagem , Artéria Oftálmica/fisiopatologia , Substância Branca/diagnóstico por imagem , Substância Branca/fisiopatologia , Substância Branca/irrigação sanguínea , Substância Branca/patologia , Estudos Transversais , Hemodinâmica/fisiologia , Pessoa de Meia-Idade , Idoso , Velocidade do Fluxo Sanguíneo , Imageamento por Ressonância Magnética , Adulto
2.
Ophthalmic Res ; 67(1): 387-392, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38897178

RESUMO

INTRODUCTION: The aim of the study was to investigate the clinical efficacy of superselective ophthalmic artery thrombolysis for central retinal artery occlusion (CRAO). METHODS: Retrospective study of CRAO patients who attended the Department of Ophthalmology of Affiliated Hospital of Weifang Medical University from January 2022 to July 2023, 138 CRAO patients with onset time of 1-3 days were selected for the study. Among them, 86 patients refused thrombolytic treatment and chose to adopt traditional treatment, which was categorized as the control group; 52 patients adopted superselective ophthalmic artery thrombolytic treatment, which was categorized as the observation group. The visual acuity of the patients treated with traditional modality on the 4th day after the onset of the disease and the visual acuity of the patients treated with superselective ophthalmic artery thrombolysis on the 1st postoperative day were recorded, and the visual acuity improvement after different modalities of treatment was compared between the two groups. RESULTS: In the control group, 77 (89.5%) of the treated patients had no improvement in visual acuity, 9 (10.5%) had improvement, 0 (0.0%) had significant improvement, and the total improvement was 9 (10.5%); in the observation group, 18 (34.6%) of the treated patients had no improvement in visual acuity, 21 (40.4%) had improvement, 13 (25.0%) had significant improvement, and the total improvement was 34 (65.4%). The total improvement rate of treatment in the observation group was 65.4%, which was significantly higher than the 10.5% in the control group, and the difference was statistically significant (p < 0.05). CONCLUSION: Superselective ophthalmic artery thrombolysis for patients with CRAO is clinically effective, promotes improvement in patient vision, and has a high safety profile.


Assuntos
Fibrinolíticos , Artéria Oftálmica , Oclusão da Artéria Retiniana , Terapia Trombolítica , Acuidade Visual , Humanos , Oclusão da Artéria Retiniana/diagnóstico , Oclusão da Artéria Retiniana/tratamento farmacológico , Oclusão da Artéria Retiniana/fisiopatologia , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Terapia Trombolítica/métodos , Fibrinolíticos/uso terapêutico , Idoso , Resultado do Tratamento , Adulto , Seguimentos , Ativador de Plasminogênio Tecidual/administração & dosagem , Ativador de Plasminogênio Tecidual/uso terapêutico
3.
BMC Surg ; 24(1): 139, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38714953

RESUMO

BACKGROUND: Ophthalmic artery aneurysm (OAA) can be secured in endovascular or microsurgical approaches. Still there are controversies in technique selection and their long term outcomes. METHODS: All the patients with OAA were treated microsurgically and followed. Demographic data, neurological status, physical examination findings, angiographic data, operation details, and intraoperative and postoperative events were recorded and analyzed. P < 0.05 was considered significant. RESULTS: Among 55 patients, 38 were females (69.1%). Median preoperative glasgow coma scale (GCS), Fisher Grade, and Hunt and Hess(HH) scores were 15, 1 and 1, respectively. The most common neurologic manifestation was visual problems (n = 15). The most common anatomical projection was medial (43.6%) oriented lesions. 85.5% of them only had 1 ophthalmic aneurysm while multiple aneurysms were reported in 14.6%. In 52 patients temporary clip was used. in 21 patients (38.2%) intraoperative aneurysm rupture occurred. Larger aneurysm size and preoperative hydrocephalus were associated with higher rates of aneurysm rupture (P = 0.003 and 0.031). 28.5% of the patients with visual problems had clinical improvement in the postoperative period. The mean follow-up period was 5 years. Follow-up angiography showed a 100% obliteration rate with a 0.0% recurrence rate. Median values for follow-up glasgow outcome scale and modified Rankin scale were 5 and 0, respectively. favorable neurological outcomes were associated with better primary GCS and HH scores. CONCLUSION: OAA microsurgery is an effective and safe procedure with significant improvement in both visual and neurological status. Low recurrence rate and excellent clinical recovery are the most important advantages of microsurgery in OAA treatment.


