1,721,092 research outputs found
Gunshot orbital wounds
No full textFour cases of orbital gunshot wounds are described in this article. The first patient attempted suicide. The bullet crossed his right orbit and ethmoidal sinus and stopped in his left ethmoidal sinus, partially penetrating in the left orbit. The right eye had no light perception because of an undirect optic neuropathy. The second patient was shot during a war by a sniper in his left orbit. His left eye had no light perception because of a total retinal detachment-the bullet had remained deep in the orbit. In these first two cases, the projectile was successfully removed by a transconjunctival orbitotomy. The third patient and fourth patient accidently shot themselves several years previously. They both had a severe bilateral traumatic optic neuropathy. Plain X-ray films and coronal and axial computed tomography scan with bone window are the most effective imaging techniques in foreign body location and orbital, bulbar, and cranial damage evaluation. Foreign body removal should be always considered because of local and general reactions caused by lead and copper; but intraoperative projectile localization may result unexpectedly difficult. Early medical treatment of traumatic optic neuropathies is advised
Diagnosis and treatment of orbital hemorrhagic lesions
No full textOrbital hemorrhagic lesions include a group of heterogeneous conditions that may be idiopathic or caused by trauma, surgery, or preexisting vascular tumors or malformations. We report clinical, computed tomographic, and magnetic resonance imaging features of eight cases of orbital hemorrhage (2 cystic lymphangiomas, 2 subperiosteal hematomas, 1 traumatic hematoma, 1 hemorrhagic varix, 1 cholesterol granuloma, and 1 postsurgical hemosiderin deposit). The differential diagnosis of orbital hemorrhagic lesions may be difficult because of their relative rarity and nonspecific presentation. In particular, on computed tomography, cholesterol granulomas may simulate a lacrimal gland epithelial tumor and subperiosteal hematomas, a lymphoid tumor. Magnetic resonance imaging is an ideal imaging technique because of its ability to identify blood and blood products in all stages of degradation. Treatment can be limited to observation in varices, lympohangiomas, and trauma if vision is not threatened; otherwise, surgical blood drainage should be attempted. Cholesterol granulomas are best treated by curettage through an extraperiosteal orbitotomy. For subperiosteal acute or subacute hemorrhages, surgical drainage is recommended if the blood is not spontaneously reabsorbed within a few weeks
Colobomatous ocular cyst excision with globe preservation
No full textColobomatous ocular cyst is a rare malformation consisting of a cavity lined by neuroectodermic tissue and communicating with the vitreous cavity, generally associated with microphthalmos. The usual treatment for unsightly cases is enucleation and cyst excision, followed by prosthesis fitting. The authors treated a case of colobomatous ocular cyst associated with a mild microphthalmos by cyst excision and pedicle ligature, via a transconjunctival orbitotomy. The postoperative appearance was satisfactory. Pathology confirmed a thick fibrous wail with calcifications, lymphocytic infiltrates, and neruofilaments and internally lined by dysplastic retinal elements. A conservative approach is advised for colobomatous cysts associated with a globe almost normally in size, in order to avoid cosmetic complications associated with enucleation in childhood
Primary and secondary orbital melanomas: a clinical and prognostic study
No full textThe clinical, radiologic, and histologic features of 14 cases of orbital melanoma are reviewed. Two cases were presumed to be primary orbital melanomas because no primary pigmented lesion was found in the globe, conjunctiva, or skin. Five cases originated from a conjunctival melanoma, one case from an eyelid cutaneous melanoma, and the remaining six patients had extrascleral extension of a choroidal melanoma. Four patients at the time of first diagnosis already had extraorbital metastases (one patient with extrascleral extension of a choroidal melanoma also had a metastasis to the opposite orbit). The median time interval between diagnosis and metastasis was 14 months. Patients without metastatic disease received radical surgery (partial or total orbital exenteration, in addition to regional lymph node resection if indicated) or conservative treatment (tumor excision plus chemotherapy and interferon). Log-rank test showed an equally poor prognosis for both groups (median time to metastasis was, respectively, 19.5 and 8 months), with no statistically significant difference between the two groups. The authors' reconstructive techniques (dermis-fat grafting and transplantation of temporalis muscle) following partial- and total orbital exenteration are described
Mri In Graves Orbitopathy - Recognition of Enlarged Muscles and Prediction of Steroid-response
No full textThe purpose of this study is to compare MRI to CT in the recognition of Graves orbitopathy and to compare MRT to clinical examination in the prediction of steroid response. Sixteen patients with dysthyroid orbitopathy (21 orbits) were examined by CT and MRI; muscle enlargement was measured by ultrasonography. Sensitivity in recognizing enlarged muscles was 85.4% for CT and 61.2% for MRI; CT recognized all affected orbits but 1, while MRI failed in 4 cases. Clinical inflammatory signs (p = 0.17) were more reliable predictors of steroid response than muscular T-2 hyperintensity on MRI (p = 0.64). In a patient where histological examination documented edematous changes, MRI failed to reveal edema. MRI adds no morphologic information to CT; moreover, T-2 intensity is less specific than clinical examination in documenting active disease and forecasting therapeutic outcome
Painful ophthalmoplegia caused by superior ophthalmic vein thrombosis
No full textA diabetic 69-year-old woman experienced a sudden painful ophthalmoplegia (third, fourth, and sixth cranial nerves) in the left eye, with visual loss and corneal hypesthesia, due to superior ophthalmic vein thrombosis. This was revealed by magnetic resonance imaging (MRI). Left eye fundus was characterized by an atrophic optic disc and by obliteration of all retinal vessels. The authors recommend early use of MRI in order to diagnose vascular affections, which may benefit by early appropriate therapy
Aeterna memoria. Forme della memoria funeraria nel mondo classico, Atti del Convegno (Gaeta, 8-11 maggio 2024)
No full textIn vivo confocal microscopy in a patient with conjunctival lymphoma
No full textA case of primary conjunctival mucosa-associated lymphoid tissue lymphoma studied by in vivo corneal confocal microscopy (IVCM) is described for the first time. Examination of the lower mediobulbar and forniceal conjunctiva of the left eye of a 37-year-old female patient showed a typical salmon-pink patch. IVCM examination of the conjunctival lesion showed irregular, polygonal, conjunctival bulbar epithelial cells with blurred edges and without visible nucleus. Many small, roundish, hyper-reflective cells were also seen. These cells were arranged diffusely or in nests in cyst-like hypo-reflective spaces. A few highly reflective cells were also visible among deep stromal collagen fibres. The IVCM picture recalled the histological profile of low-grade mucosa-associated lymphoid tissue lymphoma, characterized by sheets of neoplastic cells around reactive follicles. IVCM enabled non-invasive evaluation of the eye surface at high magnification and with good contrast, and could be useful for early differential diagnosis of conjunctival lesions. © 2007 The Author Journal compilation © 2007 Royal Australian and New Zealand College of Ophthalmologists
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