1
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Ortiz A, Osorio D, Díaz P, Cofre W, Montenegro L, Muñoz T. Orbital ophthalmomiasis due to Dermatobia hominis in an immunosuppressed patient from the ecuadorian andean area. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:180-4. [PMID: 36621638 DOI: 10.1016/j.oftale.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/24/2022] [Indexed: 01/07/2023]
Abstract
An 83-year-old Ecuadorian male, indigent with a history of malnutrition and chronic alcoholism, presented with a clinical feature characterized by progressive growth of larvae at the left eye level (LE), associated with areas of ocular tissue putrefaction. Upon admission, his vision in the right eye (RE) was of hand movement and no light perception in LE, the anterior segment of the RE showed a brunescent cataract, with no other alteration, while the LE presented edema, bipalpebral erythema and an abundant number of mobile larvae distributed throughout the orbit, associated with areas of necrosis, putrefaction and distortion of the anatomy of the ocular tissues. Orbital tomography showed a significant compromise of the orbit, indicating surgical management by left orbital exenteration with taxonomic identification of the larvae as Dermatobia hominis associated with it, antibiotic treatment was implemented and a frontal fasciocutaneous flap was performed by the plastic surgery department.
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2
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Cheng T, Wang F, Denisova K, Barmettler A. Normative exophthalmometry values in Hispanic individuals. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:199-205. [PMID: 36738924 DOI: 10.1016/j.oftale.2023.02.002] [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] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/13/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE Normative exophthalmometry values have been established in Caucasians, Asians, and Black individuals. While prior studies have examined periocular measurements in different racial and ethnic groups, this study is the first to establish a set of normative exophthalmometry values in a Hispanic population in New York City. METHODS This prospective, cross-sectional cohort study was IRB approved and HIPAA compliant. Adult patients self-identifying as Hispanic were included. The degree of ocular prominence (exophthalmometry value, EV) and the inter-orbital distance (Hertel's base, IOD) was obtained by Hertel exophthalmometry. Differences in EV between sexes were evaluated using two sample t-tests. Multivariable linear regression was utilized to determine the effect of age, sex, and body mass index (BMI) on EV. RESULTS Of the 277 Hispanic individuals included, 189 (68.2%) were female and the mean age was 63.0 years (SD = 15.0). The mean Hertel's base and mean EV for all participants was 92.0 mm (SD = 4.1) and 16.7 mm (SD = 2.4), respectively. Average exophthalmometry values for men were significantly higher than women's (17.6 mm and 16.2 mm, respectively, p ≤ 0.001). Higher EVs were positively associated with male gender (ß = -1.60, p < 0.0001) and BMI (ß = 0.084, p = 0.001), but not age. CONCLUSIONS The mean EV in Hispanic individuals is 16.7 mm, higher than that reported for most Caucasians and Asians, but less than that of Black individuals. Higher EV is significantly associated with male sex and increased BMI. This study is the first to create a set of normative exophthalmometry values in a Hispanic population, which may serve as a valuable tool for clinicians to reference when diagnosing and monitoring orbital disease.
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Affiliation(s)
- T Cheng
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States
| | - F Wang
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States
| | - K Denisova
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States
| | - A Barmettler
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States.
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3
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Tresserra F, López-Fortuny M, Martínez-Lanao MA, D'Antin JC, Fernandez M, Barraquer RI. Orbital amyloid tumor associated with myasthenia gravis. Rev Esp Patol 2022; 55 Suppl 1:S7-S10. [PMID: 36075668 DOI: 10.1016/j.patol.2020.06.007] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 06/15/2023]
Abstract
We present a case of a 53-year-old female with an 11 year history of myasthenia gravis (MG) with palpebral ptosis in the left eye which had become more marked over the previous year. Examination revealed a painless left orbital mass causing ptosis. The tumor was surgically removed and histopathology revealed deposits of a hyaline substance which when stained with Congo Red had an apple-green birefringence with polarized light, typical of amyloid. In the absence of amyloid deposits elsewhere in the body, amyloid tumor (AT) was diagnosed. No myelo- or lymphoproliferative syndromes, systemic involvement by amyloidosis or any autoimmune disease were found. The evolution and aesthetic results where satisfactory. Only two cases of orbital AT associated with MG have been described previously; however, in one of the cases, the symptoms of the AT had led to a false diagnosis of MG.
