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Lloreda-Martin L, Berrocal-Cuadrado A, Torres Nieto MA, Galindo-Ferreiro A. Orbital mucosa-associated lymphoid tissue (MALT) lymphoma as the initial presentation in patients with hepatitis C virus infection. Arq Bras Oftalmol 2024; 87:e20220091. [PMID: 38451678 DOI: 10.5935/0004-2749.2022-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/08/2022] [Accepted: 02/23/2023] [Indexed: 03/08/2024] Open
Abstract
Hepatitis C virus infection may be implicated in 12.7% of ocular adnexal marginal zone lymphomas. We present the first case of an orbital-systemic mucosa-associated lymphoid tissue lymphoma that responded to hepatitis C virus medical treatment. A 62-year-old male with a right-sided orbital mass was diagnosed with stage IIA orbital marginal zone lymphoma in addition to hepatitis C virus infection based on clinical, imaging, laboratory, and histological examinations. The systemic and orbital responses were achieved 1 year after undergoing hepatitis C virus treatment with glecaprevir/pibrentasvir. The association between the hepatitis C virus infection and orbital-systemic mucosa-associated lymphoid tissue lymphoma is relevant. Accordingly, patients with orbital mucosa-associated lymphoid tissue lymphoma should be assessed for hepatitis C virus seroreactivity for therapeutic and prognostic purposes.
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Affiliation(s)
- Leyre Lloreda-Martin
- Department of Ophthalmology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
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Martinez-Fernandez E, Pereira Bigheti C, Sanchez-Tocino H, Moreira Zornoff D, Schellini SA, Galindo-Ferreiro A. Management of external ocular prosthesis by ocularists: results of an online survey conducted in Brazil and Spain. Int Ophthalmol 2023; 43:4297-4304. [PMID: 37574470 DOI: 10.1007/s10792-023-02841-9] [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: 12/11/2022] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE To analyse the ocularist's perspective on the management of the anophthalmic socket and external ocular prosthesis (EOP). METHODS Ocularists from two countries were invited to participate in an online questionnaire. Data were collected on demographics, anophthalmic socket and EOP management (manufacturing, use, cleaning), complications, follow-up visits and multidisciplinary care. The frequency and proportions of the responses were statistically analysed. RESULTS The questionnaire was addressed to 20 Brazilian and 17 Spanish ocularists, obtaining a response rate of 65% and 64.7%, respectively. 62.5% of respondents were men. The most common cause of anophthalmia in Brazil (69.2%) and Spain (36.4%) is an eye disease (chi square: p = 0.188). Polymethylmethacrylate (PMMA) is the most commonly used material in EOP manufacture (chi square: p = 0.448), and 70.8% reported using customized EOPs (chi square: p = 0.069). Deposits are frequently observed in both countries (chi square: p = 0.157). Changing the prosthesis is recommended after 5 to 10 years by Brazilian ocularists, and after less than 5 years of use by Spanish ocularists (81.8%) (chi square: p = 0.041). Annual follow-up is recommended by Spanish ocularists (45.5%), while semestral (38.5%) and case-dependent (38.5%) follow-up is recommended by Brazilian ocularists (chi square: p = 0.267). Daily cleaning is advocated by 61.5% of Brazilian ocularists and once a month by 45.5% of Spanish ocularists (chi square: p = 0.098), with 75% of ocularists from both countries not recommending EOP removal at night (Fisher´s exact test: p = 0.166). Good communication between ocularists and ophthalmologists was reported by 87.5% of our responders (chi square: p = 0.642). CONCLUSION Although there are no unified protocols on the management of EOPs, Brazilian and Spanish ocularists follow similar guidelines. Differences between countries were the patients´ referral and the prosthesis´ useful life.
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Affiliation(s)
| | - Carolina Pereira Bigheti
- Botucatu Medical School, Universidade Estadual Paulista Júlio de Mesquita Filho, São Paulo State University (UNESP), Botucatu, Brazil
| | | | - Denise Moreira Zornoff
- Botucatu Medical School, Universidade Estadual Paulista Júlio de Mesquita Filho, São Paulo State University (UNESP), Botucatu, Brazil
| | - Silvana Artioli Schellini
- Botucatu Medical School, Universidade Estadual Paulista Júlio de Mesquita Filho, São Paulo State University (UNESP), Botucatu, Brazil
| | - Alicia Galindo-Ferreiro
- Department of Ophthalmology-Oculoplastic, Rio Hortega University Hospital, Valladolid, Spain.
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Berrocal-Cuadrado A, Sánchez-Tocino H, Galindo-Ferreiro A. Retrospective study of success rate and associated factors of two laser dacryocystorhinostomy techniques, in a third-level hospital. Arch Soc Esp Oftalmol (Engl Ed) 2023:S2173-5794(23)00080-4. [PMID: 37247660 DOI: 10.1016/j.oftale.2023.05.006] [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: 01/14/2023] [Accepted: 03/31/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND OBJECTIVE To compare the success rate of two laser dacryocystorhinostomy (L-DCR) techniques. MATERIALS AND METHODS A retrospective study of patients who underwent surgery for acquired nasolacrimal duct obstruction (NLDO) between 2000 and 2021, carried out in a third level hospital, using L-DCR and modifications of this technique. Intraoperative findings, complications, and anatomical and functional success rate of the 2 techniques were analyzed. The follow-up time was 1 year. RESULTS We included 92 lacrimal ducts with NLDO. 66 (71.7%) were women. 78 (84.8%) underwent unilateral surgery. The mean age was 62.77 ± 13.08 years. 61 (66.3%) underwent intraoperative laser dacryocystorhinostomy with MMTC (L-DCR + MMTC) and 31 (33.6%) L-DCR associated with endoscopic ostium enlargement (L-DCRend-amp). The one-year anatomical/functional success rate of the L-DCRend-amp + MMTC was 71%/64,5%. L-DCR + MMTC obtained a lower success rate, 65.6/60,7% (p = 0.391). There were no differences throughout the follow-up between the anatomical or functional success rates of the 2 techniques, nor between the different visits (p > 0,05). Intraoperative findings rate was 3.63% in L-DCR + MMTC, and 32.26% in L-DCRend-amp + MMTC. Postoperative complication rate was 3.27% in L-DCR + MMTC, and 3.23% in L-DCRend-amp + MMTC. CONCLUSIONS The L-DCRend-amp + MMTC gets a higher success rate than the L-DCR + MMTC. We must consider the surgical time-cost of the L-DCRend-amp + MMTC, as well as the learning curve of endoscopy techniques, and the skill of the surgeon, without a clear benefit in the success rate.
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Affiliation(s)
- A Berrocal-Cuadrado
- Servicio Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain
| | - H Sánchez-Tocino
- Servicio Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain
| | - A Galindo-Ferreiro
- Servicio Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain.
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Equitério B, Garcia D, Galindo-Ferreiro A, Marqués-Fernández V, Sales-Sanz M, Cruz AAV. Effect of Rim-Off Deep Lateral Orbital Decompression on Interpalpebral Fissure Shape. Ophthalmic Plast Reconstr Surg 2023; 39:170-173. [PMID: 36356185 DOI: 10.1097/iop.0000000000002273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE The purpose of this study is to compare the palpebral fissure shape after rim-off deep lateral decompression with and without restoration of the lateral orbital rim. METHODS Retrospective cross-sectional quantitative analysis of the palpebral fissure images of 17 patients (25 eyes) who underwent rim-off deep lateral orbital decompression without repositioning of the rim (G1) and of 20 patients (34 eyes) operated with rim restoration. Quantification of palpebral fissure images included MRD 1 and MRD 2 , two lateral mid-pupil lid margin (MPD) distances, the width of the palpebral fissure, and the height and shape of the lateral canthus. RESULTS Proptosis reduction did not differ significantly between G1 and G2. In both groups, decompression reduced the mean values of the MRD 1 and MRD 2 , the lateral height of the upper eyelid, and the height and angle of the lateral canthus. The palpebral fissure width and lateral height of the lateral lower eyelid were not affected. There was no significant difference between the mean changes of G1 and G2. Multivariate analysis showed that the lateral canthus decrease was correlated with changes in MRD 1 and MRD 2 . CONCLUSIONS Small changes in palpebral fissure shape after deep lateral decompression are not dependent on the presence or absence of the lateral rim.
