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At least 1,765 records · Page 98Linked to original sources
PubMed2005

Minimally invasive orbital decompression: local anesthesia and hand-carved bone.

OBJECTIVE: To investigate the safety and efficacy of a conservative orbital decompression using sharp-curette bony decompression and intraconal fat debulking through a transconjunctival incision in patients with thyroid-related orbitopathy and mild to moderate proptosis. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS AND METHODS: Data from all patients undergoing minimal orbital decompression at the Jules Stein Eye Institute, Los Angeles, Calif, over a period of 4(1/4) years were collected and analyzed. Data included visual acuity, exophthalmometry measurements, intraocular pressure, complete slitlamp examination results, ocular ductions, new-onset primary or downgaze diplopia, and patient satisfaction. Conservative decompression was performed through a transconjunctival incision using a manual curette and by removing cortical bone from the zygomatic marrow space on the anterior rim of the inferior orbital fissure; intraconal fat was bluntly dissected and excised or suctioned with a Frasier tip aspirator. MAIN OUTCOME MEASURES: Patient perception of pressure pain and ocular discomfort, proptosis, visual acuity, intraocular pressure, postoperative complications, and new-onset primary or downgaze diplopia. RESULTS: Eighty minimally invasive orbital decompression surgeries were performed in 48 patients (6 male, 42 female). Six surgeries (4 patients) were performed for prominent globes with relative proptosis and no thyroid-related orbitopathy (non-Graves proptosis). All patients had improvement in congestive orbitopathy and pressure pain associated with thyroid-related orbitopathy. Exophthalmos decreased by a mean +/- SD of 2.4 +/- 2.6 mm from 22.7 +/- 2.5 mm (range, 17-29 mm) to 20.3 +/- 2.3 mm (range, 14-25 mm) (P<.001 [95% confidence interval, 1.8-3.0]). Mean visual acuity improved after surgery (P = .02). One patient (2.1%) developed postoperative primary or downgaze diplopia; he underwent successful eye muscle surgery at a later stage. No complications were associated with orbital decompression. CONCLUSIONS: Minimally invasive orbital decompression surgery with intraconal fat debulking in this group of patients was effective in proptosis reduction; improvement in subjective pressure pain and high patient satisfaction were noticed. Surgery was associated with a low rate (2.1%) of new-onset primary or downgaze diplopia. Proptosis reduction using a graded approach accounting for 4 mm of retrodisplacement was achieved.

Adipose Tissue↗
PubMed1975

Teratogenicities of ophthalmic drugs. I. Antiviral ophthalmic drugs.

Nonradioactive idoxuridine (IDU,5-iodo-2'-deoxyuridine), while not teratogenic to rats, does produce fetal maliformations in rabbits when administered topically to the eye in doses similar to those used clinically, 0.1% four times a day for 12 days. These maliformations include exophthalmos and clubbing of the forelegs. By contrast, trifluorothymidine (F3TdR), another highly effective antiherpetic agent currently under investigation but not available for general use, was found not to be teratogenic to rabbits, even when given in concentrations tenfold greater than the doses used to produce idoxuridine teratogenicity.

Administration, Topical↗
PubMed1980

Pseudotumor of the orbit and retroperitoneal fibrosis. A form of multifocal fibrosclerosis.

A patient with advanced renal failure and bilateral exophthalmos was found to have urinary obstruction caused by retroperitoneal fibrosis, as well as bilateral orbital pseudotumors. Pseudotumor of the orbit, especially when bilateral, has been associated with a wide variety of systemic conditions. Although the association of pseudotumor and retroperitoneal fibrosis is uncommon, any patient with bilateral orbital pseudotumor and renal insufficiency should be examined for the possible presence of a treatable urinary obstruction.

Aged↗
PubMed1983

Sector B-scan ultrasonographic 'hemangiomalike' pattern.

Eleven patients with unilateral exophthalmos had sector B-scan ultrasonography. The ultrasonograms were all similar and demonstrated a "hemangiomalike" pattern consisting in a rounded, well-outlined orbital mass with a sharp anterior border, moderate to strong tissue reflectivity, and fair to good sound transmission. Although the postoperative pathologic findings in six cases confirmed the presence of cavernous hemangioma of the orbit, other lesions, such as hemangiopericytoma, lymphangioma, orbital varix, meningioma, and mixed cell tumor, were found to show a similar ultrasonographic pattern.