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Affiliation(s)
| | | | | | | | - Melissa Fernandez
- Service of Pathology. Hospital Universitario Dexeus, Barcelona, Spain
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4
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Plazola-Hernández SI, Arroyo-Garza I, Rodríguez-Reyes A. Rapidly progressive orbital intravascular papillary endothelial hyperplasia in a newborn. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:413-416. [PMID: 35779898 DOI: 10.1016/j.oftale.2022.02.001] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/27/2021] [Indexed: 06/15/2023]
Abstract
Intravascular papillary endothelial hyperplasia (IPEH), also known as "vegetant intravascular haemangioendothelioma", is a rare benign proliferation of vascular endothelial cells secondary to intravascular thrombosis and thrombus organisation. It can develop from vascular lesions such as haemangiomas, pyogenic granulomas or varicose veins. This vascular tumour of the skin and subcutaneous tissue may exhibit rapid and progressive growth, and is usually located in the neck or head. Ocular presentation is unusual and orbital involvement is even rarer. We report a case of a preterm newborn male with a rapidly growing left orbital mass that was histologically diagnosed as intravascular papillary endothelial hyperplasia. He was successfully managed with total excision of the tumour and propranolol therapy and remains recurrence free after an eight-year follow-up.
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Affiliation(s)
- S I Plazola-Hernández
- Departamento de Órbita y Oculoplástica, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico.
| | - I Arroyo-Garza
- Departamento de Oftalmología y Ciencias Visuales, Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Nuevo León, Mexico
| | - A Rodríguez-Reyes
- Departamento de Patología Ocular, Hospital Dr. Luis Sánchez Bulnes, Mexico City, Mexico
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5
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Montejano-Milner R, López-Gaona A, Fernández-Pérez P, Sánchez-Orgaz M, Romero-Martín R, Arbizu-Duralde A. Orbital metastasis: Clinical presentation and survival in a series of 11 cases. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:81-88. [PMID: 35152953 DOI: 10.1016/j.oftale.2020.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/21/2020] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Orbital metastases are an uncommon condition. They may be the clinical presentation of a previously unknown malignancy. Depending on the series, the rate of orbital metastasis as a first manifestation of a malignant tumour is 20%-42%. The clinical presentation and survival is presented in a series of 11 cases of orbital metastasis corresponding to 10 patients. MATERIAL AND METHODS Descriptive retrospective study of a series of 10 adult patients diagnosed with orbital metastasis from solid tumours during a 9-year period. Metastasis involving the orbit was included, and lymphomas and contiguity invasions from adjacent structures were excluded. A note was made on whether the clinical picture was the first sign of tumour onset. Signs and symptoms at clinical debut were registered, as were primary tumour location, distance seeding, orbital structures involved, and survival time since the diagnosis was established. RESULTS One-half (50%) of the patients were women. Mean age at diagnosis was 60.9 years (range 42-82). In nine cases (90%), the metastasis was unilateral, while in the remaining one the involvement was bilateral. The most frequent primary tumour location was the breast (36% of the cases); followed by the bladder (27%), lung (18%), and ovary and cavum (9%). Seventy percent of the patients had a previously diagnosed neoplasm; in 3 cases the metastasis was the first malignancy manifestation. Most frequent symptoms were diplopia (60%), visual impairment (40%), and pain (30%). The most common signs were resistance to ocular retropulsion (60%), presence of a mass on orbital palpation, and ocular dystopia (50%), and bulbar hyperaemia and proptosis (40%). The most employed management modality was clinical observation (5 patients). In 3 patients radiotherapy was administered, combining chemotherapy plus hormonal therapy in one case, and orbital exenteration in another one. In 2 cases, chemotherapy was administered as an isolated regime. Median survival time was 4.8 months since the diagnosis. There was a statistically significant difference between the survival time in the observation group (median 2.5 months) and in the active treatment group (median 29.2 months), p=.034. CONCLUSIONS In the series presented, 27% of the cases established the clinical debut of the malignant neoplasm. The ophthalmologist plays an essential role when this condition is suspected, diagnosing it, and proposing its management together with the Oncology Service.