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Affiliation(s)
- Bruna Equitério
- Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Denny Garcia
- Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | | | | | - Marco Sales-Sanz
- Service of Ophthalmology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
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Galindo-Ferreiro A, Akaishi PM, Bermudez-Castellanos I, Cruz AV. Lateral eyelid island flap for reconstruction of large central and medial full-thickness defects of the lower eyelid. Eur J Ophthalmol 2022; 33:1484-1489. [PMID: 36536597 DOI: 10.1177/11206721221146817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction To report our experience with lateral eyelid island flaps for reconstruction of large central and medial full-thickness defects of lower eyelid. Methods Retrospective case series of patients with large central and medial full-thickness lower lid defects repaired with medial transposition of the lateral lower lid combined with a temporal myocutaneous flap. Preoperatively the authors collected demographic data, etiology and percentage of the defects. Postoperatively the lids were assessed for flap viability and lower eyelid margin position and contour. Results The sample was comprised of 10 patients (5 females) with a mean of age 60.10 (SD 13.75) years. The defects ranging from 50% to 75% of the lid width resulted from excision of eight basal cell carcinomas, one (10%) malignant schwannoma and one (10%) squamous cell carcinoma. The median follow-up was 1.58 years (IQR 2.58). Flap ischemia was not observed in any eyelid. One mild ectropion was observed in just one lid. All patients were satisfied with the esthetic results. Conclusions Medial transposition of the lateral lower lid island flap combined with horizontal myocutaneous advancement flap is an excellent one-stage procedure that avoids the drawbacks of the two-stages procedures
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Affiliation(s)
| | - Patricia M Akaishi
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto–University of São Paulo, Ribeirao Preto, Brazil
| | | | - Augusto Velasco Cruz
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto–University of São Paulo, Ribeirao Preto, Brazil
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Navarro-Hernandez E, Galindo-Ferreiro A. Endocanalicular Laser Dacryocystorhinostomy and its modifications: A systematic review of techniques and success rates. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:692-704. [PMID: 35879174 DOI: 10.1016/j.oftale.2022.06.007] [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: 10/31/2021] [Accepted: 03/08/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE the main objective of this work is to review the articles that refer to transcanalicular diode laser dacryocystorhinostomy (TCL-DCR) in acquired nasolacrimal duct obstruction (NLDO), as well as its modifications. MATERIAL AND METHODS A systematic review of publications related to TCL-DCR of the lacrimal duct from 2000 to March 2021 was carried out in the MEDLINE, EMBASE and COCHRANE LIBRARY databases. The search terms in Spanish and English were: «Endocanalicular laser», dacryocystorhinostomy or «primary DCR-L» or «laser» and «tear ducts». RESULTS After subjecting the articles to the inclusion and exclusion criteria, we got 49 articles: 21 retrospective and 28 prospective studies. The bibliometric result obtained guaranteed, for this review, a level C recommendation according to the Scottish Intercollegiate Guidelines Network scale. CONCLUSIONS Currently, the classic TCL-DCR has lower success rates than its modifications, so we suggest using the latter. We prefer TCL-DCR with IS-MMC or TCDL associated with endoscopy techniques, without being able to opt for any option, since their success rates are very similar. We leave the choice to the discretion of the surgeon, depending on the management skills of endonasal techniques. More studies, with longer follow-up, and better defined criteria are necessary to clarify which is the best TCL-DCR technique.
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Affiliation(s)
| | - A Galindo-Ferreiro
- Servicio de Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain
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Cruz AAV, Diniz SB, Guimarães JA, Souza RL, Galindo-Ferreiro A, Araujo LMF, Cecchetti SAP, SanťAnna AEB. Margin rotation for tarsal buckling following ptosis surgery. Int Ophthalmol 2022; 43:741-748. [PMID: 36038692 DOI: 10.1007/s10792-022-02473-5] [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: 05/11/2022] [Accepted: 08/20/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the clinical characteristics of tarsal buckling after ptosis correction and its management with margin rotation techniques. METHODS Multicenter retrospective review of ten patients who developed upper eyelid entropion following ptosis correction. In all cases the tarsal deformity was corrected with margin rotational procedures with either a lid crease anterior approach or a traditional posterior approach. Data collection included patient demographics, type of ptosis surgery, and photographic documentation of the affected eyelids. RESULTS Entropion occurred after a variety of different ptosis surgery techniques, including frontalis sling, levator advancement and supramaximal levator resection. A horizontal tarsal fold was detected in all eyelids, being in the upper third of the tarsus in 70% and in the central tarsus in 20% of the cases. Tarsal buckling was corrected in all cases with rotational surgery, with nine cases being operated through an anterior lid crease approach and 1, through the traditional posterior approach. The most reported complication was minimal residual ptosis. CONCLUSION Tarsal buckling following ptosis surgery is associated with folds located in the upper part of the tarsus. Margin rotation techniques are effective in restoring the natural position of the eyelid margin in these cases.
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Affiliation(s)
- Antonio A V Cruz
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, Hospital das Clínicas de Ribeirão Preto-CAMPUS, University of São Paulo, Av Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.
| | - Stefania B Diniz
- Department of Ophthalmology, Orbital and Ophthalmic Plastic Surgery, Instituto Hospital de Base Do Distrito Federal, Brasília, DF, Brazil
| | - Juliana A Guimarães
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, Hospital das Clínicas de Ribeirão Preto-CAMPUS, University of São Paulo, Av Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Roque L Souza
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, Hospital das Clínicas de Ribeirão Preto-CAMPUS, University of São Paulo, Av Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | | | | | | | - Ana Estela B SanťAnna
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo - UNIFESP, Sao Paulo, SP, Brazil
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Galindo-Ferreiro A, Zornoff DCM, Correntes JE, Akaishi PM, Schellini SA. Current management of upper lid ptosis: a web-based international survey of oculoplastic surgeons. Arq Bras Oftalmol 2022; 86:S0004-27492022005007202. [PMID: 35857976 DOI: 10.5935/0004-2749.2021-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 02/03/2022] [Indexed: 02/18/2024] Open
Abstract
PURPOSE This study aimed to evaluate the current practice patterns for assessing and managing upper lid ptosis among members of the Latin American and Spanish societies of Ophthalmic Plastic and Reconstructive Surgery. METHODS An e-mail was sent to invite members of both societies to participate in this anonymous web-based survey. The survey collected data on surgeons' demographics and four other sections: upper lid ptosis preoperative evaluation, surgical preferences, postoperative management, and complications. The frequency and proportions of the responses were then statistically analyzed. RESULTS The survey was responded by 354 experienced oculoplastic surgeons, 47.7% of whom generally performed more than 20 upper lid ptosis surgeries annually. Of those respondents, 244 (68.9%) routinely check for dry eye preoperatively. Less than half of the respondents (47.4%) perform the phenylephrine test for congenital or acquired ptosis. Mild upper lid ptosis was reported to be usually corrected with conjunctival mullerectomy (43.6%). Severe upper lid ptosis was reported to be usually corrected with frontalis surgery (57%), followed by anterior levator resection, mainly supramaximal resection (17.5%). In cases of severe congenital ptosis, the main reason for surgery was to alleviate the risk of amblyopia (37.3%). An anterior approach was reported to be usually (63.3%) used to manage involutional ptosis associated with dermatochalasis. Common complications comprised undercorrection after levator resection (40%) or frontalis suspension (27.5%). CONCLUSIONS This study reports the current practice patterns among Spanish and Latin American oculoplastic surgeons in upper lid ptosis diagnosis and treatment. Surgeons can use this study data to compare disease management with their colleagues.
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Affiliation(s)
| | - Denise C M Zornoff
- Distance Education and Health Information Technology Center, School of Medicine of State University of São Paulo, Brazil
| | - Jose Eduardo Correntes
- Department of Biostatistics, Biosciences Institute, Universidade de São Paulo, SP, Brazil
| | - Patricia M Akaishi
- Department of Ophthalmology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, SP, Brazil
| | - Silvana A Schellini
- Department of Ophthalmology, Faculdade de Medicina, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
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Galindo-Ferreiro A, Marqués-Fernandez VE, Cruz AV, Chahud F. Upper Eyelid and Orbital Involvement in Congenital Infiltrating Lipomatosis. J Pediatr Ophthalmol Strabismus 2022; 59:e46-e49. [PMID: 35856428 DOI: 10.3928/01913913-20220526-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Congenital infiltrating lipomatosis of the face is a rare entity that has not been reported in the ophthalmic literature. The authors describe two patients affected by this condition. Diagnosis and management of congenital infiltrating lipomatosis of the face involving the eye adnexa is challenging and the psychological impact on such patients must be considered. [J Pediatr Ophthalmol Strabismus. 2022;59(3):e46-e49.].
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Galindo-Ferreiro A, Marqués-Fernández VE, Gonzalez JC, Schellini SA. Large Conjunctival Inclusion Cyst after Anterior Approach Ptosis Surgery. Middle East Afr J Ophthalmol 2022; 29:163-166. [PMID: 37408724 PMCID: PMC10319082 DOI: 10.4103/meajo.meajo_181_21] [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: 06/09/2021] [Revised: 01/21/2023] [Accepted: 03/06/2023] [Indexed: 07/07/2023] Open
Abstract
An 8-year-old male child who underwent an anterior approach left upper lid levator resection to correct congenital ptosis. After 6 months, he developed mechanical ptosis secondary to a painless cystic mass on his upper lid. Magnetic resonance proved a postseptal circumscribed cystic mass. The lesion was excised and a histopathology examination confirmed a conjunctival inclusion cyst (CIC). CIC is common benign lesions of conjunctiva but rarely detected as a complication of levator muscle surgery.
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Affiliation(s)
| | | | | | - Silvana A. Schellini
- Department of Ophthalmology, Faculty of Medicine of Botucatu, UNESP, Sao Paolo, Brasil
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Galindo-Ferreiro A, de Prado Otero DS, Marquez PI, Schellini S. Recurrent and recalcitrant upper lid cicatricial entropion following combined chemotherapy: Clinical and pathology correlation. Saudi J Ophthalmol 2022; 35:347-349. [PMID: 35814986 PMCID: PMC9266477 DOI: 10.4103/1319-4534.347308] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/26/2020] [Accepted: 12/09/2020] [Indexed: 11/04/2022] Open
Abstract
We report a case of recalcitrant bilateral upper eyelid cicatricial entropion associated with distichiasis/trichiasis which followed an adjuvant systemic chemotherapy. The chemotherapy, administered for treatment of breast cancer, consisted of docetaxel, carboplatin, and herceptin. Shortly following the combined chemotherapy treatment, epiphora and eyelash abnormalities commenced. The patient presented with a swollen eyelid margin and tarsal conjunctival inflammation associated with cicatricial entropion and diffused distichiasis/trichiasis affecting the upper lids, with greater severity observed in the medial portion. Despite manual epilation and multiple argon laser sessions, no improvement was noted. Surgical treatment was performed using a lid split, distichiasis excision of the right upper lid, and homolateral tarsoconjunctival graft. The biopsy examination showed chronic inflammation, dermal fibrosis with squamous metaplasia process, and an abnormal epithelial differentiation. After 6 months, entropion recurred. Tarsal marginal rotation associated with posterior lamella advancement was performed. However, cicatricial entropion and distichiasis/trichiasis recurred. The patient was prescribed bandage contact lenses and topical lubrication to relieve symptoms.