Assuntos
Aneurisma Intracraniano , Microcirurgia , Artéria Oftálmica , Humanos , Feminino , Masculino , Microcirurgia/métodos , Pessoa de Meia-Idade , Artéria Oftálmica/cirurgia , Adulto , Seguimentos , Aneurisma Intracraniano/cirurgia , Aneurisma Intracraniano/complicações , Idoso , Resultado do Tratamento , Estudos Retrospectivos , Adulto Jovem , Adolescente
4.
Clin Neurol Neurosurg ; 241: 108289, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38692117

RESUMO

OBJECTIVE: Transcranial Doppler ultrasound (TDUS), computed tomography angiography (CTA), and transcranial Doppler ultrasound to detect cerebral blood flow are among the adjunctive tests in diagnosing brain death. This study aimed to investigate the effectiveness of orbital doppler ultrasound (ODUS). METHODS: This prospective, single-blind study included 66 patients for whom brain death was to be diagnosed. Primary outcome measures were ODUS measurements, Ophthalmic artery peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive indices (RI) measurements recorded during the brain death determination process. Secondary outcome measures were computed tomography angio (CTA), transcranial Doppler ultrasound (TDUS), and demographic data. RESULTS: This study investigating the effectiveness of ODUS in diagnosing brain death provided diagnostic success with 100% sensitivity and 93% specificity compared to CT angiography. It was noted that anatomical variations may limit its use. CONCLUSION: ODUS was found to have high sensitivity and specificity in the diagnosis of clinical brain death. It may assist in early prognostic assessment and shorten patient follow-up and diagnostic processes.


Assuntos
Morte Encefálica , Ultrassonografia Doppler Transcraniana , Humanos , Morte Encefálica/diagnóstico por imagem , Morte Encefálica/diagnóstico , Masculino , Feminino , Pessoa de Meia-Idade , Método Simples-Cego , Adulto , Estudos Prospectivos , Ultrassonografia Doppler Transcraniana/métodos , Idoso , Angiografia por Tomografia Computadorizada/métodos , Adulto Jovem , Artéria Oftálmica/diagnóstico por imagem , Sensibilidade e Especificidade , Circulação Cerebrovascular/fisiologia , Adolescente , Órbita/diagnóstico por imagem , Órbita/irrigação sanguínea
7.
Eur Arch Otorhinolaryngol ; 281(5): 2761-2765, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38498188

RESUMO

BACKGROUND: Surgical closure of large nasoseptal perforation (NSP) is challenging. The use of an extended anterior ethmoidal artery (eAEA) flap to reconstruct NSP may present with difficulties for NSPs which have their upper edge in a high position. METHOD: We propose adding a "donut-shape" flap from surrounding septal tissue to the eAEA flap. Thus, the inverted edges of this flap allow to cover the uppermost aspect of the NSP. A series of 18 patients with complete closure of NSPs was included. CONCLUSION: This novel "Boot-on-Donut" technique consisting of the eAEA flap (Boot) and inverted edges (Donut) is a feasible procedure that allows to reconstruct large NSP located superiorly.


