[Ophthalmological surgery education. 23. Evisceration].
Explore the source record for details and available documents.
Eye Evisceration↗
Biomedical subjects
B G Haik
Publications and source records attributed to B G Haik.
A pigmented adenoma of the ciliary epithelium examined by magnetic resonance imaging.
PURPOSE: We studied a case of a pigmented adenoma of the ciliary epithelium. METHODS: We used magnetic resonance imaging in the clinical diagnosis of this tumor. RESULTS: The tumor was successfully treated by local excision. CONCLUSIONS: Magnetic resonance imaging is most useful in evaluating a ciliary body mass for local extension. It cannot clinically distinguish a pigmented adenoma of the ciliary epithelium from a uveal melanoma.
Adenoma↗
Magnetic resonance imaging artifacts induced by ocular prosthesis.
Explore the source record for details and available documents.
Artifacts↗
Adenoid cystic carcinoma of the lacrimal gland: a case report.
A 70-year-old woman was referred to our clinic for evaluation and treatment of a recurring case of adenoid cystic carcinoma of the lacrimal gland. She had been diagnosed with this tumor three years earlier, and a local resection was attempted on two occasions. We encountered this patient on the third recurrence of the tumor, and a thorough work-up revealed extensive local involvement but no metastases. A total exenteration of the right orbit was then performed with aggressive resection of local extension followed by irradiation. Thirteen years later, our patient presented with metastases throughout her scalp. She died shortly thereafter, having survived a total of 16.5 years after the time of her initial treatment and 13 years after exenteration with bony removal of the orbit and irradiation. A review of the literature reveals that this patient had one of the longest reported survival times in the literature from the time of initial treatment. Also noteworthy is the 13 years this patient survived after aggressive surgical resection combined with radiotherapy following two previous incomplete resections.
Aged↗
Hydroxyapatite orbital implant abscess: histopathologic correlation of an infected implant following evisceration.
A 60-year-old diabetic man with a history of ocular trauma and absolute glaucoma underwent evisceration with placement of an 18 mm hydroxyapatite orbital implant. The host scleral shell was left intact with no posterior opening for vascular ingrowth. One year later the patient presented with implant exposure, limited fibrovascular ingrowth into the implant, and a Staphylococcus aureus orbital abscess. The implant was removed, and pathology demonstrated suppurative inflammation with limited vascular ingrowth. This patient's risk factors for an implant-associated wound infection included diabetes, impaired wound healing, history of trauma, early implant exposure, and delayed fibrovascular ingrowth. Awareness of the infectious complications of any orbital implant including hydroxyapatite allows the surgeon to alter management strategies in an attempt to reduce such risk. Surgeons may consider posterior scleral portals with evisceration surgery to facilitate hydroxyapatite vascularization. Patient selection, implant size, and surgical technique are key factors for a management strategy designed to reduce the risk of implant infection.
Abscess↗
Severe enophthalmos following intracranial decompression in a von Recklinghausen patient.
A patient with neurofibromatosis type I and absence of the sphenoid wing developed proptosis of the right eye secondary to expansion of the intracranial contents from an intracranial astrocytoma associated with cerebral edema and hydrocephalus. Marked enophthalmos developed following excision of the intracranial tumor and placement of a ventriculoperitoneal shunt. Absence of the sphenoid bone limited the orbit's ability to halt posterior refraction of the orbital contents when the intracranial volume decreased.
Astrocytoma↗
Patient characteristics, methods of evaluation and treatment of ocular melanoma in the United States for the years 1981 and 1987.
The American College of Surgeons performed a patient care and evaluation study of malignant melanoma for 1981 and 1987 to determine the presenting symptoms, methods of evaluation, clinical management and resulting outcome. A previous report on malignant melanoma of the skin has been published. This report details the findings of 245 ocular melanomas in 1981 and 275 ocular melanomas in 1987. Most of the ocular melanomas were uveal. The patients with ocular melanoma were older than the patients with skin melanoma. No significant difference was found in the number of ocular instances by gender and by study year. A high percentage of non-Hispanic Caucasians were documented with this disease, and a high percentage of ocular melanomas were not classified by the standard Callender classification. A significant number of melanomas had pigmentation, and a significant number of patients had imaging studies that, in the absence of an elevated alkaline phosphatase, usually yielded negative results. Most patients were treated with enucleation, with an increase in frequency of radiation therapy from 1981 to 1987. Local and regional recurrence was not a problem, but systemic metastases occurred frequently. Type of histologic factors by the Callender classification had an influence on survival.
Adult↗
Magnetic resonance imaging of orbital lymphangioma with and without gadolinium contrast enhancement.