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Affiliation(s)
- Alicia Galindo-Ferreiro
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain,Address for correspondence: Dr. Alicia Galindo-Ferreiro, Department of Ophthalmology. Rio Hortega University Hospital. Dulzaina St. 2, 47012. Valladolid, Spain. E-mail:
| | | | - Pilar I.G. Marquez
- Department of Pathology, Rio Hortega University Hospital, Valladolid, Spain
| | - Silvana Schellini
- Department of Ophthalmology, Faculdade de Medicina de Botucatu - UNESP, São Paulo, Brasil
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Díaz SV, González JAP, Galindo-Ferreiro A, Monar PSC, Tarancón AMA, Frutos MPGD. Liver abscess and endogenous endophthalmitis secondary to Klebsiella variicola in a patient with diabetes: first reported case. Arq Bras Oftalmol 2022; 85:324-326. [PMID: 35730821 DOI: 10.5935/0004-2749.202200104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/14/2022] [Indexed: 06/15/2023] Open
Affiliation(s)
- Saúl Villoria Díaz
- Department of Ophthalmology, Complejo Asistencial Universitario de Palencia, Palencia, Spain
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Alhammad FA, Edward DP, Alkatan HM, Maktabi AM, Khandekar RB, Galindo-Ferreiro A, Al-Sheikh OH. The association of cosmetic-related lacrimal sac black deposits with primary-acquired nasolacrimal duct obstruction and dry eye disease. Saudi J Ophthalmol 2022; 35:220-224. [PMID: 35601862 PMCID: PMC9116085 DOI: 10.4103/sjopt.sjopt_122_21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/28/2021] [Accepted: 07/07/2021] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To determine the incidence of cosmetic-related lacrimal sac black deposits (LSBDs) in primary-acquired nasolacrimal duct obstruction (PANDO) biopsies and the role of LSBD in the pathogenesis of PANDO, in addition to their association with dry eye disease (DED). METHODS A clinicopathological study included all patients who underwent surgical management of PANDO. We excluded patients in whom lacrimal sac biopsy was not taken during the surgery. Lacrimal sac tissues were evaluated for the presence of LSBD and related inflammation, with correlation to the demographics, clinical presentation, and pre-operative clinical assessment of dry eye. P <0.05 was considered statistically significant. RESULTS Of the 177 PANDO specimens, black deposit aggregates were noted in the sac stroma of 61 lacrimal sac specimens (34.5%; 95% confidence interval: 27.5-47.5). LSBDs were significantly more common in females (P < 0.001). The age, residence, past ailments, and laterality were not associated with LSBD. Dry eye was more common with LSBD (P = 0.004). Other presenting symptoms were not significantly associated with LSBD. The stromal black deposits in biopsies were mostly extracellular or in macrophages. The LSBD in only 10 specimens demonstrated birefringence. Energy dispersive spectroscopy determined that carbon and sulfur were the main elements in the black aggregates. CONCLUSION Cosmetic-related LSBD is unlikely to play a role in the pathogenesis of PANDO. However, they were significantly associated with DED.
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Affiliation(s)
- Fatimah A. Alhammad
- Division of Oculoplastic and Orbit, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia,Department of Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia
| | - Deepak P. Edward
- Department of Ophthalmology, University of Illinois Eye and Ear Infirmary, Chicago, United States of America
| | - Hind M. Alkatan
- Department of Ophthalmology and Pathology & Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Department of King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia,Address for correspondence: Dr. Hind M. Alkatan, Department of Ophthalmology and Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. E-mail:
| | - Azza M.Y. Maktabi
- Pathology & Laboratory Medicine Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Rajiv B. Khandekar
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Osama H. Al-Sheikh
- Division of Oculoplastic and Orbit, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Martinez-Fernandez E, Sanchez-Tocino H, Calles Monar PS, Galindo-Ferreiro A. Recurrent bilateral asynchronous cellulitis: Report of two cases and a literature review. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:113-116. [PMID: 35152947 DOI: 10.1016/j.oftale.2020.10.009] [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: 05/15/2020] [Accepted: 10/14/2020] [Indexed: 06/14/2023]
Abstract
Bilateral recurrent periorbital cellulitis is a very rare condition, with only five cases having been reported. Two cases are presented of recurrent bilateral asynchronous eyelid oedema in two paediatric patients. It was associated with respiratory infections, with no systemic disease. The patients had recurrent episodes (three times) since nine months old. They received oral and intravenous antibiotics, with a good response. There were no complications and no surgery was needed.
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Affiliation(s)
- E Martinez-Fernandez
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain.
| | - H Sanchez-Tocino
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain
| | - P S Calles Monar
- Departamento de Oftalmología, Complejo Asistencial Universitario de Palencia, Palencia, Spain
| | - A Galindo-Ferreiro
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain
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15
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Galindo-Ferreiro A, Marqués-Fernández V, Sanchez-Tocino H, Schellini SA. Objective assessment of eyelid position and tear meniscus in facial nerve palsy. Orbit 2021; 41:700-707. [PMID: 34958290 DOI: 10.1080/01676830.2021.1992789] [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] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate lower lid position and tear meniscus in peripheral idiopathic facial nerve palsy (FNP). METHODS A prospective study enrolled patients with peripheral idiopathic FNP and epiphora. Data were collected on patient demographics, House-Brackmann (HB) scale, digital photographs of the face, and tear meniscus at the 1st, 30, and 90 day after onset of FNP. Marginal reflex distance to the upper (MRD1) and lower eyelid (MRD2) were evaluated using ImageJ software. Anterior segment optical coherence tomography (OCT) was performed to measure the tear menis- cus. P< .05 was considered statistically significant. RESULTS Sixteen patients were evaluated. The HB scale at presentation was grade III in six patients (37.5%). At 90 day, nine patients (56.25%) were grade I-normal. Three (18.7%) had upper lid retraction, three (18.7%) upper eyelid asymmetry and 7 (43.75%), lower eyelid retraction. The difference between MRD2-FNP with MRD2-healthy side was 0.51 ± 1.9 mm at the 1st visit, decreasing to 0.09 ± 1.47 mm at 90 days (P= .877). Tear meniscus measurements were significantly higher in FNP at the 1st visit (P= .001). The decrease in MRD2 was statistically correlated with the reduction of the tear meniscus area (TMA) (r = 0.67; P= .007) at 90 days. No correlation was found between HB and TMA. There is a difference in TMA between age groups at the 1st day(p= .009). Eldest group had higher HB scales. CONCLUSION Quantitative evaluation of eyelid position and tear meniscus are effective to document the evolution of FNP and can serve as a clue of orbicularis recovery.
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Affiliation(s)
| | | | | | - Silvana A Schellini
- Department of Ophthalmology, Medical School, State University of São Paulo - UNESP - University Campus, São Paulo, Brazil
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16
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Galindo-Ferreiro A, Marqués-Fernández VE. Orbitopatía tiroidea. Revisión sobre puntos clave para el diagnóstico y tratamiento. ORL 2021. [DOI: 10.14201/orl.23829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción y objetivo: La orbitopatía tiroidea (OT) es una patología autoinmune de etiología desconocida. Se trata de una enfermedad edematosa e inflamatoria crónica y a veces subaguda o aguda, cuyas características principales son edema palpebral, úlceras corneales, hipertensión ocular, exoftalmos generalmente bilateral, estrabismo restrictivo, diplopía y neuropatía óptica. Objetivo: Realizar una revisión y actualización acerca del enfoque diagnóstico y terapéutico de la OT. Métodos: Revisión de la literatura publicada referente a la OT y manera actual de enfocar esta patología. Resultados: OT es una enfermedad inflamatoria orbitaria con un posible origen autoinmune y que suele asociarse a trastornos metabólicos de la glándula tiroidea. Fisiopatológicamente su mecanismo no está claro. Afecta mayormente a mujeres y está negativamente influenciada por factores como el tabaquismo, la edad, el sexo y la raza. Es imprescindible clasificarla en cuanto a su severidad y su actividad para un correcto manejo. Conclusiones: El conocimiento clínico de OT es esencial para el diagnóstico precoz de la enfermedad. El tratamiento médico, en caso de OT activa, debe ser precoz, agresivo y acorde a la fase en que se presente el paciente con el fin de evitar las graves consecuencias de la OT. El tratamiento quirúrgico deberá ser lógico y ordenado, pero a su vez rápido, con el fin de devolver al paciente al entorno laboral, social y familiar.