Assuntos
Perfuração do Septo Nasal , Humanos , Perfuração do Septo Nasal/cirurgia , Resultado do Tratamento , Endoscopia/métodos , Retalhos Cirúrgicos/irrigação sanguínea , Artéria Oftálmica , Septo Nasal/cirurgia
8.
Aesthetic Plast Surg ; 48(9): 1698-1705, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38480656

RESUMO

BACKGROUND: Knowledge of the anatomy of the infraorbital artery (IOA) is crucial for the rejuvenation of the anterior medial aspect of the midface; however, studies adequately describing the anatomy of the IOA branches are lacking, and their connection with the ophthalmic artery branches remains unclear. OBJECTIVES: This study aims to elucidate the anatomical characteristics of the IOA in its deployment within the lower eyelid using three-dimensional (3D) technology, thereby offering an anatomical foundation for clinical surgical procedures. METHODS: An analysis was conducted on computed tomography scans of 132 cadaveric head sides post-contrast injection, utilizing the Mimics software for reconstruction. The study focused on examining the anastomosis of the IOA, its principal branches, and the branches emanating from the ophthalmic artery. RESULTS: The prevalence of type I IOA was observed at 38.6% (51/132), while Type II IOA was found in 61.4% (81/132) of cases. A 7.6% incidence (10/132) of IOA directly anastomosing with the angular artery was noted. The presence of palpebral branches (PIOA) was identified in 57.6% (76/132) of instances. In the lower eyelid, four distinct distribution patterns of IOA were discerned: The likelihood of Type I PIOA was 5.3%, whereas for Types IIA, IIB, and IIC PIOA, the probabilities were 8.3%, 32.6%, and 11.4%, respectively. The occurrence of the orbital branch of IOA was recorded at 41.7% (55/132). CONCLUSIONS: 3D technology can map IOA variants and identify the deployment patterns of IOA branches in the lower eyelid vascular vesicles at high resolution as a guide in clinical practice. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Cadáver , Imageamento Tridimensional , Tomografia Computadorizada por Raios X , Humanos , Tomografia Computadorizada por Raios X/métodos , Feminino , Masculino , Pálpebras/irrigação sanguínea , Pálpebras/diagnóstico por imagem , Pálpebras/anatomia & histologia , Órbita/irrigação sanguínea , Órbita/diagnóstico por imagem , Órbita/anatomia & histologia , Artéria Oftálmica/anatomia & histologia , Artéria Oftálmica/diagnóstico por imagem , Idoso , Pessoa de Meia-Idade , Variação Anatômica , Idoso de 80 Anos ou mais , Artérias/anatomia & histologia , Artérias/diagnóstico por imagem , Relevância Clínica
10.
Aesthetic Plast Surg ; 48(11): 2190-2196, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38429528

RESUMO

BACKGROUND: There are serious complications associated with hyaluronic acid (HA) facial injections, including vision impairment due to retinal artery ischemia. In this study, we put forth a clinically relevant model of retinal ischemia and reperfusion in rabbit. We used this to verify the efficacy of hyaluronidase intra-artery thrombolysis in the treatment of hyaluronic acid-induced retinal artery occlusion. METHODS: Retinal artery ischemia was induced by injecting HA into the ophthalmic artery (OA) of adult chinchilla rabbit, and reperfusion was achieved by intra-artery thrombolysis therapy with hyaluronidase following 60 min and 4 h of occlusion. Digital subtraction angiography (DSA) and fundus fluorescein angiography (FFA) were used to evaluate blood flow in the retina. Electroretinogram (ERG), hematoxylin and eosin staining and transmission electron microscope were used to evaluate the structure and function of the retina after ischemia and reperfusion following 60 min and 4 h of occlusion. RESULTS: DSA and FFA images confirmed occlusion of the ophthalmic and central retinal arteries, as well as reperfusion after hyaluronidase thrombolysis. ERG indicated retinal dysfunction following ischemia, and thrombolysis partially rescued its impairment following 4 h of occlusion. Hematoxylin and eosin staining and TUNEL staining revealed ischemia-induced histological damages in the retina at different time windows, and hyaluronidase thrombolysis partially mitigated these damages. CONCLUSIONS: We report a method to establish a HA-induced retinal artery occlusion animal model. Hyaluronidase intra-artery thrombolysis was used to recanalize the embolized OA at different time points. Using our method, we achieved retinal reperfusion, and an improvement was observed in the visual function of rabbits after hyaluronidase thrombolysis following 4 h of occlusion. We believe that hyaluronidase intra-artery thrombolysis is an effective method to treat HA-induced retinal artery occlusion in clinic. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Modelos Animais de Doenças , Ácido Hialurônico , Hialuronoglucosaminidase , Oclusão da Artéria Retiniana , Terapia Trombolítica , Animais , Coelhos , Oclusão da Artéria Retiniana/tratamento farmacológico , Oclusão da Artéria Retiniana/induzido quimicamente , Hialuronoglucosaminidase/uso terapêutico , Hialuronoglucosaminidase/administração & dosagem , Ácido Hialurônico/administração & dosagem , Terapia Trombolítica/métodos , Angiofluoresceinografia/métodos , Eletrorretinografia , Artéria Oftálmica , Angiografia Digital , Masculino
11.
Cardiovasc Intervent Radiol ; 47(4): 407-415, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38509339

