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Assayag E, Tsessler M, Wasser LM, Drabkin E, Reich E, Weill Y, Zadok D, Nair AG, Andron A. Telemedicine comes of age during coronavirus disease 2019 (COVID-19): An international survey of oculoplastic surgeons. Eur J Ophthalmol 2021; 31:2881-2885. [PMID: 33073613 PMCID: PMC8606803 DOI: 10.1177/1120672120965471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 09/19/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE The Coronavirus disease 2019 (COVID-19) pandemic is an ongoing healthcare crisis that continues its worldwide spread. Ophthalmologists are at high risk of acquiring and transmitting the virus. Telemedicine platforms have evolved and may play an important role in attenuating this risk. For patients, these platforms provide the possibility of clinic consultation without the concerns of a clinic visit. We aimed to assess the utilization of telemedicine by oculoplastics specialists worldwide during the COVID-19 pandemic. METHODS A 13-item survey was distributed internationally to practicing oculoplastic surgeons. Collected data included demographics, clinical practice variables and perceptions regarding telemedicine. Significance of associations and single survey items was evaluated by Chi-squared and z-score of proportions tests, respectively. RESULTS The questionnaire was completed by 70 oculoplastic surgeons (54.3% male, mean age 47.3 years, median experience 10 years) from eight countries, practicing in various clinical settings (50.0% hospitals, 45.7% private clinics, 4.3% community clinics). Most respondents reported telemedicine to be an effective tool for oculoplastic consultations (67.1%, p = 0.004), while only 12.8% (p < 0.00001) had incorporated this modality into clinical practice prior to the pandemic. Even though a vast majority (98.6%) of participants had limited outpatient activity, most (55.7%) felt unprotected from the virus. Telemedicine had been incorporated by 70.5% (p = 0.001) of respondents during the COVID-19 pandemic, whereas most (57.1%) predicted continued use of the modality. CONCLUSION Telemedicine can be effectively and rapidly incorporated into the clinical practice of oculoplastic surgeons during the COVID-19 pandemic. Further research into the most effective utilization of these platforms appears warranted.
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Affiliation(s)
- Elishai Assayag
- Department of Ophthalmology, Shaare Zedek Medical Center, affiliated with the Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Maria Tsessler
- Department of Ophthalmology, Shaare Zedek Medical Center, affiliated with the Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Lauren M Wasser
- Department of Ophthalmology, Shaare Zedek Medical Center, affiliated with the Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Elena Drabkin
- Department of Ophthalmology, Shaare Zedek Medical Center, affiliated with the Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Ehud Reich
- Department of Ophthalmology, Shaare Zedek Medical Center, affiliated with the Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Yishay Weill
- Department of Ophthalmology, Shaare Zedek Medical Center, affiliated with the Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - David Zadok
- Department of Ophthalmology, Shaare Zedek Medical Center, affiliated with the Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Akshay Gopinathan Nair
- Ophthalmic Plastics and Ocular Oncology Services, Aditya Jyot Eye Hospital, Mumbai, Maharashtra, India
| | - Aleza Andron
- Department of Ophthalmology, Shaare Zedek Medical Center, affiliated with the Hebrew University-Hadassah Medical School, Jerusalem, Israel
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Andron A, Peleg U, Genzel C, Drabkin E. Masquerading solitary plasmacytoma; an eyelid lump in disguise. Oman J Ophthalmol 2021; 14:42-44. [PMID: 34084034 PMCID: PMC8095310 DOI: 10.4103/ojo.ojo_147_2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/02/2020] [Accepted: 10/25/2020] [Indexed: 11/04/2022] Open
Abstract
Solitary plasmacytoma is a rare orbital lesion, most commonly appearing in patients with multiple myeloma. We report a case of a 75-year-old woman who presented with a left upper eyelid lesion, initially misdiagnosed and treated as a chalazion. Histopathological testing revealed plasmacytoma originating from the frontal sinus. This case demonstrates a rare presentation for this malignancy.