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17
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Galvez-Ruiz A, Galindo-Ferreiro A, Lehner AJ. A new gene mutation in a family with idiopathic infantile nystagmus. Saudi J Ophthalmol 2021; 35:61-65. [PMID: 34667935 PMCID: PMC8486036 DOI: 10.4103/1319-4534.325787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 01/20/2021] [Accepted: 01/30/2021] [Indexed: 12/04/2022] Open
Abstract
Idiopathic infantile nystagmus (IIN) is an inherited disease, which can occur through a number of different inheritance patterns (autosomal dominant, recessive, or X-linked). The most common of these is X-linked inheritance with incomplete penetrance and variable expressivity, and can also be dominant or recessive. To date, only two mutations have been described: the first, affecting the FPR143 gene, which is associated with ocular albinism type I, and located on chromosome Xp22, and the second, affecting the FRMD7 gene located on chromosome X26-q27. To date, a causative gene on locus Xp11.3p11.4 has not yet been identified. The most common cause of IIN is due to mutations in the FRMD7 gene, located on chromosome Xq26. We present a case of a new mutation found in three siblings from a family with FRMD7-related infantile nystagmus, whose parents are consanguineously related in the first degree. A complex mutation has occurred in this family, which, to date, has not been previously reported in the scientific literature. The complex mutation consists of the presence of three consecutive 1 bp deletions in exon 12 (c.1248delT; 1299del C; and 1312delT), causing a secondary deletion (c. 1340–2145 + 214del), and resulting in a truncated protein. We also present a 7-year-old patient from a different family, with periodic alternating nystagmus, having no mutation in the FRMD7 gene, which we assume may be an example of non-FRMD7-related IIN. This patient does not have a family history of nystagmus.
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Affiliation(s)
- Alberto Galvez-Ruiz
- Neuro-ophthalmology Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Anthony J Lehner
- Orthoptics Division, Clinical Orthoptist, Vision Eye Institute, University of Sydney, New South Wales, Australia.,Orthoptics Division, Save Sight Institute, University of Sydney, New South Wales, Australia
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18
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Galindo-Ferreiro A, Marqués-Fernández VE, Juárez Martín Á, González-Márquez PI, Vega-Gutiérrez J. Eyelid nodules in idiopathic facial aseptic granuloma. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:556-560. [PMID: 34620487 DOI: 10.1016/j.oftale.2020.07.008] [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: 06/09/2020] [Accepted: 07/20/2020] [Indexed: 06/13/2023]
Abstract
Idiopathic facial aseptic granuloma (IFAG) is a recently described and rare condition. It is considered a form of infantile granulomatous rosacea. IFAG with facial and eyelid nodules is very rare. A description is presented of three cases of IFAG eyelid nodules. They concern healthy children with no history of trauma. Biopsy examination revealed non-caseating inflammatory granulomas. Different medical treatments have been tried that seem to accelerate its healing, although its tendency is spontaneous resolution within several months. Painless recurrent eyelid nodules can be confused with chalazion. The diagnosis of IFAG should be considered in chronic eyelid nodules.
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Affiliation(s)
- A Galindo-Ferreiro
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain
| | - V E Marqués-Fernández
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain.
| | - Á Juárez Martín
- Departamento de Dermatología, Hospital Universitario Río Hortega, Valladolid, Spain
| | - P I González-Márquez
- Departamento de Anatomía Patológica, Hospital Universitario Río Hortega, Valladolid, Spain
| | - J Vega-Gutiérrez
- Departamento de Anatomía Patológica, Hospital Universitario Río Hortega, Valladolid, Spain
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Galvez-Ruiz A, Galindo-Ferreiro A, Lehner AJ. CHARGE syndrome: A case report of two new CDH7 gene mutations. Saudi J Ophthalmol 2021; 34:306-309. [PMID: 34527879 PMCID: PMC8409354 DOI: 10.4103/1319-4534.322601] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 05/20/2019] [Accepted: 06/20/2020] [Indexed: 11/29/2022] Open
Abstract
CHARGE syndrome is a genetic disorder comprising the following clinical features: coloboma, heart defects, choanal atresia, retardation (of growth and development), as well as genitourinary and ear abnormalities. This syndrome is caused by mutations in the CDH7 gene, located on chromosome 8 (8q12). We present two new gene mutations in two patients with CHARGE syndrome, not previously reported in the scientific literature. Both of these patients clearly demonstrate the difference in the clinical expression of this syndrome, with patient 1 having a greater clinical severity compared to patient 2. We conclude that although in the scientific literature to date there is no clear correlation between a patient's genotype and phenotype expression, we can assume from the cases we present that a correlation does in fact exist. Specifically, missense mutations (as in case of patient 2) are associated with milder clinical expression, whereas mutations which result in truncation of the CDH7 protein (as in the case of patient 1 having a nonsense mutation) may be associated with a more severe clinical expression.
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Affiliation(s)
- Alberto Galvez-Ruiz
- Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Anthony J Lehner
- Department of Ophthalmology, Vision Eye Institute, Riyadh, Saudi Arabia.,Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
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Zucoloto LH, Artioli MTR, Zornoff DM, Galindo-Ferreiro A, Schellini SA. Nasolacrimal obstruction concomitant to cataract: diagnosis and management in the preoperative period of cataract surgery. Arq Bras Oftalmol 2021; 84:311-315. [PMID: 33567033 DOI: 10.5935/0004-2749.20210044] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/08/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Concomitant nasolacrimal duct obstruction can occur in cataract carriers, which increases the risk of postoperative endophthalmitis. The primary aim of this study is to evaluate the knowledge of Brazilian cataract surgeons on the diagnosis and management of cataracts associated with nasolacrimal duct obstruction. METHODS This survey was based on a questionnaire involving Brazilian cataract surgeons that was conducted from March to April 2018. Data were collected on the participant's profile, time and experience in ophthalmic practice, previous training in diagnosis and management of nasolacrimal duct obstruction, and background with endophthalmitis after cataract surgery in patients with nasolacrimal duct obstruction. All data were entered into an Excel spreadsheet and analyzed according to the frequency of occurrence. RESULTS Ninety-one ophthalmologists answered the questionnaire. Most (63.7%) had been performing cataract surgery for >10 years, and most (84.6%) received training to diagnose and handle nasolacrimal duct obstruction during their medical residence training. Nasolacrimal duct obstruction was investigated in the preoperative period of the cataract by lacrimal sac expression test (53.8%) or by irrigation of the tear pathways (23.1%). Nasolacrimal duct obstruction was treated with antibiotic eye drops by 47.2% of respondents. Seventy-eight percent of surgeons indicate usually performing lacrimal surgery prior to the intraocular surgery, waiting for 4 to 6 weeks to proceed with the cataract surgery. The procedure of choice for treating nasolacrimal duct obstruction prior to cataract surgery was dacryocystorhinostomy (88.4%). Most participants recognized the need for a protocol to assist in the detection and management of nasolacrimal duct obstruction in cataract carriers. CONCLUSION Improvement in the diagnosis and management of nasolacrimal duct obstruction concomitant to cataract is needed, as this is a risk factor for endophthalmitis.
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Affiliation(s)
- Luis Henrique Zucoloto
- Faculdade de Medicina, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
| | - Marina Trentin Regueiro Artioli
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
| | - Denise Moreira Zornoff
- Computer Technical Service and Distance Education Center, Faculdade de Medicina, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
| | - Alicia Galindo-Ferreiro
- Department of Ophthalmology, Rio Hortega University Hospital, Dulzaina St, Valladolid, Spain
| | - Silvana Artioli Schellini
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
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21
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Galindo-Ferreiro A, Sanchez-Tocino H, Diez-Montero C, Belani-Raju M, García-Sanz R, Diego-Alonso M, Llorente-Gonzalez I, Callejo Perez P, Ferrer-Gómez A, Sales-Sanz M, Martinez-Fernandez E, Schellini S. Primary periocular squamous cell carcinoma in central Spain: Factors related to recurrence. Eur J Ophthalmol 2021; 32:2101-2107. [PMID: 34318716 DOI: 10.1177/11206721211035629] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To describe the characteristics and recurrence rates of primary periocular squamous cell carcinoma (SCC) in Spain. METHODS This retrospective study investigates the characteristics of primary periocular SCC at two tertiary centers in Spain from 2000 to 2020. Data were collected on demographics, skin phenotype, location, clinical and histological diagnosis, the commitment of surgical margins, recurrence, and risk factors. Multivariate analysis and risk factors were used to investigate recurrence rates, considering p < 0.05 as statistically significant. RESULTS Over the 20-year studied period, 107 patients with primary periocular SCC were assessed. The mean age of SCC was 76.8 ± 12.8 years, 55 (50.9%) were females, and 105 (98.1%) had Fitzpatrick skin phenotype type II or III. SCC lesions affected less than 1/3 of the eyelid (56/52.3% cases), mainly the lower lid (42/39.3% lesions). Sixty (56.1%) cases were SCC differentiated, 76 (71%) had clear margins. Clinical diagnosis of SCC corroborated with histological in 84 (78.5%) cases and orbital involvement occurred in 18 (16.8%) cases. Recurrence was observed in 13 (12.1%) cases, occurring more in large tumors and undifferentiated subtype (53.8%), with committed margins (69.2%) (p = 0.001), being the commitment of margins a significant predictor for recurrence, although thickness was an independent predictor. CONCLUSION Periocular SCC in Spain showed a similar pattern as in the world. The risk of recurrence is increased in undifferentiated and large periocular SCC, partially removed with committed margins.