RESUMO

Retinoblastoma is the most common eye malignancy in children that if left untreated can invade intraocular structures, metastasize, and rarely lead to death. Traditionally treated with systemic chemotherapy, Intra-arterial chemotherapy is gaining popularity as it allows for the direct administration of chemotherapy through the ophthalmic artery, thus reducing systemic side effects. Intra-arterial chemotherapy procedures have evolved, with refinements to reduce risks and radiation exposure. Intra-arterial chemotherapy boasts an impressive technical success rate and one year ocular survival even amongst advanced cases. This review offers a thorough examination of the technique, indications, contraindications, outcomes, and alternative options for Intra-arterial chemotherapy.


Assuntos
Exposição à Radiação , Neoplasias da Retina , Retinoblastoma , Criança , Humanos , Lactente , Retinoblastoma/induzido quimicamente , Retinoblastoma/tratamento farmacológico , Neoplasias da Retina/induzido quimicamente , Neoplasias da Retina/tratamento farmacológico , Infusões Intra-Arteriais , Artéria Oftálmica/patologia , Melfalan/uso terapêutico , Estudos Retrospectivos
12.
BMC Ophthalmol ; 24(1): 89, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38413884

RESUMO

BACKGROUND: To evaluate the changes in retrobulbar circulation after strabismus surgery and to assess the relationship of these changes with choroidal thickness (CT). METHODS: This prospective study included 26 eyes of 26 patients who underwent strabismus surgery and 15 eyes of 15 healthy individuals as control group. The patients who had single horizontal muscle surgery were included in Group 1 (n = 14); and those who had surgery on both horizontal muscles were included in Group 2 (n = 12). Peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI) and pulsatility index (PI) of ophthalmic artery (OA), posterior ciliary artery (PCA), and central retinal artery (CRA) were measured using Color Doppler Ultrasonography. Subfoveal CT was measured via Optical Coherence Tomography. All measurements were obtained preoperatively, at 1st week and 1st month after surgery. RESULTS: There were no differences regarding preoperative blood flow velocity parameters among the groups. OA RI increased significantly at 1st week and 1st month after surgery in Group 1 and 2 (P = 0.029 and P = 0.045, respectively). There was a significant increase in PCA PSV at 1st week in Group 1 (P = 0.002). There was no difference between the mean preoperative and postoperative CT among the 3 groups. A negative correlation between the percentage changes of CT and CRA EDV was found in Group 2 (P = 0.011). CONCLUSION: Single and double horizontal rectus muscle surgery have a measurable effect on retrobulbar hemodynamics but these changes do not correlate with CT.