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Affiliation(s)
- Aleza Andron
- Shaare Zedek Medical Center, Oculoplastic Unit, Jerusalem, Israel
| | - Uri Peleg
- Shaare Zedek Medical Center, Oculoplastic Unit, Jerusalem, Israel
| | - Chezi Genzel
- Shaare Zedek Medical Center, Oculoplastic Unit, Jerusalem, Israel
| | - Elena Drabkin
- Shaare Zedek Medical Center, Oculoplastic Unit, Jerusalem, Israel
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Andron A, Hostovsky A, Nair AG, Sagiv O, Schiby G, Simon GB. The impact of IgG-4-ROD on the diagnosis of orbital tumors: A retrospective analysis. Orbit 2017; 36:359-364. [PMID: 28829660 DOI: 10.1080/01676830.2017.1337192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 05/28/2017] [Indexed: 06/07/2023]
Abstract
This study was to determine the prevalence of immunoglobulin G4 (IgG4)-related orbital disease (IgG4-ROD) among patients who have previously undergone biopsy and were diagnosed to have idiopathic orbital inflammatory disease (IOID) or orbital lymphoproliferative disease (OLD), namely, lymphoma and benign reactive lymphoid hyperplasia (BRLH). This is a retrospective cross-sectional study. The charts and slides of all patients who underwent biopsies and were histopathologically diagnosed to have either IOID or OLD were reviewed. Demographics, clinical features, initial histopathological diagnoses, treatment received, and final outcome were noted. Using the diagnostic criteria for diagnosis for IgG4 disease, those cases that would classify as "possible IgG4-related disease (IgG4-RD)" were reviewed, reclassified, and reassigned a diagnosis of IgG4-ROD. We reviewed 105 patients' clinical charts. Of these 105 patients, upon reviewing the histopathology, 18 (17.15%) patients were found to fit the diagnostic criteria for possible IgG4-ROD. Of these 18 patients who were now reassigned the diagnosis of IgG4-ROD, the most common previous histopathological diagnosis was found to be IOID, for eight patients (44%), then BRLH, which was noted in five patients (27.8%), followed by lymphoma, which was noted in two patients (11.1%). Previously diagnosed cases of IOID and OLD were found to fulfill the criteria for IgG4-ROD. Given the advent of recent diagnostic and histopathological techniques, all cases of suspected IOID and OLD should be screened for IgG4-ROD and all previously diagnosed cases must be closely followed up, given the systemic implication of IgG4-RD. Histopathological reassessment of previously diagnosed cases may be considered.
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Affiliation(s)
- Aleza Andron
- a New York Eye and Ear Infirmary of Mount Sinai , New York , New York , USA
| | | | | | - Oded Sagiv
- b Sheba Medical Center , Tel Hashomer , Israel
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Abstract
Plasmacytoma is an uncommon presentation of plasma cell malignancy, especially in the absence of multiple myeloma. Orbital plasmacytomas generally originate from bone, although few cases in the literature report orbital extramedullary plasmacytomas. We present the case of a 68-year-old man found to have a solitary extramedullary plasmacytoma in the lateral rectus muscle without further evidence of multiple myeloma. This case demonstrates a rare presentation for such a malignancy, and a review of the literature highlights the importance of proper workup and close monitoring to rule out multiple myeloma to guide management.