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Affiliation(s)
| | | | | | - Minal Belani-Raju
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | - Raquel García-Sanz
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | - Miguel Diego-Alonso
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | | | | | | | - Marco Sales-Sanz
- Department of Ophthalmology, Oculoplastic Unit, Hospital Ramón y Cajal, Madrid, Spain.,Department of Oculoplastic, Instituto de Microcirugía Ocular Madrid, Madrid, Spain
| | | | - Silvana Schellini
- Department of Ophthalmology, Faculdade de Medicina de Botucatu - UNESP, Botucatu, São Paulo, Brazil
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Schellini SA, Marques-Fernandez V, Meneghim RLFS, Galindo-Ferreiro A. Current management strategies of congenital nasolacrimal duct obstructions. Expert Review of Ophthalmology 2021. [DOI: 10.1080/17469899.2021.1945923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Silvana Artioli Schellini
- Department of Ophthalmology, Medical School, State University of Sao Paulo, Botucatu, São Paulo, Brazil
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Bermudez-Castellanos I, Marques-Fernandez V, Gonzalez-Gonzalez D, Alvarez-Garcia M, Galindo-Ferreiro A. Orbital neuromuscular choristoma of the ophthalmic nerve. Eur J Ophthalmol 2021; 32:NP85-NP90. [PMID: 34109844 DOI: 10.1177/11206721211024821] [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] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Neuromuscular choristoma (NC) is a rare tumor composed of striated muscle fibers admixed with nerve fibers that often affects large peripheral nerve trunks in children. To the best of our knowledge, this is the first reported case in the literature of a NC of the ophthalmic nerve in an adult. CASE DESCRIPTION A 27-year-old woman presented with a 20-day history of left periorbital headache radiating to the frontotemporal region, with associated tearing, nausea, and vomiting. The examination was normal, except for hypoesthesia in the distribution of the first trigeminal nerve branch (V1). Cranial computerized tomography showed a lesion in the left orbit and cavernous sinus with widening of the superior orbital fissure. On magnetic resonance imaging, the lesion was well-defined with fusiform morphology and showed a central cystic component and peripheral enhancement. An extradural approach was performed with subtotal tumor resection. Biopsy showed proliferation of striated muscle cells admixed with nerve fascicles and Schwann cells. A pathological diagnosis of NC of V1 was determined. Six months after surgery, left hypotropia with limitation of supraduction was observed, as well as hypoesthesia and paralysis of the left forehead with ipsilateral eyebrow ptosis. The rest of the examination remained within normal limits. CONCLUSION NC should be considered in the differential diagnosis of a young patient with periorbital headache and hypoesthesia in the V1 region.
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Galindo-Ferreiro A, Torres Nieto MA, Barbado Ajo J, Schellini S. Focal Eosinophilic Myositis Affecting the Orbicularis Muscle: Clinical and Image Aspects. Ophthalmic Plast Reconstr Surg 2021; 36:e51-e53. [PMID: 31868790 DOI: 10.1097/iop.0000000000001567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Focal eosinophilic myositis (FEM) is a rare disease that is even more uncommon in affecting the periocular area. The authors are reporting the first case of FEM occurring in the lower eyelid of a 45-year-old Caucasian female who presented with localized painful area of glossy induration and peau d'orange skin lesion. Magnetic resonance image shows significant hyperintense thickening of the pre-septal orbicularis muscle region on T2-weighted images. Incisional biopsy of the induration revealed marked fibrinoid degeneration of the orbicularis muscle and adjacent fascia, mixed cellular infiltration of lymphocytes and eosinophils and a predominant CD8+ lymphocytic infiltrates in the immunohistochemical study. The final diagnosis was FEM. Oral prednisolone improved symptoms and the lesions disappeared, with no recrudescence in a one year follow-up.
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Affiliation(s)
| | | | - Julia Barbado Ajo
- Department of Internal Medicine, Rio Hortega University Hospital, Valladolid, Spain
| | - Silvana Schellini
- Department of Ophthalmology, Faculdade de Medicina de Botucatu - UNESP, São Paulo, Brazil
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Díez-Montero C, Alonso MD, Marquez PIG, Schellini SA, Galindo-Ferreiro A. Solitary fibrofolliculoma: a retrospective case series review over 18 years. Arq Bras Oftalmol 2021; 83:485-489. [PMID: 33470275 DOI: 10.5935/0004-2749.20200092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/12/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The purpose of this study was to report a series of cases of solitary fibrofolliculoma, a lesion seldom observed in the lids. Demographics, as well as clinical and histological aspects of the lesion were evaluated. METHODS This was a retrospective case series spanning a period of 18 years. All the included patients were diagnosed with solitary fibrofolliculoma confirmed by histological examination. Data regarding patient demographics, signs, and symptoms, course of the disease, location of the lesion, clinical and histological diagnosis, and outcome were collected. RESULTS Eleven cases of solitary fibrofolliculoma were diagnosed in the study period. The median age of patients was 51 ± 16.3 years (range: 27-78 years). Most patients were females (7/11; 64%). Five of the patients (45%) were asymptomatic; four (36%) reported bleeding, one (9%) had referred itching, and one (9%) rubbing of the lesion. The lesion occurred in a wide range of locations; one of them was located in the lids. The diagnosis for all lesions was histological based on characteristic findings of a hair follicle occasionally dilated and containing keratin material surrounded by a moderately well-circumscribed thick mantle of fibrous tissue. The infundibular follicular epithelium extended out into this fibrous mantle forming epithelial strands or cords. There were no relapses after exeresis. CONCLUSION Solitary fibrofolliculoma is a rare lesion, seldom affecting the eyelids. We reported 11 cases, and the third case reported thus far in the literature affecting the lids. Diagnosis may be easily missed due to the nonspecific symptoms and clinical appearance. Therefore, it is necessary to perform excisional biopsy and histological examination for the recognition of this lesion.
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Affiliation(s)
| | - Miguel Diego Alonso
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | | | - Silvana Artioli Schellini
- Department of Ophthalmology, Faculdade de Medicina, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
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Equiterio BS, Garcia DM, Cruz AA, Rootman DB, Goldberg RA, Sales-Sanz M, Galindo-Ferreiro A, Diniz S. Lid Flare Measurement with Lateral Midpupil Distances. Curr Eye Res 2021; 46:1309-1313. [PMID: 33517799 DOI: 10.1080/02713683.2021.1878541] [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] [Indexed: 10/22/2022]
Abstract
PURPOSE To assess the sensitivity and specificity of lateral midpupil lid distances for the detection of upper lid lateral flare. METHODS Lateral lid flare was determined by unanimous agreement among six experienced oculoplastic surgeons in the grading of photographs obtained for patients with Graves orbitopathy (GO). Bézier lines were employed to extract the upper eyelid contours of the patients and a control group of age and sex matched subjects. Custom software was employed to determine 5 lateral midpupil eyelid distances. The sensitivity and specificity of each measurement in detecting lateral flare were estimated from receiver operating characteristic curves. The non-parametric Kruskal-Wallis one-way analysis of variance (ANOVA) with Dunn's posthoc test was used to compare the median values of the contour parameters between groups. RESULTS The degree of agreement between judges evaluated with the Fleiss' Kappa test was relatively high (K = 0.69, z = 16.6, p < .0001). The raters classified 12 lids with lateral lid flare (LLF) and 7 without LLF in patients with GO. There was no agreement on the presence or absence of LLF in 11 lids. In all eyes, lateral midpupil lid distances diminished from the center of the eyelid towards the lateral canthus. Receiver operating characteristic analysis for the midpupil distances revealed that the fourth distance from the center demonstrated high sensitivity and specificity in detecting flare. At this location (2.5 mm medial to the lateral canthus) a midpupil distance equal to or greater than 60% of the margin reflex distance (MRD1) indicated the presence of flare. CONCLUSIONS - A single measurement of a lateral midpupil eyelid distance 2.5 mm medial to the lateral canthus is a sensitive and specific measurement for the diagnosis of the LLF.
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Affiliation(s)
- Bruna S Equiterio
- Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Denny M Garcia
- Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Antonio Av Cruz
- Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniel B Rootman
- Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California, Los Angeles, California, USA
| | - Robert A Goldberg
- Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California, Los Angeles, California, USA
| | - Marco Sales-Sanz
- Ophthalmology, Hospital Universitario Ramón Y Cajal, IRYCIS, Madrid, Spain
| | - Alicia Galindo-Ferreiro
- Ophthalmology, Ophthalmology-Oculoplastic, Río Hortega University Hospital, Valladolid, Spain
| | - Stefania Diniz
- Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California, Los Angeles, California, USA
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Alkatan H, Alhammad F, Edward D, Y. Maktabi A, Khandekar R, Galindo-Ferreiro A, Al-Sheikh O. The association of cosmetic-related lacrimal sac black deposits with primary-acquired nasolacrimal duct obstruction and dry eye disease. Saudi J Ophthalmol 2021. [DOI: 10.4103/sjopt.sjop_122_21] [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: 11/04/2022] Open
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Martinez-Fernandez E, Sanchez-Tocino H, Calles Monar PS, Galindo-Ferreiro A. Recurrent bilateral asynchronous cellulitis: Report of two cases and a literature review. Arch Soc Esp Oftalmol (Engl Ed) 2020; 97:S0365-6691(20)30431-7. [PMID: 33358470 DOI: 10.1016/j.oftal.2020.10.010] [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: 05/15/2020] [Revised: 10/05/2020] [Accepted: 10/14/2020] [Indexed: 11/22/2022]
Abstract
Bilateral recurrent periorbital cellulitis is a very rare condition, with only five cases having been reported. Two cases are presented of recurrent bilateral asynchronous eyelid oedema in two paediatric patients. It was associated with respiratory infections, with no systemic disease. The patients had recurrent episodes (three times) since nine months old. They received oral and intravenous antibiotics, with a good response. There were no complications and no surgery was needed.