Assuntos
Artéria Retiniana , Estrabismo , Humanos , Estudos Prospectivos , Órbita , Hemodinâmica/fisiologia , Artéria Retiniana/diagnóstico por imagem , Artéria Oftálmica , Velocidade do Fluxo Sanguíneo/fisiologia , Corioide , Ultrassonografia Doppler em Cores/métodos , Estrabismo/cirurgia
13.
Clin Exp Ophthalmol ; 52(3): 365-373, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38380782

RESUMO

Injectable dermal fillers continue to increase in popularity in aesthetic medicine. Although rare, vision loss secondary to filler injections is a devastating complication associated with a poor visual prognosis. The mechanism for vision loss is thought to be related to retrograde embolization of the dermal filler from peripheral vessels in the face into the ophthalmic arterial system. Early recognition and prompt management are essential if vision is to be salvaged. The use of retrobulbar hyaluronidase is still contentious, however when administered by a specialist, this treatment gives the best chance at visual recovery and should be considered for all cases.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Humanos , Preenchedores Dérmicos/efeitos adversos , Injeções , Transtornos da Visão , Artéria Oftálmica , Ácido Hialurônico , Técnicas Cosméticas/efeitos adversos , Hialuronoglucosaminidase
14.
Curr Eye Res ; 49(6): 631-638, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38384233

RESUMO

PURPOSE: To compare blood pressure (BP), intraocular pressure (IOP), ophthalmic artery flow (OAF) velocity, retinal nerve fiber layer (RNFL) thickness, and visual fields in newly diagnosed hypertension (HT) patients (before treatment), chronic HT (on antihypertensive medications >5 years) and normotensives. METHODS: A prospective, cross-sectional study at a tertiary care centre in India. Three groups of 45 patients each: group 1 - early HT, group 2 - chronic HT, and Group 3 - normotensives, underwent evaluation of BP, IOP by Goldmann applanation tonometry (GAT), OAF velocity by transcranial doppler (TCD), RNFL analysis by spectral-domain optical coherence tomography (SD-OCT), and visual fields. RESULTS: The BP was highest in early HT > chronic HT > normotensives (p < 0.001). The IOP of early HT, chronic HT, and normotensives were 15.87 ± 2.19 mmHg, 13.47 ± 1.92 mmHg, and 15.67 ± SD 1.75 mmHg (p < 0.001). The OAF velocity [peak systolic velocity (PSV), end-diastolic velocity (EDV) in cm/sec] was lowest in chronic HT (30.80 ± 7.05, 8.58 ± 1.58) < early HT (35.47 ± 5.34, 10.02 ± 1.74) < normotensives (36.29 ± 4.43, 10.44 ± 2.29), (p < 0.001). The average RNFL thickness was significantly lower in chronic HT (p = 0.022). The PSV, EDV, and MFV showed significant correlation with IOP (r = 0.247, p = 0.004; r = 0.206, p = 0.016; r = 0.266, p = 0.002) and average RNFL thickness (r = 0.309, p= <0.001; r = 0.277, p = 0.001; r = 0.341, p < 0.001). CONCLUSIONS: Patients with chronic HT demonstrated the lowest retrobulbar flows, IOP and lower RNFL measurements. Lower ocular perfusion may be associated with lower IOP and may be a risk factor for end-organ damage (RNFL) independent of IOP.


Assuntos
Pressão Sanguínea , Hipertensão , Pressão Intraocular , Fibras Nervosas , Fluxo Sanguíneo Regional , Células Ganglionares da Retina , Tomografia de Coerência Óptica , Tonometria Ocular , Campos Visuais , Humanos , Pressão Intraocular/fisiologia , Estudos Transversais , Masculino , Feminino , Estudos Prospectivos , Fibras Nervosas/patologia , Tomografia de Coerência Óptica/métodos , Células Ganglionares da Retina/patologia , Pessoa de Meia-Idade , Velocidade do Fluxo Sanguíneo/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Pressão Sanguínea/fisiologia , Campos Visuais/fisiologia , Hipertensão/fisiopatologia , Hipertensão/complicações , Doença Crônica , Artéria Oftálmica/fisiopatologia , Artéria Oftálmica/diagnóstico por imagem , Artéria Oftálmica/fisiologia , Adulto
15.
BMC Cardiovasc Disord ; 24(1): 100, 2024 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-38341582

