1,721,004 research outputs found
Tumors of the Optic Nerve and Its Sheath
No full textThe tumors of the optic nerve may arise from the nerve itself or from its sheath. Benign gliomas and meningiomas are the most frequent types, whereas other histological types are exceptional. Benign tumors cause slowly progressive visual loss and variable proptosis. The radiological diagnosis is rather easy for gliomas and meningiomas. The observation is justified in patients with preserved or stable vision. The surgery is often delayed because of the significant risk of visual worsening. Pediatric benign gliomas often respond to chemotherapy. Patients with optic nerve sheath meningiomas may be treated by stereotactic radiosurgery. However, the visual prognosis is more often poor. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023
Epithelioid myoepithelioma of lacrimal gland.
No full textA rare case of myoepithelioma of the lacrimal gland composed exclusively of epithelioid cells is described.A 57-year-old female had been complaining for 1 month of progressive swelling of the temporal region of the left orbit. Computed tomography scan revealed a lesion involving the left lacrimal gland. The lesion was entirely removed en-bloc along with the lacrimal gland. Grossly, the tumour was a well-circumscribed 3.5×25×1.5 cm mass. An extensive sampling was performed. The surgical specimen was routinely formalin fixed and paraffin embedded. Sections 5-m thick were obtained and stained with haematoxylin-eosin. Immunostaining was performed on 5-m serial sections. Histologically, the lesion showed a solid pattern of growth and was composed exclusively of cells with epithelioid (plasmacytoid) features. Atypical myoepithelial cells, abnormal mitotic figures, necrosis and invasive growth throughout the tumour were absent.
Myoepithelioma of the lacrimal gland is extremely rare, and thus far only seven cases have been reported. Of these cases, two were considered malignant and one potentially malignant . All but one showed spindle to cuboidal cells arranged in a solid or trabecular pattern .
Myoepithelial cells are generally immunoreactive for S-100, vimentin, cytokeratin, desmin, m-actin and sm-actin. There is a considerable variation in the immunoreactivity for these antigens in our case, as in the seven previously reported cases. These differences may be dependent on the degree of differentiation .The size of the tumour prompted us to recommend a careful clinical follow-up. The patient had an uneventful post-operative course, and there has been no evidence of relapses over 24 months of follow-up
Management of the optic canal invasion and visual outcome in spheno-orbital meningiomas.
No full textOBJECTIVE: Spheno-orbital meningiomas often present with visual deficit due to invasion of the optic canal by the tumor. This study discusses the reasons of visual impairment, the choice of the surgical approach according to the type of optic canal involvement, and the factors correlated to the visual outcome in patients harboring a spheno-orbital meningioma.
MATERIALS AND METHODS: A surgical series of 60 spheno-orbital meningiomas is reviewed. The preoperative visual symptoms, the involvement of the optic canal in both neuroradiological studies and surgical descriptions, the different surgical approaches are reviewed. These data are correlated with the postoperative visual outcome.
RESULTS: The 60 spheno-orbital meningiomas were classified in 4 types according to the intraorbital tumor localization: type I, supero-lateral (18 cases); type II, inferomedial (8 cases); type III, orbital apex (22 cases); type IV, diffuse (12 cases). Thirty-six of the 60 patients (60%) had variable decrease of the visual acuity on the tumor side. Forty-three patients (71.6%) had tumor extension into the optic canal on imaging studies. On the whole, 36 patients among 43 with invasion of the optic canal (83.7%) had preoperative visual dysfunction; on the
other hand, none among 17 patients without tumor invasion of the optic canal had visual dysfunction. The surgical approaches according to the tumor location were
as follows. A supraorbital-pterional approach was used in the 8 inferomedial tumors, in the 22 orbital apex tumors, and in 9/12 diffuse tumors; these last two types had concentric involvement of the optic canal. Three diffuse tumors with significant extension in the infratemporal fossa were operated on via a frontotemporal-orbitozygomatic approach. A wide decompression of the optic canal was performed in all cases, excepting in two inferomedial tumors without optic canal invasion. The 18 patients with lateral tumors were approached via a lateral orbitocranial approach, including removal of the sphenoid wing and lateral orbital wall without bone flap; the resection of the lateral aspect of the optic canal was performed in the 3 cases with canal invasion. Postoperative improvement
of the visual function was observed in 18 of 36 cases with visual dysfunction (50%). The rate of visual improvement was significantly higher in cases with lateral involvement (3/3 or 100%) than in those with concentric involvement of
the optic canal (11/27 or 40.7%).
CONCLUSION: The invasion of the optic canal by the tumor is the main reason of visual dysfunction in patients with spheno-orbital meningiomas. A wide opening of the optic canal must be performed routinely in patients with orbital apex and diffuse orbital tumors, where there is concentric invasion of the optic canal wall. In these cases the supraorbital-pterional approach is the technique of choice. In selected cases with lateral intraorbital tumors and invasion of the lateral aspect of the optic canal the complete tumor resection coupled with good
decompression of the optic nerve may be achieved via a less invasive lateral orbitocranial approach without craniotomy
Comparison between echographic and histological findings in choroidal malignant melanomas.