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Affiliation(s)
- R Montejano-Milner
- Servicio de Oftalmología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
| | - A López-Gaona
- Servicio de Oftalmología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - P Fernández-Pérez
- Servicio de Oftalmología, Hospital Universitario La Paz, Madrid, Spain
| | - M Sánchez-Orgaz
- Servicio de Oftalmología, Hospital Universitario La Paz, Madrid, Spain
| | - R Romero-Martín
- Servicio de Oftalmología, Hospital Universitario La Paz, Madrid, Spain
| | - A Arbizu-Duralde
- Servicio de Oftalmología, Hospital Universitario La Paz, Madrid, Spain
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6
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Rachwani-Anil R, Zamorano-Martín F, Rocha-de-Lossada C, García-Lorente M, Pérez-Casaseca C, Hernando-Ayala C, Ortiz-Pérez S. Orbital inflammatory disease. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:89-99. [PMID: 35152954 DOI: 10.1016/j.oftale.2021.05.001] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/17/2021] [Indexed: 06/14/2023]
Abstract
Orbital inflammatory disease (OID), commonly known as orbital pseudotumour, is an inflammatory disease of unknown cause. It has different forms of presentation and different degrees of severity. Its variable nature is the main cause for this disease to be misdiagnosed and misclassified. The prognosis of OID depends on the tissues affected and the histology. OID usually responds favourably to systemic steroid treatment. However, empiric steroids may mask other underlying diseases that respond well to this treatment as well, namely, IgG4-related disease or lymphoproliferative disorders. This fact has led to controversy among various authors as some recommend performing a biopsy in most of the cases, whereas others defend that this procedure should only be performed if the patient has not responded to empiric steroid treatment. Although steroids have been the mainstream treatment of OID, the side effects, relapse rates and lack of response in some cases have resulted in them being replaced by immunosuppressive and immunomodulator therapies that currently stand as a key steroid-sparing treatment option, in addition to radiotherapy and surgery. The aim of this review is to update the evidence on the diagnosis and treatment of OID.
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Affiliation(s)
- R Rachwani-Anil
- Departamento de Oftalmología, Hospital Norte de Málaga, Antequera, Málaga, Spain.
| | - F Zamorano-Martín
- Departamento de Oftalmología, Hospital Regional Universitario-Hospital Civil, Málaga, Spain
| | - C Rocha-de-Lossada
- Qvision: Departamento de Oftalmología, Hospital Vithas Virgen del Mar, Almería, Spain; Departamento de Oftalmología, Hospital Virgen de las Nieves, Granada, Spain; Departamento de Oftalmología, Ceuta Medical Center, Ceuta, Spain
| | - M García-Lorente
- Departamento de Oftalmología, Hospital Regional Universitario-Hospital Civil, Málaga, Spain
| | - C Pérez-Casaseca
- Departamento de Oftalmología, Hospital Regional Universitario-Hospital Civil, Málaga, Spain
| | - C Hernando-Ayala
- Departamento de Oftalmología, Hospital Regional Universitario-Hospital Civil, Málaga, Spain
| | - S Ortiz-Pérez
- Departamento de Oftalmología, Hospital Virgen de las Nieves, Granada, Spain
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7
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Dávila-Camargo A, Samaniego-Novelo FF, Vidal-Muñoz M, Jiménez-López JM, López-Facio E. Multidisciplinary approach to orbital embryonic rhabdomyosarcoma: about a case. Arch Soc Esp Oftalmol (Engl Ed) 2020; 96:S0365-6691(20)30360-9. [PMID: 33153818 DOI: 10.1016/j.oftal.2020.09.004] [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] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/23/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
Of the head and neck tumoral lesions in children and adolescents, 5 to 10% are primary malignant tumors. Among these tumors, orbital rhabdomyosarcoma stands out, which is the most common primary soft tissue sarcoma in children. Its diagnosis requires a high degree of clinical suspicion, and it can be corroborated with a series of examinations, in order to stage it and carry out the appropriate treatment. Currently, surgery and chemotherapy are the primary treatments, and the use of conventional radiotherapy is limited to cases where previous treatments fail or there is a risk of recurrence. The following case report aims to expose the clinical picture, diagnosis, staging and integral treatment of orbital rhabdomyosarcoma, as well as the interdisciplinary management that was performed to improve the patient's prognosis.