RESUMO

BACKGROUND: Dolichoectasia is a rare arterial condition characterized by the dilatation, tortuosity, and elongation of cerebral blood vessels. The vertebrobasilar artery and internal carotid artery are the common sites of dolichoectasia. However, dolichoectasia of the branch arteries, such as the ophthalmic artery (OA), is extremely rare. To the best of our knowledge, this is the first case of ophthalmic dolichoectasia that was successfully treated with endovascular internal coil trapping. CASE PRESENTATION: A 54-year-old female patient presented with transient left ophthalmalgia and visual disturbance. Magnetic resonance imaging revealed a dilated and elongated left OA compressing the optic nerve at the entrance of the optic canal. However, a previous image that was taken 17 years back revealed that the OA was normal, which suggested the change in dolichoectasia was acquired. Cerebral angiography showed that the dilated and tortuous OA was running from the ophthalmic segment of the left internal carotid artery into the orbit. The symptoms could have been attributed to the direct compression of the dolichoectatic OA in the optic canal. A sufficient anastomosis between the central retinal artery and the middle meningeal artery was identified on external carotid angiography with balloon occlusion of the internal carotid artery. Endovascular treatment with internal trapping of the OA was performed due to ophthalmic symptom progression. Internal coil trapping of the OA was performed at the short segment between the OA bifurcation and the entrance of the optic canal. As expected, the central retinal artery was supplied via the middle meningeal artery after the treatment. The transient visual disturbance was immediately resolved. Ophthalmalgia worsened temporarily after the treatment. However, it completely resolved after several days of oral corticosteroid therapy. Postoperative angiography showed that the origin of the OA was occluded and that the OA in the optic canal was shrunk. The flow of the central retinal arteries via the middle meningeal artery was preserved. CONCLUSIONS: OA dolichoectasia is rare, and its pathogenesis and long-term visual prognosis are still unknown. However, endovascular therapy can improve symptom by releasing the pressure site in the optic canal.


Assuntos
Procedimentos Endovasculares , Artéria Oftálmica , Feminino , Humanos , Pessoa de Meia-Idade , Artéria Oftálmica/diagnóstico por imagem , Artéria Oftálmica/cirurgia , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/cirurgia , Angiografia Cerebral , Imageamento por Ressonância Magnética , Dilatação Patológica
16.
Sci Rep ; 14(1): 3495, 2024 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-38347086

RESUMO

Soft tissue filler injections are among the most popular facial rejuvenation methods. Cerebral infarction and ophthalmic artery occlusion are rare and catastrophic complications, especially when facial cosmetic fillers are injected by inexperienced doctors. Radiologists and plastic surgeons need to increase their awareness of the complications associated with fillers, which allows early diagnosis and intervention to improve patient prognosis. Regarding the mechanism by which vascular occlusion occurs after facial filler injections, a retrograde embolic mechanism is currently the predominant theory. Numerous case reports have been presented regarding complications associated with injections of facial aesthetics. However, the small sample sizes of these studies did not allow for an adequate assessment of the clinical and imaging manifestations based on the location of the occlusion and the type of filler, and detailed elaboration of multiple cerebral infarctions is also lacking. Therefore, this study aimed to investigate the clinical and radiological features of severe cerebral and ocular complications caused by cosmetic facial filler injections. In addition, we discuss the pathogenesis, treatment, and prognosis of these patients. The clinical, computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA) findings were described and analysed. Radiological examinations are crucial for demonstrating severe complications, and brain MRI is especially strongly suggested for patients with cosmetic filler-induced vision loss to identify asymptomatic cerebral infarctions. Extreme caution and care should be taken during facial injections by plastic surgeons.