BACKGROUND: Lymphangioma is a vascular tumor of the orbit with a propensity for recurrent hemorrhage. These tumors may be difficult to diagnose in young patients who present with sudden proptosis due to hemorrhage into a previously unrecognized lesion. Magnetic resonance imaging (MRI) should be ideally suited for evaluating lymphangioma due to the unique ability of MRI to characterize hemorrhage because of the paramagnetic qualities of hemoglobin. METHODS: The authors performed T1-, T2-, and proton density-weighted MRI on 12 patients with orbital lymphangioma. Six patients underwent MRI with gadolinium-DTPA contrast enhancement. The MRI studies were performed using a 1.5 Tesla super-conducting magnetic resonance unit, except for 3 early studies performed with a 0.5 Tesla unit. All studies were performed with orbital surface coil imaging. Computed tomography (CT) was performed in 10 patients. RESULTS: Tumor was visible on MRI in all 12 patients. Magnetic resonance imaging delineated clearly the internal structure of subacute and chronic hemorrhagic cysts, and differentiated between these tumors because of the different paramagnetic qualities of subacute hemorrhage compared to chronic hemorrhage. In two patients, MRI detected large tumor feeding vessels by the flow void phenomenon unique to MRI. Computed tomography did not detect these vessels. Gadolinium-contrasted T1-weighted MRI did not further delineate or characterize the tumor. CONCLUSION: Magnetic resonance imaging is the modality of choice for imaging orbital lymphangioma because of its unequalled differentiation of hemorrhagic cysts, and its unique ability to detect tumor feeding vessels by the flow void phenomenon.
Contrast Media↗
The radioprotective effects of WR-2721 on radiation-induced goblet cell loss.
We assessed the efficacy of the radioprotective effects of WR-2721 in radiation-induced goblet cell loss. Fourteen female New Zealand white rabbits were divided into radioprotected, radiounprotected, and control groups. Ten rabbits received 5,000 rad of beta irradiation to the temporal conjunctiva of both eyes. The right eyes were pretreated with topical applications of WR-2721 30 minutes and 1 minute before irradiation. The left eyes received irradiation only. Four additional rabbits received neither irradiation nor pretreatment with WR-2721. After a 2-month waiting period, each animal was killed and goblet cell densities per high-power field (GCD/HPF) were determined over the areas in question and compared using paired sample t tests. The mean GCD/HPF for the radioprotected, unprotected, and control groups were 10.93, 4.68, 23.15 (right eye), and 26.25 (left eye). Paired sample t tests showed a significant radioprotective effect when comparing WR-2721-treated animals with those receiving radiation only (p less than 0.003). Independent sample t tests showed significant goblet cell loss in both the radioprotected (p less than 0.018) and radiounprotected eyes (p less than 0) when compared with control groups. These data suggest a radioprotective effect of WR-2721 in radiation-induced goblet cell loss.
Amifostine↗
The ultrastructural defect in conjunctiva from a case of recessive dystrophic epidermolysis bullosa.
The predominant feature in the several forms of epidermolysis bullosa is the formation of cutaneous bullous lesions arising after minimal mechanical trauma. Ocular involvement has been noted as a complication. To our knowledge to date, only four investigators have correlated clinical eye disease with light microscopic findings. Ultrastructure of the ocular lesions has not been described previously. We present four cases of recessive dystrophic epidermolysis bullosa emphasizing their associated ocular complications. Diagnosis was confirmed by skin biopsy specimen and in one patient by demonstrating light and electron microscopic findings in eyelid skin. This tissue exhibited ultrastructural recessive cutaneous lesions; namely, bullous separation occurring below the basal lamina and absence of anchoring fibrils in both bullous and nonbullous areas. By electron microscopy, the conjunctiva in this patient exhibited an absence of clear anchoring fibrils that were numerous in control tissue. This defect may increase the susceptibility of the conjunctiva to minor mechanical trauma, resulting in the bullous and cicatricial changes seen clinically.
Aged↗
Magnetic resonance imaging of choroidal melanoma with and without gadolinium contrast enhancement.
Choroidal melanoma is the most common intraocular tumor and is uniquely suited for evaluation by magnetic resonance imaging (MRI) because of the paramagnetic effect of the melanin molecule. The authors performed T1-, T2-, and proton-density-weighted MRI on 34 patients with choroidal melanoma. Nineteen patients received gadolinium contrast, T1-weighted images were superior in both detecting and delineating tumors, showing increased contrast-to-noise ratios over other images. Gadolinium contrast further increased this ratio. These images are presented as evidence that gadolinium-enhanced MRI is valuable in the evaluation of choroidal melanoma.
Choroid Neoplasms↗
Advanced Coats' disease.