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Affiliation(s)
- E Martinez-Fernandez
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España.
| | - H Sanchez-Tocino
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España
| | - P S Calles Monar
- Departamento de Oftalmología, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - A Galindo-Ferreiro
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España
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Marqués-Fernández V, De Las Heras Flórez P, Galindo-Ferreiro A. Dacriocistorrinostomía externa, conjuntivo-dacriocistorrinostomía y cirugía de la vía lagrimal en el meato inferior. ORL 2020. [DOI: 10.14201/orl.24154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción y objetivo: Realizar una revisión sobre la dacriocistorrinostomía externa (DCR-ext), sondaje de la vía lagrimal y conjuntivodacriocistorrinostomía(CDCR) empleadas ante la obstrucción de la vía lagrimal.
Material y métodos : Revisión bibliográfica sobre técnicas quirúrgicas mencionadas.
Discusión: La obstrucción de la vía lagrimal puede dividirse según su localización en proximales y distales. Ante obstrucciones distales, la DCR ext es la técnica gold standard con porcentajes de éxito superiores al 95%, y la CDCR en caso de obstrucciones proximales.El sondaje de la vía lagrimal es la primera indicación quirúrgica en obstrucción congénita.
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Diez-Montero C, Marqués-Fernandez V, De Las Heras Florez P, Galindo-Ferreiro A. Abordaje del paciente con patología de la vía lagrimal: Indicaciones quirúrgicas. ORL 2020. [DOI: 10.14201/orl.24145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción y objetivo: Realizar una revisión y actualización del diagnóstico e indicaciones terapéuticas de la obstrucción de la vía nasolagrimal (ONL), así como un abordaje clínico sencillo, precoz y práctico. Método: revisión de la literatura publicada referente a la ONL y sobre la manera actual de enfocar esta patología. Resultados: El lagrimeo excesivo (epífora) puede tener un origen funcional o anatómico. Las obstrucciones funcionales son secundarias al fracaso de la bomba lagrimal, mientras que la obstrucción anatómica es causada por un obstáculo físico a lo largo de la vía lagrimal que impide el drenaje de la misma en la cavidad nasal. La pseudoepífora (lagrimeo reflejo), por el contrario, es secundaria a la presencia de patología de la superficie ocular (ojo seco) o a estímulos mecánicos, químicos, infecciosos o psíquicos. Hasta un 40% de los pacientes referidos a consultas de oftalmología por lagrimeo/epífora, presentan un ojo seco con lagrimeo reflejo, sin obstrucción anatómica de la vía lagrimal. Conclusiones: El lagrimeo es uno de los síntomas más frecuentes en las consultas de oftalmología. Sin embargo, son muy numerosos los factores etiológicos que pueden conducir a esta queja. Es fundamental un estudio multidisciplinar (oftalmología y otorrinolaringología) para realizar un correcto diagnóstico. El éxito de la cirugía lagrimal reside en una correcta indicación quirúrgica.
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Al Essa D, Khandekar R, Galindo-Ferreiro A, Edward DP, Maktabi A, Al Hussein H, Al Sheikh O, Strianese D, Schellini SA. Clinical and histological features and outcomes of upper eyelid colobomas in the Saudi population. Orbit 2020; 39:325-330. [PMID: 31722593 DOI: 10.1080/01676830.2019.1690006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 10/29/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To study the clinical features, histopathology, and management of congenital upper eyelid coloboma (CEC) in the Saudi population. METHODS A retrospective review of health records evaluated the demographics, histopathology, and surgical outcomes of patients with CEC. RESULTS Thirty-nine eyelids of 27 patients were included in this study. CEC was bilateral in 12 (44.4%) patients, isolated in 17 (62.9%), and as part of a syndrome in 10 (37.1%) patients. CEC was commonly located in the medial upper lid (22 lids, 56.4%) and mostly involved the full thickness of the lid (27 lids, 69.2%). Corneal adhesion (18 eyes, 46.1%) and poorly formed eyebrows (21 eyebrows, 53.8%) were the most common ocular/adnexa associations. Histopathology was similar in all cases and the main features were scarred dermis, atrophic orbicularis oculi, and atrophic or absent tarsus. Visual acuity at the final follow-up was 20/50 or better in 13 (33.3%) eyes. Complete lid closure without lagophthalmos after one or more surgical procedures was achieved in 11 (40.7%) cases. CONCLUSIONS CEC features in Saudi patients are similar to those described in the literature. Dermal scarring and defective orbicularis muscles are common. Achieving cosmetic and functional success after management remains challenging.
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Affiliation(s)
- Dalal Al Essa
- Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
- Department of Ophthalmology, College of Medicine, Imam Muhammad Ibn Saud Islamic University , Riyadh, Saudi Arabia
| | - Rajiv Khandekar
- Department of Research, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
| | - Alicia Galindo-Ferreiro
- Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
- Department of Ophthalmology, Rio Hortega University Hospital , Valladolid, Spain
| | - Deepak P Edward
- Pathology Division, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
- Department of Ophthalmology, University of Illinois Eye and Ear Infirmary , Chicago, Illinois, USA
| | - Azza Maktabi
- Pathology Division, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
| | - Hailah Al Hussein
- Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
| | - Osama Al Sheikh
- Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
| | - Diego Strianese
- Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
| | - Silvana A Schellini
- Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital , Riyadh, Saudi Arabia
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Galindo-Ferreiro A, Marqués-Fernández VE, Juárez Martín Á, González-Márquez PI, Vega-Gutiérrez J. Eyelid nodules in idiopathic facial aseptic granuloma. Arch Soc Esp Oftalmol (Engl Ed) 2020; 96:S0365-6691(20)30306-3. [PMID: 32868084 DOI: 10.1016/j.oftal.2020.07.010] [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: 06/09/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
Idiopathic facial aseptic granuloma (IFAG) is a recently described and rare condition. It is considered a form of infantile granulomatous rosacea. IFAG with facial and eyelid nodules is very rare. A description is presented of 3cases of IFAG eyelid nodules. They concern healthy children with no history of trauma. Biopsy examination revealed non-caseating inflammatory granulomas. Different medical treatments have been tried that seem to accelerate its healing, although its tendency is spontaneous resolution within several months. Painless recurrent eyelid nodules can be confused with chalazion. The diagnosis of IFAG should be considered in chronic eyelid nodules.
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Affiliation(s)
- A Galindo-Ferreiro
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España
| | - V E Marqués-Fernández
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España.
| | - Á Juárez Martín
- Departamento de Dermatología, Hospital Universitario Río Hortega, Valladolid, España
| | - P I González-Márquez
- Departamento de Anatomía Patológica, Hospital Universitario Río Hortega, Valladolid, España
| | - J Vega-Gutiérrez
- Departamento de Anatomía Patológica, Hospital Universitario Río Hortega, Valladolid, España
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Galindo-Ferreiro A, Khandekar R, Akaishi PM, Cruz AAV, Galvez-Ruiz A, Dolmetsch A, Schellini SA. Topical mitomycin in endoscopic-assisted probing for the treatment of congenital nasolacrimal duct obstruction in older children. Arq Bras Oftalmol 2020; 83:229-235. [PMID: 32490970 DOI: 10.5935/0004-2749.20200062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 07/02/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Mitomycin C has been used in ophthalmic surgery to mitigate postoperative scarring. However, the outcomes of endoscopic-assisted probing for the treatment of congenital nasolacrimal duct obstruction with adjunctive mitomycin C in children remain unknown. Our study was aimed to evaluate the efficacy and safety of adjunctive application of mitomycin C after endoscopic-assisted probing for the treatment of congenital nasolacrimal duct obstruction in children. METHODS This is a retrospective chart review performed in a tertiary eye care hospital involving children with congenital nasolacrimal duct obstruction, who underwent endoscopic-assisted probing from October 2013 to August 2015. We compared children who underwent endoscopic-assisted probing with mitomycin C (mitomycin C group) versus others who underwent endoscopic-assisted probing without mitomycin C (endoscopic-assisted probing group). The mitomycin C group received 0.2 mg/ml within 4 min to the nasolacrimal duct ostium using a cotton tip applicator immediately after probing. Probing was considered successful when patient complaints of tearing were reduced or the results of the dye disappearance test were normal. Demographic data, clinical features, and intraoperative and postoperative variables were correlated to the success rate. RESULTS The study sample comprised 68 lacrimal vies. The majority of children had bilateral obstruction and no previous history of probing. The mean age of the patients was approximately 4 years. Most obstructions were considered complex. The success rates were high in both groups (p>0.05). There were no adverse events related to the use of mitomycin C (p>0.05). CONCLUSIONS Although mitomycin C has no adverse effects when applied to the opening of the nasolacrimal duct, its use after lacrimal probing for the treatment of congenital nasolacrimal duct obstruction does not improve the chance of success.
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Affiliation(s)
- Alicia Galindo-Ferreiro
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia,Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | | | - Patricia Mitiko Akaishi
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São
Paulo, Ribeirão Preto, SP, Brazil
| | - Antonio Augusto Velasco Cruz
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São
Paulo, Ribeirão Preto, SP, Brazil
| | | | | | - Silvana Artioli Schellini
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia,Department of Ophthalmology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista “Prof. Júlio de Mesquita Filho”, Botucatu, SP,
Brazil
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Galindo-Ferreiro A, Torres Nieto MA, Ali MJ. Orbital fat necrosis following a revision endoscopic dacryocystorhinostomy. Eur J Ophthalmol 2020; 31:NP18-NP21. [PMID: 32486851 DOI: 10.1177/1120672120932087] [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] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This report details a case of a preseptal fat necrosis in a 55-year old female, following a revision endoscopic dacryocystorhinostomy (DCR). CASE DESCRIPTION Upon initial examination, significant right eyelid swelling, tenderness, and pain in the peritrochlear area, was observed. An overlying skin edema was noted in the supero-medial portion of the right upper eyelid. This edema was palpable, firm, and tender. Orbital computed tomography revealed heterogeneous infiltration including an ill-defined margin in the preseptal regions of the clinically evident location. Marked, soft tissue edema and thickening in the inner preseptal area were demonstrated through magnetic resonance images (MRI). An excision biopsy was required as the lesion did not respond to medical treatment. A necrosis of adipose tissue surrounded by abundant foamy macrophages and inflammatory infiltrates, was exposed. CONCLUSION This is an exceptionally rare case of orbital fat necrosis following a DCR. Four possible mechanisms for the development of fat necrosis are discussed.