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Affiliation(s)
- A Dávila-Camargo
- Departamento de Oftalmología, Hospital Ángeles, Torreón (Coahuila), México.
| | | | - M Vidal-Muñoz
- Departamento de Radiooncología, Unidad Médica de Alta Especialidad N.° 71 IMSS, Torreón (Coahuila), México
| | - J M Jiménez-López
- Departamento de Radiooncología, Unidad Médica de Alta Especialidad N.° 71 IMSS, Torreón (Coahuila), México
| | - E López-Facio
- Departamento de Oncología Pediátrica, Unidad Medica de Alta Especialidad N.° 71 IMSS, Torreón (Coahuila), México
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8
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Montejano-Milner R, López-Gaona A, Fernández-Pérez P, Sánchez-Orgaz M, Romero-Martín R, Arbizu-Duralde A. Orbital metastasis: Clinical presentation and survival in a series of 11 cases. Arch Soc Esp Oftalmol (Engl Ed) 2020; 97:S0365-6691(20)30317-8. [PMID: 32873479 DOI: 10.1016/j.oftal.2020.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/15/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Orbital metastases are an uncommon condition. They may be the clinical presentation of a previously unknown malignancy. Depending on the series, the rate of orbital metastasis as a first manifestation of a malignant tumour is 20-42%. The clinical presentation and survival are presented in a series of 11 cases of orbital metastasis corresponding to 10 patients. MATERIAL AND METHODS Descriptive retrospective study of a series of 10 adult patients diagnosed with orbital metastasis from solid tumours during a 9-year period. Metastases involving the orbit were included, and lymphomas and contiguity invasions from adjacent structures were excluded. A note was made on whether the clinical picture was the first sign of tumour onset. Signs and symptoms at clinical debut were registered, as were primary tumour location, distance seeding, orbital structures involved, and survival time since the diagnosis was established. RESULTS One-half (50%) of the patients were women. Mean age at diagnosis was 60.9years (range 42-82). In nine cases (90%), the metastasis was unilateral, while in the remaining one the involvement was bilateral. The most frequent primary tumour location was the breast (36% of the cases), followed by the bladder (27%), lung (18%), and ovary and cavum (9%). Seventy percent of the patients had a previously diagnosed neoplasm; in 3 cases the metastasis was the first malignancy manifestation. Most frequent symptoms were diplopia (60%), visual impairment (40%), and pain (30%). The most common signs were resistance to ocular retropulsion (60%), presence of a mass on orbital palpation and ocular dystopia (50%), and bulbar hyperaemia and proptosis (40%). The most employed management modality was clinical observation (5 patients). In 3 patients radiotherapy was administered, combining chemotherapy plus hormonal therapy in one case, and orbital exenteration in another one. In 2 cases, chemotherapy was administered as an isolated regime. Median survival time was 4.8months since the diagnosis. There was a statistically significant difference between the survival time in the observation group (median 2.5months) and in the active treatment group (median 29.2months), P=.034. CONCLUSIONS In the series presented, 27% of the cases established the clinical debut of the malignant neoplasm. The ophthalmologist plays an essential role when this condition is suspected, diagnosing it, and proposing its management together with the Oncology Service.
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Affiliation(s)
- R Montejano-Milner
- Servicio de Oftalmología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
| | - A López-Gaona
- Servicio de Oftalmología, Complejo Hospitalario Universitario de A Coruña, A Coruña, España
| | - P Fernández-Pérez
- Servicio de Oftalmología, Hospital Universitario La Paz, Madrid, España
| | - M Sánchez-Orgaz
- Servicio de Oftalmología, Hospital Universitario La Paz, Madrid, España
| | - R Romero-Martín
- Servicio de Oftalmología, Hospital Universitario La Paz, Madrid, España
| | - A Arbizu-Duralde
- Servicio de Oftalmología, Hospital Universitario La Paz, Madrid, España
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9
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Tabuenca Del Barrio L, Gasparini C, Devoto MH. Intramuscular cavernous venous malformation of extraocular muscles. Fractionated stereotactic radiotherapy as a therapeutic alternative. ACTA ACUST UNITED AC 2020; 95:293-296. [PMID: 32409245 DOI: 10.1016/j.oftal.2020.01.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 10/24/2022]
Abstract
Intramuscular cavernous venous malformations affecting extraocular muscles are extremely uncommon. Due to their location, complete resection could be difficult. A clinical case is presented of an inferior rectus muscle orbital cavernous malformation treated with fractionated stereotactic radiotherapy after post-surgical excision recurrence. The malformation responded to radiotherapy with a reduction in size and symptoms. Fractionated stereotactic radiotherapy is an alternative and effective treatment for cavernous venous malformations that are surgically challenging due to their radiotherapy sensitivity.