Assuntos
Técnicas Cosméticas , Humanos , Técnicas Cosméticas/efeitos adversos , Estudos Retrospectivos , Artéria Oftálmica , Face/diagnóstico por imagem , Infarto Cerebral/patologia , Ácido Hialurônico
17.
BMC Ophthalmol ; 24(1): 64, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38350897

RESUMO

OBJECTIVE: To evaluate the alterations in retrobulbar color Doppler imaging (CDI) parameters and retinal/choroidal optical coherence tomography angiography (OCTA) parameters and their association with the clinical activity and severity in thyroid-associated orbitopathy (TAO) patients. METHODS: In this study, the retrobulbar flow parameters including resistance index (RI), Pulsatile Index(PI), peak systolic velocity (PSV) and end diastolic velocity (EDV) in posterior ciliary artery (PCA), central retinal artery (CRA) and ophthalmic artery (OA) were determined by CDI. Moreover, the retina and choroidal vascularity including the superficial vessel density (SVD), deep vessel density (DVD), choroidal thickness (ChT) and choroidal vascularity, including total choroidal area (TCA), luminal area (LA), stromal area (SA) and Choroidal Vascularity Index (CVI), were determined by OCTA. All patients grouped as active TAO and inactive TAO based on Clinical activity score (CAS). We picked the severe eye among the subjects and compared all parameters between two groups. We analyzed the correlations among those parameters. RESULTS: There was a significant difference in CAS score, proptosis value, ChT, LA, CVI between patients with active TAO and inactive TAO. In the active group, PSV and EDV of PCA were significantly higher than the inactive group. On logistic regression analysis, CAS was closely associated with PSV-PCA. On multiple linear regression, proptosis value was closely associated with ChT, LA, SA and CVI. CONCLUSION: Choroidal vascularization and retrobulbar blood flow were concurrently higher in active TAO patients and several variables in choroid circulation was closely related to TAO clinical features.


Assuntos
Oftalmopatia de Graves , Humanos , Estudos Transversais , Órbita/diagnóstico por imagem , Artéria Oftálmica/diagnóstico por imagem , Corioide , Ultrassonografia Doppler em Cores/métodos , Velocidade do Fluxo Sanguíneo/fisiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-38367956

RESUMO

AIM: The study aimed to define the coursing pattern of the anterior ethmoidal artery in the orbit to minimize complications during endoscopic interventions. MATERIALS AND METHODS: A total of ten formalin-fixed cadaveric halves were included in the study. Orbital regions were shown with a superior approach. The superior rectus and superior oblique muscles, as well as the connective tissue and vessels were removed to observe the path of the anterior ethmoidal artery. Measurements such as the width of the artery, the anterior-posterior length of the U formation, the length of the intraorbital part of the ophthalmic artery, and the distance of the AEA from its opthalmic origin to the anterior ethmoidal foramen were made. RESULTS: Ten of the AEAs originated from the ophthalmic artery. The AEA branches originated from the ophthalmic artery approximately 18.4 mm after the orbital artery entered the orbital, and the mean width of the AEAs was 0.82 mm. In seven of the total anterior ethmoidal arteries, they coursed in the intraethmoidal cavities below the cranial base. The mean distance from the origin of AEAs to the medial wall of the orbit was 4.9 mm. After leaving the ophthalmic artery, seven of the AEAs were coursing forward and turned back ('U' turn formation), which have proximately 1.5 mm in anteroposterior direction. CONCLUSION: The anterior ethmoidal artery is 0.8 mm wide, originates from the distal part of the ophthalmic artery, entering the orbit after a 1.5 mm U-turn.