Advanced Coats' disease and retinoblastoma can both present with the triad of a retinal detachment, the appearance of a subretinal mass, and dilated retinal vessels. Thus, even the most experienced observer may not be able to differentiate these entities on ophthalmoscopic findings alone. Coats' disease is the most common reason for which eyes are enucleated with the misdiagnosis of retinoblastoma. Ultrasonography is the auxiliary diagnostic test most easily incorporated into the clinical examination, and can be utilized repeatedly without biologic tissue hazard. Ultrasonically identifiable features allowing differentiation between Coats' disease and retinoblastoma include the topography and character of retinal detachment and presence or absence of subretinal calcifications. Ultrasonography is of lesser use in poorly calcified retinoblastoma and in detecting optic nerve or extraocular extension in heavily calcified retinoblastoma. CT is perhaps the single most valuable test because of its ability to: (a) delineate intraocular morphology, (b) quantify subretinal densities, (c) identify vascularities within the subretinal space through the use of contrast enhancement, and (d) detected associated orbital or intracranial abnormalities. Optimal computed tomographic studies, however, require multiple thin slices both before and after contrast introduction and expose the child to low levels of radiation if studies are repeated periodically. MR imaging is valuable for its multiplanar imaging capabilities, its superior contrast resolution, and its ability to provide insights into the biochemical structure and composition of tissues. It is limited in its ability to detect calcium, which is the mainstay of ultrasonic and CT differentiation. Aqueous LDH and isoenzyme levels were not valuable in distinguishing between Coats' disease and retinoblastoma. The value of aqueous NSE levels in the differentiation of advanced Coats' disease and exophytic retinoblastoma deserves further study. Specimens from patients with intraocular hemorrhage should be viewed cautiously, since erythrocytes contain high levels of enolase. Analysis of subretinal aspirates is an extremely accurate method of confirming the diagnosis of Coats' disease. The key diagnostic findings are the presence of cholesterol crystals and pigment-laden macrophages and the absence of tumor cells on fresh preparations. The technique should be reserved for patients where retinoblastoma has been ruled out by all noninvasive means and massive subretinal drainage is anticipated. The natural progression in advanced Coats' disease is toward the development of a blind, painful eye. Spontaneous regression does rarely occur, and some eyes quietly progress to a phthisical state.(ABSTRACT TRUNCATED AT 400 WORDS)
Child↗
Hematoma of the optic nerve sheath after penetrating trauma.
We have presented a case involving the diagnosis and management of optic nerve sheath hematoma. Our patient's positive outcome demonstrates the usefulness of megadose steroid therapy for acute optic nerve injury.
Adult↗
Harada's disease associated with fibrous dysplasia.
Harada's disease is a well-described entity consisting of bilateral serous retinal detachments and diffuse choroiditis. The etiology of Harada's disease is obscure. Fibrous dysplasia of the orbit is also a well-known entity associated with many orbital and ophthalmologic findings. The defect in fibrous dysplasia appears to be a congenital nonhereditary abnormality in bone-forming mesenchyme. We present a case of Harada's disease and fibrous dysplasia of the orbit. The clinical photographs, fluorescein angiograms, ultrasound study, and histologic specimens are presented.
Adult↗
Gadolinium-DTPA enhancement of an optic nerve and chiasmal meningioma.
The advent of gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA), a magnetic resonance imaging (MRI) contrast agent, has significantly improved MRI's diagnostic accuracy by enabling the physician to separate magnetically similar but histologically different tissues. A patient with optic nerve meningioma, whose tumor was clearly demonstrated on Gd-DTPA-enhanced MRI but did not appear on noncontrast MRI, is described. The usefulness of contrast agents in MRI diagnosis of neuro-ophthalmologic disorders and ophthalmic tumors is emphasized through this case report.
Aged↗
Mascara and eyelining tattoos: MRI artifacts.
Magnetic resonance imaging (MRI) is very useful in the evaluation of ocular and orbital disease. Heavy metal particles, used in the pigment base of mascara and eyelining tattoos, have a paramagnetic effect that causes alteration of the local magnetic field in adjacent tissues. These changes in normal signal result in distortion of the globes. In some cases, the distortion may mimic actual ocular disease such as a ciliary body melanoma or cyst.
Cosmetics↗
Teflon sleeve canalicular splints.
Explore the source record for details and available documents.
Equipment Design↗
Frozen section of the optic nerve in retinoblastoma surgery.
The usefulness of the frozen section examination to determine the extension of retinoblastoma into the optic nerve is discussed. Frozen sections performed at the time of surgery in seven retinoblastoma patients revealed the presence of tumor at the resection margin of the optic nerve in two cases.
Eye Enucleation↗