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Affiliation(s)
- L Tabuenca Del Barrio
- Servicio de Oftalmología, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
| | - C Gasparini
- Consultores Oftalmológicos, Buenos Aires, Argentina
| | - M H Devoto
- Consultores Oftalmológicos, Buenos Aires, Argentina
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10
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Villalonga JF, Sáenz A, Revuelta Barbero JM, Calandri I, Campero Á. Surgical anatomy of the orbit. A systematic and clear study of a complex structure. Neurocirugia (Astur) 2019; 30:259-267. [PMID: 31221573 DOI: 10.1016/j.neucir.2019.04.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/01/2019] [Accepted: 04/07/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVE The orbit is a structure of interest for many medical specialties. Surgical approaches to the orbit present significant difficulties for the general neurosurgeon. Whoever decides to practice orbital surgery must have vast anatomical knowledge of this structure. However, although many of the existing publications about orbital anatomy show the complexity of this structure in detail, they fail to facilitate their understanding. The purpose of this study was to systematise and simplify the anatomical study of the orbit from a surgical perspective, to facilitate its understanding. MATERIALS AND METHODS A review of the international literature on the subject was carried out, and the principle of the rule of 7was followed for its ordering. For illustration purposes, photographs of cadaveric preparations and digital drawings were used. RESULTS The orbits are 2cavities located symmetrically on both sides of the nose. They have a pyramidal shape, with 4sides, a posterior vertex, an anterior base and their axis established from the sagittal plane at a 20-degree angle. A distinctive feature of the orbit is that its elements are organised into groups of seven: 7bones, 7intraorbital extraocular muscles and 7nerves. CONCLUSION A systematisation of the orbital anatomy was performed with clear illustrations to simplify its study. The understanding of the anatomy of the orbit is vital to classify lesions and provides a solid basis when choosing the most appropriate approach for their treatment.
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Affiliation(s)
- Juan F Villalonga
- LINT, Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina
| | - Amparo Sáenz
- LINT, Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina.
| | | | - Ismael Calandri
- Cátedra de Neurología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Álvaro Campero
- LINT, Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina; Fellowship Albert L. Rothon Neuro-Microanatomy Lab, Gainesville, Florida, Estados Unidos; Cátedra de Neurología, Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina; Servicio de Neurocirugía, Hospital Ángel C. Padilla, Tucumán, Argentina
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11
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Urdapilleta-Contreras M, Padilla-Pérez L, Aguilar-Ruiz A, Verdugo-Unigarro A. Thyroid orbitopathy masked a carotid-cavernous fistula. Case report. ACTA ACUST UNITED AC 2019; 94:400-404. [PMID: 31176495 DOI: 10.1016/j.oftal.2019.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/22/2019] [Revised: 05/05/2019] [Accepted: 05/08/2019] [Indexed: 11/19/2022]
Abstract
The case concerns a 73 year-old female with a diagnosis of hyperthyroidism of 8 months onset. Since then, she has suffered hyperaemia and ocular proptosis. Bilateral exophthalmos was observed in the physical examination, along with mild conjunctival hyperaemia in the right eye associated with dilated episcleral vessels. Computed tomography showed enlarged inferior rectus with no signs of ocular nerve or ophthalmic superior vein compression. In the orbital Doppler ultrasound scan, there was an arterialised flow over the superior ophthalmic vein, giving a possible diagnosis of cavernous carotid. Thyroid orbitopathy with a cavernous carotid fistula is an unusual combination in which the clinical signs of both pathologies can mask the complete diagnosis; thus it is important to be acquainted with both pathologies for their correct management and multidisciplinary treatment.