No full textEvaluation of vessel density in disorganization of retinal inner layers after resolved diabetic macular edema using optical coherence tomography angiography.
Full text linkPurposeTo evaluate the retinal vessel density (VD) in the macular region and the foveal avascular zone (FAZ) area using optical coherence tomography angiography (OCTA) in patients with and without disorganization of retinal inner layers (DRILs) after resolution of diabetic macular edema.MethodsThirty-seven eyes of 37 DRIL patients (mean age 63 ± 13.97 years), 30 eyes of 30 no DRIL patients and 35 eyes of 35 controls were enrolled in this study. We evaluated the VD in the macular region of superficial capillary plexus (SCP), deep capillary plexus (DCP) and FAZ area.ResultsDRIL and no DRIL groups showed decreased VD in SCP and DCP (pConclusionOCTA highlights the role of retinal vascular ischemia in the pathogenesis of DRILs. This parameter could represent an important functional predictive factor in diabetic patients
Prospective Study of Vessel Density by Optical Coherence Tomography Angiography After Intravitreal Bevacizumab in Exudative Age-Related Macular Degeneration
Full text linkINTRODUCTION:
The aim of this study was to evaluate retinal and choriocapillaris (CC) vessel density, using optical coherence tomography angiography (OCTA), in the macular region at baseline and after three once-monthly intravitreal injections of bevacizumab (loading phase) in patients affected by exudative age-related macular degeneration (AMD).
METHODS:
A total 38 eyes of 38 patients with exudative AMD (16 women, 22 men; mean age 72.47 ± 7.46 years) were included in this study. We evaluated vessel density in different macular areas (whole image, fovea and parafovea) of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and CC. In addition, central macular thickness (CMT) and choroidal thickness in the foveal region and 500 μm in the nasal and temporal directions were analyzed by enhanced depth image-OCT.
RESULTS:
There were no significant differences in vessel density in the SCP, DCP and CC after the loading phase compared to baseline (p > 0.05). In contrast, CMT (p = 0.039; 320.63 ± 175.05 vs. 372.47 ± 167.05 μm) and subfoveal choroidal thickness (SFCT) (p 0.05) at baseline and after the loading phase. Also, best corrected visual acuity did not correlate with CMT, SCP and DCP at baseline and after treatment (p > 0.05).
CONCLUSION:
Macular and choroidal thickness did not correlate with vessel density, but probably correlated to vascular exudation. The anti-VEGF treatment, acting on vascular hyperpermeability, determines the reduction of the retinal and choroidal exudation, resulting in a decrease of their thicknesses. Consequently, these parameters could reflect the effectiveness of the anti-VEGF injections for treating exudative AMD respect to OCTA parameter
Cytotoxicity, Mitochondrial Functionality, and Redox Status of Human Conjunctival Cells after Short and Chronic Exposure to Preservative-Free Bimatoprost 0.03% and 0.01%: An In Vitro Comparative Study
Full text linkProstaglandin analogues (PGAs), including bimatoprost (BIM), are generally the first-line therapy for glaucoma due to their greater efficacy, safety, and convenience of use. Commercial solutions of preservative-free BIM (BIM 0.03% and 0.01%) are already available, although their topical application may result in ocular discomfort. This study aimed to evaluate the in vitro effects of preservative-free BIM 0.03% vs. 0.01% in the human conjunctival epithelial (HCE) cell line. Our results showed that long-term exposure to BIM 0.03% ensues a significant decrease in cell proliferation and viability. Furthermore, these events were associated with cell cycle arrest, apoptosis, and alterations of ΔΨm. BIM 0.01% does not exhibit cytotoxicity, and no negative influence on conjunctival cell growth and viability or mitochondrial activity has been observed. Short-time exposure also demonstrates the ability of BIM 0.03% to trigger reactive oxygen species (ROS) production and mitochondrial hyperpolarisation. An in silico drug network interaction was also performed to explore known and predicted interactions of BIM with proteins potentially involved in mitochondrial membrane potential dissipation. Our findings overall strongly reveal better cellular tolerability of BIM 0.01% vs. BIM 0.03% in HCE cells
Endovascular occlusion of dural cavernous fistulas through a superior ophthalmic vein approach.
No full textA rare case of bilateral conjunctival Kaposi's sarcoma in a HIV-negative patient
Full text linkPurpose: Kaposi's sarcoma (KS) is a rare multi-centric vascular neoplasm, first described by Moritz Kaposi in 1872. It can appear in four different forms: classic, endemic, HIV-related and post-transplant form. We present an uncommon case of seronegative HIV infection patient with skin KS involving conjunctiva of both eyes. Observations: Firstly, right eye lesions were surgically removed. Subsequently, the patient was administered with systemic chemotherapy (doxorubicin) to treat both skin and left eye lesions. No signs of recurrence were observed at 20 months' follow-up. Conclusions: Both eyes involvement in KS is rarely described in scientific literature. Both surgery and chemotherapy could be considered valid treatment options for conjunctival KS
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