19.
Arch Gynecol Obstet ; 310(1): 461-467, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38252305

RESUMO

PURPOSE: To investigate the effect of intravenous MgSO4 on maternal cerebral hemodynamics as well as the association between altered Doppler indices of the ophthalmic arteries and ocular lesions in patients with preeclampsia. METHODS: After each of the 15 included patients was diagnosed with preeclampsia, MgSO4 was infused followed by transcranial Doppler tests of the indices of the ophthalmic, anterior, middle, posterior cerebral, vertebral, and basilar arteries, followed by a second MgSO4 infusion. The peak, mean, diastolic velocity, and pulsatile and resistance indices of each artery were automatically measured during testing. Based on the emergent data, the cerebral perfusion pressure, resistance-area product, and cerebral flow index were calculated. RESULTS: The cerebral perfusion pressure of the posterior cerebral arteries significantly decreased following the infusion of MgSO4 (p < 0.05). Before the infusion of MgSO4, cerebral perfusion pressure and cerebral flow index of the ophthalmic arteries were significantly increased (p < 0.05) in the preeclamptic pregnant patients with ocular lesions compared those without ocular lesions. After the infusion of MgSO4, the cerebral perfusion pressure and cerebral flow index of both ophthalmic arteries were slightly decreased, but the difference was not significant. CONCLUSIONS: Altered Doppler indices following the infusion of MgSO4 suggest significant changes in the hemodynamics of the posterior cerebral and ophthalmic arteries that are particularly related to the neurological signs and symptoms of women with preeclampsia. These findings may improve the understanding of the mechanism of the cerebral complications of preeclampsia. Advancing comprehension of these underlying mechanisms is postulated to play a pivotal role in the mitigation of hypertensive encephalopathy associated with preeclampsia.


Assuntos
Circulação Cerebrovascular , Sulfato de Magnésio , Artéria Oftálmica , Pré-Eclâmpsia , Ultrassonografia Doppler Transcraniana , Humanos , Feminino , Pré-Eclâmpsia/fisiopatologia , Pré-Eclâmpsia/tratamento farmacológico , Sulfato de Magnésio/administração & dosagem , Gravidez , Adulto , Artéria Oftálmica/diagnóstico por imagem , Circulação Cerebrovascular/efeitos dos fármacos , Adulto Jovem , Velocidade do Fluxo Sanguíneo/efeitos dos fármacos
20.
Invest Ophthalmol Vis Sci ; 65(1): 35, 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38241030

RESUMO

Purpose: The purpose of this study was to evaluate comparatively the changes in HIF-1ɑ, EPO, sICAM-1, hemodynamic, and electrophysiological parameters during the progression of non-proliferative diabetic retinopathy (NPDR). Methods: This retrospective longitudinal study included 82 patients with NPDR, who were divided into 2 groups: group I (n = 40) consisted of patients without progression of NPDR after 1 year and group II (n = 42) included patients with the transition of NPDR to proliferative diabetic retinopathy (PDR). The hemodynamics of the eye was assessed by Doppler ultrasonography. The glial hypoxia index Cg was calculated using ERG. The serum levels of hypoxia-inducible factor 1-a (HIF1-α), soluble intercellular adhesion molecule-1 (sICAM-1), and erythropoietin (EPO) were determined by ELISA method. Results: In group II, resistive index (RI), short posterior ciliary arteries (SPCAs) increased significantly from 0.62 ± 0.005 to 0.65 ± 0.007 (P = 0.003), being higher than the corresponding parameter in group I (P = 0.013). In group II, there was an increase in the hypoxia index Cg (5.56 ± 0.05) relative to the primary indicators and in group I (P < 0.001). In group II, HIF1-ɑ, EPO, and sICAM-1 levels after a year significantly increased (0.213 ± 0.02 ng/mL, 37.7 ± 2.4 mIU/mL, and 576.3 ± 11.9 ng/mL, respectively) both relative to the main indicators and the values in group I (P < 0.001). When EPO exceeds 27.5 mIU/mL, a high risk of progression of NPDR to the initial stages of PDR is predicted. Conclusions: The glial Cg index and the level of HIF1-a, EPO in the serum of patients with progression of NPDR were initially higher than in patients without progression of NPDR and have increased during the year, indicating the development of PDR due to more severe hypoxia.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Humanos , Retinopatia Diabética/diagnóstico , Estudos Retrospectivos , Estudos Longitudinais , Microcirculação , Artéria Oftálmica
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