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Affiliation(s)
- M Urdapilleta-Contreras
- Instituto de Oftalmología, Fundación de Asistencia Privada Conde de Valenciana IAP, Ciudad de México, México.
| | - L Padilla-Pérez
- Instituto de Oftalmología, Fundación de Asistencia Privada Conde de Valenciana IAP, Ciudad de México, México
| | - A Aguilar-Ruiz
- Instituto de Oftalmología, Fundación de Asistencia Privada Conde de Valenciana IAP, Ciudad de México, México
| | - A Verdugo-Unigarro
- Instituto de Oftalmología, Fundación de Asistencia Privada Conde de Valenciana IAP, Ciudad de México, México
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12
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Llavero-Valero P, Garrido-Hermosilla AM, Díaz-Ruiz MC, García Aldana D, Fernández-Teijeiro Álvarez A, Espejo-Arjona F. Giant cell tumour of frontal bone in a patient with bilateral retinoblastoma. ACTA ACUST UNITED AC 2018; 94:200-203. [PMID: 30449636 DOI: 10.1016/j.oftal.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/23/2018] [Accepted: 10/09/2018] [Indexed: 10/27/2022]
Abstract
A case is presented of a 5 year-old patient with bilateral hereditary retinoblastoma treated with radiotherapy in the right eye and enucleation of the left eye. After three years without evidence of progression, the patient presented with a right orbital mass that compromised the frontal bone. After surgical excision, the histology analysis was consistent with a diagnosis of giant cell tumour. Primary orbital bone neoplasms, such as giant cell tumours, are extremely rare. Both radiological and histopathology studies are essential to establish the differential diagnosis of orbital mass lesions.
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Affiliation(s)
- P Llavero-Valero
- UGC Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - A M Garrido-Hermosilla
- Unidades de Oculoplastia-Órbita y Oncología Ocular, UGC Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, España; Unidades de Oculoplastia-órbita, RETICS OftaRed, Instituto de Salud Carlos III, Madrid, España.
| | - M C Díaz-Ruiz
- Unidades de Oculoplastia-Órbita y Oncología Ocular, UGC Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - D García Aldana
- Unidad de Oncohematología Pediátrica, Hospital Universitario Virgen Macarena, Sevilla, España
| | | | - F Espejo-Arjona
- Unidades de Oculoplastia-órbita, RETICS OftaRed, Instituto de Salud Carlos III, Madrid, España; Unidades de Retina y Oncología Ocular, UGC Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, España
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Yataco-Vicente JA, Araujo-Castillo RV, López Fuentes MH. Orbital presentation of Rosai-Dorfman disease. ACTA ACUST UNITED AC 2018; 93:515-518. [PMID: 29937156 DOI: 10.1016/j.oftal.2018.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 02/08/2018] [Revised: 04/06/2018] [Accepted: 05/02/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To report a case of orbital mass and proptosis, diagnosed as Rosai-Dorfman disease (RDD). METHODS Clinical case report based on the review of clinical charts, radiological images, and histopathology. RESULTS A 42-year-old male with orbital mass and proptosis of the right eye. A surgical biopsy was performed, and the diagnosis of RDD was established using microscopy and immunohistochemistry. Definitive management included open tumour cytoreduction, with good response. DISCUSSION The RDD is a rare, benign, proliferative condition of unknown origin. It rarely affects the cranial cavities, with the orbital presentation being very unusual. Diagnostic confirmation is essential for the best surgical management.
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Affiliation(s)
- J A Yataco-Vicente
- Departamento de Investigación, Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú; Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas (SOCIEMUPC), Lima, Perú.
| | - R V Araujo-Castillo
- Departamento de Investigación, Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - M H López Fuentes
- Servicio de Anatomía Patológica, Hospital Nacional Dos de Mayo, Lima, Perú
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Flores Balverdi J, Baenas DF, Riscanevo NC, Sánchez AV, Figueroa Rosales R, Alvarellos A. IgG4-related orbital disease. ACTA ACUST UNITED AC 2018; 93:494-496. [PMID: 29866378 DOI: 10.1016/j.oftal.2018.04.003] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 11/30/2022]
Abstract
CASE REPORT The case is presented of a 64-year-old woman with bilateral palpebral swelling and dacryoadenitis, exophthalmos, and a history of chronic rhinitis and asthma. An increase in serum IgG4 was observed, and an incisional biopsy of lacrimal glands was performed, which showed fibrosis and a lymphoplasmacytic infiltrate with IgG4 producing cells. DISCUSSION Orbital involvement in IgG4-related disease is frequent. Bilateral dacryoadenitis is the most common manifestation. Histopathology is essential for the diagnosis and to exclude malignancy.