Diagnosis, Differential↗
PubMed1996

Angiosarcoma metastatic to the orbit.

Angiosarcoma is a rare malignant endothelial cell tumor. Few reports of primary orbital angiosarcoma exist in the literature. A 46-year-old woman had a 3-month history of progressive diplopia and right-sided exophthalmos. Magnetic resonance imaging showed a right intraconal mass, consistent with a cavernous hemangioma. Ultrasound examination showed a isolated mass with moderate vascularity, consistent with a metastatic lesion. Subtotal excision through a lateral orbitotomy was performed. Tissue was stained with hematoxylineosin, periodic acid-Schiff, and immunohistochemical stains for factor-VIII-related antigen and Ulex europaeus agglutinin I lectin. Lateral orbitotomy biopsy specimens showed an angiosarcoma, similar to a primary breast angiosarcoma that had been resected 2 years previously. The patient initially underwent orbital exenteration for her only known metastasis. Despite a multidisciplinary and aggressive approach to this tumor, the tumor recurred, and the patient died.

Breast Neoplasms↗
PubMed1997

A case of Erdheim-Chester disease with orbital involvement.

The Erdheim-Chester disease is a rare idiopathic, systemic, histiocytic disorder. To our knowledge, ocular involvement has been reported in only 16 cases. We describe a 55-year-old man who had symmetrical exophthalmos and several skin nodules on the arms and trunk. A magnetic resonance imaging scan confirmed the presence of bilateral, intraconal, retrobulbar tumors. An examination of the histopathologic features of orbital and skin biopsy specimens revealed xanthogranulomatous infiltrate with Touton giant cells. Further systemic investigations showed bone and retroperitoneal involvement. Three years later, multiple eyelid xanthelasmas developed in the patient. These findings are consistent with the diagnosis of the Erdheim-Chester disease. The patient's condition is stable under therapy with low-dose corticosteroids. His survival is longer than usually described in the literature.

Bone Diseases↗
PubMed1998

Teebi hypertelorism syndrome with tetralogy of Fallot.

A 34-month-old boy presented with clinical manifestations of Teebi hypertelorism syndrome including prominent forehead with frontal bossing, hypertelorism, exophthalmos due to shallow orbits, a short and broad nose with anteverted nares, small hands and feet with interdigital webbing, umbilical hernia, and shawl scrotum. In addition, he had previously undescribed manifestations including tetralogy of Fallot, bilateral inguinal testes, and bifid scrotum. His phenotypically normal mother showed splayed labiae majora during her pregnancy, a possible manifestation of the syndrome.

Child, Preschool↗
PubMed1980

Primary meningioma of the nasal cavity and paranasal sinuses.

A case of primary meningioma of the nasal cavity and ethmoidal sinus of a 65-year-old man is described. The clinical and pathologic characteristics of the 18 cases previously reported in the literature are reviewed. Although the histological features and biological behavior of the tumors were found to be similar to that of intracranial meningioma, primary meningiomas of the nasal cavity and paranasal sinuses were found more often to involve male patients and young individuals. Meningiomas should be considered in the differential diagnosis of any lesion in a young patient with progressive exophthalmos, nasal obstruction, or episodes of epistaxis. The pathogenesis of extracranial meningiomas is briefly discussed.

Age Factors↗
PubMed2006

New cases of Bohring-Opitz syndrome, update, and critical review of the literature.

We report on four additional unrelated cases of Bohring-Opitz syndrome with the highly characteristic phenotype of facial anomalies including bulging forehead over the metopic suture, frontal nevus flammeus, exophthalmos, hypertelorism, upslanting palpebral fissures, and cleft lip and/or palate, as well as flexion deformities of the upper limbs, multiple other anomalies, and severe failure to thrive. We also update the clinical outcome of the patients reported in the original article by Bohring et al. [Am J Med Genet 85:438-446] and critically review the subsequently published cases considered to have Bohring-Opitz syndrome.

Abnormalities, Multiple↗
PubMed2006

Variability in the efficacy of interferon-alpha in Erdheim-Chester disease by patient and site of involvement: results in eight patients.