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Affiliation(s)
| | | | - Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India
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Galindo-Ferreiro A, Sanchez-Tocino H, Diez-Montero C, Belani-Raju M, García-Sanz R, Diego-Alonso M, Llorente-Gonzalez I, Perez PC, Khandekar R, Schellini S. Characteristics and Recurrence of Primary Eyelid Basal Cell Carcinoma in Central Spain. J Curr Ophthalmol 2020; 32:183-188. [PMID: 32671303 PMCID: PMC7337017 DOI: 10.4103/joco.joco_28_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/01/2020] [Accepted: 02/02/2020] [Indexed: 11/04/2022] Open
Abstract
Purpose: To define the incidence, characteristics, and management of eyelid basal cell carcinoma (BCC) in Central Spain. Methods: This retrospective study investigates the characteristics and the outcome of eyelid BCC from 2000 to 2016 in a central region of Spain. Data were collected on demographics, skin phenotype, location of the eyelid lesion, clinical and histological diagnosis, surgery, commitment of surgical margins, and recurrence rate. Results: Primary eyelid BCC occurred in a mean of 20.6 lesions a year or 9.4/100,000 inhabitants/year. The mean age of BCC carriers was 69.4 ± 16.2 years, with no gender difference (P = 0.479), predominantly affecting Fitzpatrick II–III skin (81.3%) (P < 0.001). The most common location was the inner canthus (154/45.7%) (P < 0.001) and type nodular (215 cases/63.8%) (P < 0.001). The surgical margins were affected in 69 (20.5%) individuals, and the recurrence rate was 5.6 (95% confidence interval, 3.2–8.3) significantly higher in affected margins (P < 0.001). The most common location for recurrence was the inner canthus (P = 0.003), and the most common histological type for recurrence was sclerosing (16.7%), then multinodular (12.5%), and infiltrating (10.4%) with no significant difference (P = 0.27). Conclusions: The frequency of occurrence of eyelid BCC is much less than the estimated crude incidence for skin tumors involving all areas of the body in the Spanish population. Eyelid BCC is more common in the seventh decade of life, with no predilection for gender. Nodular histological type is the most common. The recurrence rate is 5.6%, depending on site and affected margins, even though clear free margins also can present with recurrence.
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Affiliation(s)
| | | | | | - Minal Belani-Raju
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | - Raquel García-Sanz
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | - Miguel Diego-Alonso
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | | | | | - Rajiv Khandekar
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Silvana Schellini
- Department of Ophthalmology, Botucatu Medical University - UNESP, São Paulo, Brazil
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Alhammad F, Galindo-Ferreiro A, Khandekar R, Al-Sheikh O, Alzaher F, Schellini S. Management outcomes of canalicular laceration in children. Saudi J Ophthalmol 2020; 34:101-106. [PMID: 33575530 PMCID: PMC7866718 DOI: 10.4103/1319-4534.305041] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 12/05/2019] [Accepted: 12/29/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE: To report the epidemiological data, clinical profile, management, and outcomes of canalicular lacerations in the pediatric age group in a tertiary eye care hospital in Saudi Arabia. METHODS: This retrospective study evaluated pediatric patients who underwent canalicular laceration repair in the last 15 years at King Khalid Eye Specialist Hospital (KKESH), Saudi Arabia. Demographics, causes of injury, type of trauma, surgical approach, and outcomes were analyzed. The success of repair was defined as the absence of epiphora after canaliculus repair with negative dye disappearance test (DDT). Success within subgroups was compared. P < 0.05 was considered statistically significant. RESULTS: The study sample was comprised of 43 patients, with a median age of 6.35 years (range, 1.77–17.96 years). Most of the patients were males (69.8%). Sharp objects were the most common cause of canalicular laceration (46.5%), being 9 (20.9 %) caused by a metallic clothing hanger. Lower canaliculus was involved in 65.1%, upper canaliculus in 32.6%, and both canaliculi in 2.3% of patients. Canaliculus repair was performed with a bicanalicular stent in 58.1 % and monocanalicular stent in 41.9 % of patients.The success rate and risk of complications using bicanalicular or monocanalicular stent did not differ (P = 0.065). Functional success was achieved in 87.5% of patients. CONCLUSION: Canalicular laceration is common in male children, mainly affecting the lower canaliculus. There was no difference in success rate between monocanalicular and bicanalicular stent. As canalicular laceration could be related to social determinants, the main causes should be highlighted in community health education initiatives.
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Affiliation(s)
- Fatimah Alhammad
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Oculoplastics and Orbit Department, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia
| | | | - Rajiv Khandekar
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Osama Al-Sheikh
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Fatimah Alzaher
- Oculoplastics and Orbit Department, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia
| | - Silvana Schellini
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology Faculdade de Medicina de Botucatu - UNESP, São Paulo, Brazil
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Alhammad F, Galindo-Ferreiro A, Khandekar R, Al-Sheikh O, Alzaher F, Schellini S. Management Outcomes of Canalicular Laceration in Children. Saudi J Ophthalmol 2020. [DOI: 10.1016/j.sjopt.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Galindo-Ferreiro A, Sanchez-Tocino H, Varela-Conde Y, Diez-Montero C, Belani-Raju M, García-Sanz R, Diego-Alonso M, LLorente-Gonzalez I, Pazó-Jaudenes C, Schellini S. Ocular emergencies presenting to an emergency department in Central Spain from 2013 to 2018. Eur J Ophthalmol 2019; 31:748-753. [PMID: 31865769 DOI: 10.1177/1120672119896420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To determine the frequency of ocular conditions among patients presenting to an emergency department at a tertiary hospital in Spain. METHODS A retrospective, longitudinal analysis of all patients who presented to the ocular emergency department of Rio Hortega University Hospital, Valladolid, Spain, from 2013 to 2018 was performed. Data on demographics, ophthalmic examination, and diagnosis were collected. Diseases were classified according the International Classification of Diseases, Ninth Revision, Clinical Modification codes. RESULTS We had 20,822 patients, of which 10,878 (52.2%) were women. The main age categories were 45-65 years (7391 patients; 35.5%) and 15-45 years (5979 patients; 28.2%). Most of the patients (17,793; 85.5%) were discharged on the same day. Conjunctival pathology was the most common cause of presentation (4110; 19.7%), followed by corneal disorders (4025; 19.3%). Acute conjunctivitis was diagnosed in 2920 (14%) and ocular trauma in 2125 (10.2%) patients. Non-emergency ophthalmic conditions were diagnosed in 1581 (7.6%) patients. Retinal detachments and peripheral holes occurred more commonly in patients aged 45-65 years (p <0.001). Corneal or conjunctival disorders and lid inflammation (p <0.001) were more frequent in women, whereas men had higher incidences of trauma (p <0.001). CONCLUSION Most of our patients presented ocular surface diseases. Men were more vulnerable to trauma, mainly superficial foreign body. The majority of the patients presented with uncomplicated ocular conditions that would be managed more cost-effectively by primary health care providers. We advocate greater education of primary care physicians and patients in managing simple ocular emergencies to reduce the cases presenting to an emergency department of a tertiary hospital.
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Affiliation(s)
| | | | - Yago Varela-Conde
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | | | - Minal Belani-Raju
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | - Raquel García-Sanz
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | - Miguel Diego-Alonso
- Department of Ophthalmology, Rio Hortega University Hospital, Valladolid, Spain
| | | | | | - Silvana Schellini
- Department of Ophthalmology, Faculdade de Medicina de Botucatu - UNESP, São Paulo, Brazil
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Díaz-Cabanas L, Belani-Raju M, González-Márquez PI, Artioli-Schellini S, Guereñu-Panero I, Galindo-Ferreiro A. Sarcoidosis in the periocular scar as the first finding of systemic sarcoidosis: Clinical-radiological characteristics. Arch Soc Esp Oftalmol (Engl Ed) 2019; 94:453-459. [PMID: 31036427 DOI: 10.1016/j.oftal.2019.03.006] [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] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/01/2019] [Accepted: 03/15/2019] [Indexed: 06/09/2023]
Abstract
An unusual case is presented of a 29 year-old Caucasian woman with a granuloma in an old scar in the right periocular region as a first clinical sign of a systemic sarcoidosis. An excisional biopsy was performed, for which the histological diagnosis was a chronic non-necrotising granulomatous inflammation, suggestive of scar sarcoidosis. The lesion re-appeared one year after initial treatment, and was treated with intralesional depot steroids, showing adequate progression. This disease occurs more frequently in wound areas where there are foreign bodies and could be the first sign of systemic sarcoidosis.