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Affiliation(s)
- Phillip A Tenzel
- a Department of Ophthalmology , New York Eye and Ear Infirmary of Mount Sinai , New York , New York , USA
| | - Kapil Mishra
- a Department of Ophthalmology , New York Eye and Ear Infirmary of Mount Sinai , New York , New York , USA
| | - Aleza Andron
- a Department of Ophthalmology , New York Eye and Ear Infirmary of Mount Sinai , New York , New York , USA
| | - Robert C Della Rocca
- a Department of Ophthalmology , New York Eye and Ear Infirmary of Mount Sinai , New York , New York , USA
| | - Harsha S Reddy
- a Department of Ophthalmology , New York Eye and Ear Infirmary of Mount Sinai , New York , New York , USA
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Nair AG, Kamal S, Dave TV, Mishra K, Reddy HS, Della Rocca D, Della Rocca RC, Andron A, Jain V. Surgeon point-of-view recording: Using a high-definition head-mounted video camera in the operating room. Indian J Ophthalmol 2016; 63:771-4. [PMID: 26655001 PMCID: PMC4728975 DOI: 10.4103/0301-4738.171506] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To study the utility of a commercially available small, portable ultra-high definition (HD) camera (GoPro Hero 4) for intraoperative recording. METHODS A head mount was used to fix the camera on the operating surgeon's head. Due care was taken to protect the patient's identity. The recorded video was subsequently edited and used as a teaching tool. This retrospective, noncomparative study was conducted at three tertiary eye care centers. The surgeries recorded were ptosis correction, ectropion correction, dacryocystorhinostomy, angular dermoid excision, enucleation, blepharoplasty and lid tear repair surgery (one each). The recorded videos were reviewed, edited, and checked for clarity, resolution, and reproducibility. RESULTS The recorded videos were found to be high quality, which allowed for zooming and visualization of the surgical anatomy clearly. Minimal distortion is a drawback that can be effectively addressed during postproduction. The camera, owing to its lightweight and small size, can be mounted on the surgeon's head, thus offering a unique surgeon point-of-view. In our experience, the results were of good quality and reproducible. CONCLUSIONS A head-mounted ultra-HD video recording system is a cheap, high quality, and unobtrusive technique to record surgery and can be a useful teaching tool in external facial and ophthalmic plastic surgery.
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Affiliation(s)
- Akshay Gopinathan Nair
- Department of Ophthalmic Plastic Surgery and Ocular Oncology, Advanced Eye Hospital and Institute, Navi Mumbai, Maharashtra, India
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Mital S, Andron A, Lamour JM, Hsu DT, Addonizio LJ, Softness B. Effects of Growth Hormone Therapy in Children After Cardiac Transplantation. J Heart Lung Transplant 2006; 25:772-7. [PMID: 16818119 DOI: 10.1016/j.healun.2004.11.317] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2004] [Revised: 11/17/2004] [Accepted: 11/21/2004] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Growth hormone (GH) is used to treat growth failure in children with GH deficiency. The safety and efficacy of GH after pediatric cardiac transplantation is not known. The objective of this study was to evaluate growth and cardiovascular effects of GH in children with growth failure after cardiac transplantation. METHODS Pediatric cardiac transplant recipients who received GH from 1994 to 2004 were evaluated. Growth, cardiac function, hemodynamics and rejection frequency were serially monitored for 2 years before, during and after GH. Eight age-matched heart transplant recipients undergoing a natural growth spurt were evaluated as controls. RESULTS The mean age of subjects at initiation of GH was 13 +/- 3 years (mean duration 2.5 +/- 1 years, n = 10), of whom 3 were GH-deficient. Growth velocity (GV) increased from 2.5 +/- 2 to 8.6 +/- 3 cm/year with GH. There was an increase in left ventricular (LV) shortening fraction (SF; 37 +/- 1% to 41 +/- 1%), LV mass (93 +/- 11 to 118 +/- 15 g/m2), LV volume (138 +/- 14 to 188 +/- 21 ml/m2) and cardiac index (3.1 +/- 0.7 to 4.1 +/- 0.5 liters/min/m2) during GH therapy (p < 0.05). After discontinuation of GH, SF, cardiac index and LV mass returned to normal, but LV volume did not. In control patients, LV volume increased without an increase in SF or mass. Rejection frequency did not change in either group. There were no adverse events related to GH. CONCLUSIONS GH is safe and effective in treating growth failure in children after cardiac transplantation. GH therapy is associated with an increase in LV mass, volume and cardiac output. These changes are partially reversible after discontinuation of GH. The mechanisms and long-term consequences of these changes require further investigation.
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Affiliation(s)
- Seema Mital
- Division of Pediatric Cardiology, Department of Pediatrics, Columbia University, New York, New York, USA.
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Mital S, Andron A, Softness B, Hsu DT, Lamour JM, Addonizio LJ. Effects of growth hormone therapy following pediatric cardiac transplantation. J Am Coll Cardiol 2003. [DOI: 10.1016/s0735-1097(03)81900-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mital S, Andron A, Softness B, Lamour J, Hsu D, Addonizio L. Growth hormone therapy following pediatric cardiac transplantation. J Heart Lung Transplant 2003. [DOI: 10.1016/s1053-2498(02)01129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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