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Affiliation(s)
- J Flores Balverdi
- Servicio de Reumatología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - D F Baenas
- Servicio de Reumatología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina.
| | - N C Riscanevo
- Servicio de Reumatología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - A V Sánchez
- Servicio de Anatomía Patológica, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - R Figueroa Rosales
- Servicio de Oftalmología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
| | - A Alvarellos
- Servicio de Reumatología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
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Vela Marín AC, Seral Moral P, Bernal Lafuente C, Izquierdo Hernández B. Diagnostic imaging in neuro-ophthalmology. Radiologia (Engl Ed) 2018; 60:190-207. [PMID: 29366504 DOI: 10.1016/j.rx.2017.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 11/05/2017] [Accepted: 11/14/2017] [Indexed: 11/16/2022]
Abstract
Neuro-ophthalmology is a field combining neurology and ophthalmology that studies diseases that affect the visual system and the mechanisms that control eye movement and pupil function. Imaging tests make it possible to thoroughly assess the relevant anatomy and disease of the structures that make up the visual pathway, the nerves that control eye and pupil movement, and the orbital structures themselves. This article is divided into three sections (review of the anatomy, appropriate imaging techniques, and evaluation of disease according to clinical symptoms), with the aim of providing useful tools that will enable radiologists to choose the best imaging technique for the differential diagnosis of patients' problems to reach the correct diagnosis of their disease.
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Affiliation(s)
- A C Vela Marín
- Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - P Seral Moral
- Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España
| | - C Bernal Lafuente
- Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España
| | - B Izquierdo Hernández
- Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España
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Parada-Vásquez RH, Lomas-Guaman VE, León-Roldán CR. Conjunctival lymphoma in right eye: Case report. ACTA ACUST UNITED AC 2016; 92:78-81. [PMID: 27388111 DOI: 10.1016/j.oftal.2016.05.015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/15/2016] [Accepted: 05/23/2016] [Indexed: 11/24/2022]
Abstract
CASE REPORT A 43-year-old woman presented with a salmon-coloured patch of 0.7mm diameter in the right eye that extended into the lower fornix in the bulbar and tarsal conjunctiva, with irregular edges, and highly vascularised. Incisional biopsy was performed, showing it to be a low-grade conjunctival non-Hodgkin B cell lymphoma (or a mucosa associated lymphoid tissue [MALT] lymphoma). DISCUSSION The lesion remained stable for 24 months of follow-up, when a relapse of the condition occurred, producing an enlargement of the initial lesion. The definitive diagnosis is made by biopsy of the affected tissue and histopathologic study.
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Affiliation(s)
- R H Parada-Vásquez
- Departamento de segmento anterior, Instituto de la Visión, Hospital la Carlota, Montemorelos, Nuevo León, México.
| | - V E Lomas-Guaman
- Escuela Superior de Oftalmología, Centro Oftalmológico León, Guatemala, Guatemala
| | - C R León-Roldán
- Escuela Superior de Oftalmología, Centro Oftalmológico León, Guatemala, Guatemala
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Iglesias ME, Santesteban R, Larumbe A. Oncologic surgery of the eyelid and orbital region. Actas Dermosifiliogr 2015; 106:365-75. [PMID: 25701895 DOI: 10.1016/j.ad.2014.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/28/2014] [Accepted: 11/09/2014] [Indexed: 10/24/2022] Open
Abstract
Oncologic surgery of the eyelid and orbital region is a challenge in dermatologic surgery. This region presents difficulties and possible complications that do not exist at other sites, including ectropion, epiphora, corneal exposure, keratitis, conjunctivitis, and lagophthalmos. Adequate oncologic surgery associated with the best possible functional and cosmetic result requires extensive knowledge of the anatomy, innervation, and blood supply of the eyelid and anatomy of the lacrimal apparatus. We present examples of reconstructive surgical techniques that can be used after the excision of tumors of the upper or lower eyelid, with descriptions of the different flaps and grafts employed in our department in recent years. We also review the surgical techniques according to the site and size of the lesions.
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Affiliation(s)
- M E Iglesias
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España
| | - R Santesteban
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España.
| | - A Larumbe
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España
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