OBJECTIVE: Erdheim-Chester disease (ECD) is a rare, non-Langerhans form of histiocytosis of unknown origin, characterized by infiltration of tissues by spumous histiocytes. ECD features heterogeneous systemic manifestations, and the general prognosis remains poor despite various treatment options. METHODS: We treated 8 patients with multisystemic ECD with subcutaneous interferon-alpha (IFNalpha) at a dosage of 3-9 x 10(6) units 3 times weekly, for a median duration of 23 months (range 1-46 months). RESULTS: Treatment was generally well tolerated, and side effects remained limited to fever following injections. Treatment was discontinued in 1 patient, because of severe depression. During treatment, some manifestations of ECD disappeared (i.e., xanthelasma, exophthalmos, papilledema, and intracranial hypertension). The efficacy of IFNalpha on cardiovascular ECD was variable, however. Treatment resulted in partial regression of "coated aorta" in some cases and clear failure in others; 2 patients died. The level of C-reactive protein diminished sharply in 5 patients. CONCLUSION: IFNalpha might be a valuable first-line therapy for prolonged treatment of ECD. However, the efficacy of IFNalpha varies among patients and according to the sites of disease involvement, and symptoms may fail to respond to treatment, especially in patients with severe multisystemic forms of ECD with central nervous system and cardiovascular involvement.

Adolescent↗
PubMedDate not supplied

Prenatal sonographic diagnosis of Neu-Laxova syndrome.

We report the sonographic diagnosis of Neu-Laxova syndrome in a fetus at 27 weeks' menstrual age. The parents were first cousins. Sonography revealed microcephaly, a sloping forehead, exophthalmos, a small thorax and abdomen, hypoplastic lungs, syndactyly, hyperextended knees, polyhydramnios, a small placenta, and intrauterine growth restriction. The long bones were normal. The calvaria was hyperechoic and associated with shadowing, obscuring any intracranial abnormalities. This sonographic finding was presumed to represent calvarial calcification, not previously described with this syndrome. We believe that Neu-Laxova syndrome can be reliably diagnosed prenatally by demonstrating the sonographic features described, although other conditions with similar sonographic features need to be considered in the differential diagnosis.

Abnormalities, Multiple↗
PubMed1983

Secondary vascular glaucoma.

Secondary vascular glaucoma is increased intraocular pressure due to venous obstruction in or outside the eye. Its main aetiological features are lesions of the vortex veins and the anterior ciliary veins and orbital and cavernous sinus obstruction; increase in orbital volume, tenonitis/scleritis posterior and idiopathically elevated episcleral venous pressure are described. In 8 out of 148 patients with exophthalmos of various aetiology an abnormal difference in intraocular pressure between the eyes was found, but only 3 of them (2%) had glaucoma; this frequency equals the glaucoma frequency in an average population. In 3 out of 10 patients with tenonitis/scleritis posterior an elevated intraocular pressure was found, in contrast with the normal intraocular pressure found in 20 patients with orbital pseudotumour. Six patients with secondary vascular glaucoma due to elevated episcleral venous pressure of unknown origin were examined; 3 of them had unilateral, the other 3 bilateral, typical lesions. All were female and above the age of 40 years. In contrast with the findings in other investigations, in 3 of these 6 patients orbital neuro-ophthalmological lesions were found.

Adult↗
PubMed1989

The permeability of the corneal epithelium of Graves' ophthalmopathy as determined by fluorophotometry.

The function of the corneal epithelium was evaluated in 30 patients with Graves' ophthalmopathy in whom no signs of corneal disease were observed. This function was evaluated by determining the permeability values of the corneal epithelium for fluorescein using fluorophotometry. The permeability values of the patients were compared with those of 46 healthy individuals. A significant increase in the permeability values was seen in 11 (37%) patients and in two (4%) controls (p less than 0.05). The difference in the mean permeability values between patients en controls was statistically significant (0.053 nm/sec. +/- 0.043 SD and 0.038 nm/sec. +/- 0.017 SD, respectively, p less than 0.05). No relation was found between the permeability values of the corneal epithelium and the NOSPECS classification or the duration of the disease. There was a tendency for increased permeability values in patients having an exophthalmos larger than 20 mm. (correl. coeff. = + 0.3, p less than 0.05).

Adult↗
PubMed1977

Computed tomography or orbital lesions. A cooperative study of 210 cases.

Computed tomography (CT) has given us a new method for examining the orbit and its contents. The technique of examination is described, and the indications for the application of computed tomography in ophthalmology are considered: suspected orbital tumors, unilateral exophthalmos, pareses of the ocular muscles, traumatic lesions and malformations in the region of the orbit. The findings in 210 cases of orbital lesions examined in this study are reported and the differential diagnosis is discussed. Considerable improvement and greater accuracy in diagnosis have been achieved in the field of ophthalmology by using computed tomography. Early tumor visualization is possible without risk or discomfort to the patient.

Abscess↗
PubMed1977

A new ultrasonic apparatus for ophthalmology using manuel compound scanning.

A new ultrasonic equipment for ophthalmological diagnosis has been developed. Manual compound scanning using water immersion made acurate representation of cross-section of the orbital structure possible. A large, focused transducer brought resolution and sensitivity. Gray scale display of the ultrasonogram increased information concerning intensity of echoes. Ultrasonograms of retinoblastoma, vitreous hemorrhage, melanocytoma, optic disc coloboma and unilateral exophthalmos are presented.

Child↗
PubMed1980

The diagnostic value of computed tomography in orbital diseases. A cooperative study of 520 cases.

Computed tomography (CT) has given us a new method for examining the orbit and its contents. The indications for the application of computed tomography in ophthalmology are considered: suspected orbital tumors, unilateral exophthalmos, pareses of the ocular muscles, traumatic lesions and malformations in the region of the orbit. The findings in 520 cases of orbital lesions examined in this study are reported and the differential diagnosis is discussed. Considerable improvement and greater accuracy in diagnosis have been achieved in the field of ophthalmology by using computed tomography. Early tumor visualization is possible without risk or discomfort to the patient.

Cranial Nerve Neoplasms↗
PubMed1994

A cranial invasion model of human neuroblastoma using congenitally athymic mice.

Even though the current limits of treatment for advanced stage neuroblastoma require an understanding of biology and new therapeutic approaches, few invasion models of human neuroblastoma (HNB) which evaluate experimental therapies have been reported. We describe herein a reproducible murine model of cranial invasion after the intraocular xenograft of HNB in congenitally athymic mice. Approximately 10 weeks after the intraocular injection of 5 x 10(6) NB-1 HNB cells, 70% (14/20) of the mice developed intracranial invasion with skull involvement. There was no operative mortality. Macroscopically, deformities of the cranium were revealed in all 14 mice, 5 of which developed exophthalmos. Microscopically, cranial invasion mainly involved the extradural space, skull, and orbita; however, brain involvement could not be seen, indicating that the dura may act as a barrier. These invasive characteristics are very similar to those seen in humans; thus, we believe that this model provides a useful tool for evaluating the biology of, and new therapeutic approaches against, cranial invasion of neuroblastoma in vivo.

Animals↗
PubMed1991

Relationship of eye muscle antibodies with HLA phenotypes and thyroid-stimulating immunoglobulins in endocrine orbitopathy.

The relationship between endocrine orbitopathy and Graves' hyperthyroidism is still not clarified. The purpose of this study was to elucidate the incidence of eye muscle antibodies and the relationship with HLA phenotypes and thyroid antibodies in 65 patients with endocrine orbitopathy classes 1-5. Both bovine and abdominal muscles were used as antigens in ELISA systems in which IgG and IgM antibodies were assayed. Before starting the immunosuppressant therapy, 46/65 patients (71%) showed a positive result for eye muscle antibodies. Those patients with an active disease had such antibodies more frequently. Where the ophthalmopathy was of recent onset IgM antibodies were found, whereas patients with chronic disease were mostly IgG-Ab positive. No association was found either with HLA phenotypes (B8, DR3) or with antibodies directed against thyroglobulin, thyroid microsomes, and the TSH receptor measured as thyroid-stimulating immunoglobulins. Furthermore, there was no correlation between ophthalmopathy class and optic muscle antibody-binding activity. There was no relation between the degree of exophthalmos and eye muscle, thyroid-stimulating, antithyroglobulin, or antithyroid microsomal antibodies. These results suggest that, although very closely related, endocrine orbitopathy and Graves' hyperthyroidism are separate, organ-specific autoimmune diseases.

Adolescent↗