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Affiliation(s)
- L Díaz-Cabanas
- Departamento de Oftalmología, Hospital Clínico Universitario, Valladolid, España.
| | - M Belani-Raju
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España
| | - P I González-Márquez
- Servicio de Anatomía Patológica, Hospital Universitario Río Hortega, Valladolid, España
| | - S Artioli-Schellini
- Departamento de Oftalmología, Faculdade de Medicina de Botucatu - UNESP, São Paulo, Brazil
| | - I Guereñu-Panero
- Servicio de Anatomía Patológica, Hospital Universitario Río Hortega, Valladolid, España
| | - A Galindo-Ferreiro
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España
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Díez-Montero C, Fernández-Pérez GC, Galindo-Ferreiro A. Orbital supratrochlear fistula secondary to anaesthetic block in cataract surgery. ACTA ACUST UNITED AC 2019; 94:561-565. [PMID: 31378390 DOI: 10.1016/j.oftal.2019.07.005] [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: 03/12/2019] [Revised: 06/27/2019] [Accepted: 07/02/2019] [Indexed: 11/27/2022]
Abstract
A case is described of a woman with history of right peribulbar nerve block prior to cataract surgery that, within a few days, presented with a trochlear intraorbital arteriovenous fistula. This was resolved without sequelae after three months by performing intermittent homolateral carotid massages. This is the first case of supratrochlear intraorbital arteriovenous fistula. There are only 8 cases reported of traumatic intraorbital arteriovenous fistula, and only one was with post-peribulbar anaesthesia.
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Affiliation(s)
- C Díez-Montero
- Servicio de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España.
| | - G C Fernández-Pérez
- Servicio de Radiología, Hospital Universitario Río Hortega, Valladolid, España
| | - A Galindo-Ferreiro
- Servicio de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España
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Marqués-Fernández V, Garcia-Zamora M, Calabuig-Goena M, Diez-Montero C, Schellini SA, Khandekar R, Galindo-Ferreiro A. An Objective Evaluation of the Upper Eyelid Position after Phacoemulsification Cataract Surgery. Semin Ophthalmol 2019; 34:442-445. [PMID: 31314625 DOI: 10.1080/08820538.2019.1643379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To objectively measure the upper eyelid position following phacoemulsification cataract surgery and to identify the determinants of postoperative transient ptosis. Methods: This is a single arm prospective study of patients who underwent cataract surgery from January to May 2017 at a tertiary Eye Hospital in Spain. Data comprised of: the type of anesthesia, the duration that the speculum remained in place and the total surgical time (duration of the procedure). The total surgical time was defined as, the time from the beginning of the paracentesis to the closure of the wounds (incision time). Digital photographs were obtained of: the face with the eye in primary gaze, looking inferiorly and superiorly, preoperatively, and 1, 30, 90 and 180 days postoperatively. Measurements for eyelid crease, levator function, and marginal reflex distance 1 (MRD1) were performed using ImageJ. Statistical analysis was performed of the difference between the preoperative and postoperative measurements. Results: The study consisted of 112 patients. The median lid crease was 9.0 mm [IQR (interquartile range) 7.5; 10.0] both preoperatively and at 180 days postoperatively (IQR 8.0; 10.8). No statistical difference was determined in the lid crease measurements between these two times (P = .17). The median levator function differed significantly preoperatively, at day 1 and 30, 60 and 180 days postoperatively (P < .01). MRD1 decreased significantly from a median of 3.01 mm preoperatively to 2.7 mm at 30 days postoperatively (P = .05) but was similar at preoperative and after 180 days (P = .7). The correlation of MRD1 to the duration of the speculum in place (P = .2) and the incision time (P = .57) was not significant. Conclusions: Ptosis, following phacoemulsification cataract surgery, is mild and transient, occurring only in the early postoperative period.
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Affiliation(s)
| | - Maria Garcia-Zamora
- a Department of Ophthalmology, Rio Hortega University Hospital , Valladolid , Spain
| | - Maria Calabuig-Goena
- a Department of Ophthalmology, Rio Hortega University Hospital , Valladolid , Spain
| | - Cecilia Diez-Montero
- a Department of Ophthalmology, Rio Hortega University Hospital , Valladolid , Spain
| | - Silvana A Schellini
- b Oculoplastic Division, King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia.,c Department of Ophthalmology Faculdade de Medicina de Botucatu, UNESP , Botucatu , Brazil
| | - Rajiv Khandekar
- b Oculoplastic Division, King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia
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Galindo-Ferreiro A, Fernandez E, Weill D, Zornoff DCM, Khandekar R, Corrente JE, Schellini SA. A Web-Based Survey of Oculoplastic Surgeons Regarding the Management of Lower Lid Retraction. Semin Ophthalmol 2019; 34:125-130. [DOI: 10.1080/08820538.2019.1596290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Estrella Fernandez
- Department of Ophthalmology, Hospital Clínic de Barcelona, Institut Clínic d‘Oftalmologia, Barcelona, Spain
| | - Daniel Weill
- Department of Ophthalmology, Facultad de Medicina de Buenos Aires, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Denise C M Zornoff
- Distance Education and Health Information Technology Center, Faculdade de Medicina de Botucatu, UNESP, Sao Paulo, Brazil
| | - Rajiv Khandekar
- Diagnostic Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Silvana A Schellini
- Department of Oculoplastics, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Department of Ophthalmology Faculdade de Medicina de Botucatu, UNESP, São Paulo, Brazil
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Galindo-Ferreiro A, AlGhafri L, Akaishi P, Galvez-Ruiz A, Galindo-Alonso J, Schellini S, Cruz A. Punctal Plug as a Treatment Option for Dry Eye Associated with Congenital Supernumary Puncta. Middle East Afr J Ophthalmol 2019; 25:170-172. [PMID: 30765958 PMCID: PMC6348943 DOI: 10.4103/meajo.meajo_102_16] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aims to describe a case of double lower lacrimal punctum-canaliculi in a dry eye patient treated with a punctal plug. A 60-year-old healthy female presented with complaints of tearing, itchy eyes, and foreign body sensation in the right eye for many years. There was no history of trauma or inflammation. Two patent independent supernumerary puncta and canaliculi were present on the right lower eyelid. The Schirmer Test II (with anesthesia) was zero, the tear breakup time was 2 s, and superficial punctate erosions were present in the right eye. A long-term nonabsorbable punctal plug was inserted into one of the lower puncta. At 9-month follow-up, the dry eye symptoms decreased markedly, the Schirmer Test II improved and superficial keratitis resolved.
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Affiliation(s)
- Alicia Galindo-Ferreiro
- Oculoplastic Division, King Khaled Eye Specialist Hospital, Riyadh 12329, Saudi Arabia.,Department of Ophthalmology, Rio Hortega University Hospital, 47012, Valladolid, Spain
| | - Laila AlGhafri
- Oculoplastic Division, King Khaled Eye Specialist Hospital, Riyadh 12329, Saudi Arabia
| | - Patricia Akaishi
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto-University of São Paulo, Brazil
| | - Alberto Galvez-Ruiz
- Oculoplastic Division, King Khaled Eye Specialist Hospital, Riyadh 12329, Saudi Arabia
| | - Julio Galindo-Alonso
- Department of Ophthalmology, Rio Hortega University Hospital, 47012, Valladolid, Spain.,Department of Ophthalmology Faculdade de Medicina de Botucatu- UNESP, São Paulo, Botucatu, SP, 18607-621, Brazil
| | - Silvana Schellini
- Oculoplastic Division, King Khaled Eye Specialist Hospital, Riyadh 12329, Saudi Arabia
| | - Augusto Cruz
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto-University of São Paulo, Brazil
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Díez-Montero C, González González D, Pérez Martínez E, Schellini S, Galindo-Ferreiro A. Periocular inverted follicular keratosis: a retrospective series over 17 years. Jpn J Ophthalmol 2019; 63:210-214. [PMID: 30604112 DOI: 10.1007/s10384-018-00650-7] [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: 03/11/2018] [Accepted: 10/22/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the demographic, clinical, and histopathologic characteristics of periocular inverted follicular keratosis (IFK), a very rare lesion with poorly defined characteristics. STUDY DESIGN Retrospective case series. METHODS We evaluated 11 patients with clinically diagnosed IFK confirmed by histologic analysis. Data were collected on the patients' demographics, clinical presentation and course of the disease, signs and symptoms, location of the lesion, and outcomes of treatment. RESULTS The patients' mean age was 71 years (range, 32-91 years). Seven (64%) of the patients were female. Eight of the patients (72.7%) had no symptoms, two (18.2%) reported itching, and one (9.1%) had edema and bleeding of the lesion. The lesion affected the upper eyelid in 4 of the patients (36%), the lower lid in 3 of the patients (27%), and the inner canthus in 4 of the patients (36%). CONCLUSIONS IFK has no specific clinical characteristic and thus requires histologic confirmation for its diagnosis and appropriate management.
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Affiliation(s)
- Cecilia Díez-Montero
- Department of Ophthalmology, Rio Hortega University Hospital, Dulzaina St. 2, 47012, Valladolid, Spain
| | | | | | - Silvana Schellini
- Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Alicia Galindo-Ferreiro
- Department of Ophthalmology, Rio Hortega University Hospital, Dulzaina St. 2, 47012, Valladolid, Spain.
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Ferreira L, Schellini S, Galindo-Ferreiro A, Zornoff D, Martin J, Meneghim R, Padovani C. How much pediatricians know about congenital nasolacrimal duct obstruction. Resid Pediatr 2019. [DOI: 10.25060/residpediatr-2019.v9n2-06] [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: 11/20/2022] Open
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Galindo-Ferreiro A, AlEssa D, Elkhamary SM, Edward DP, Galvez-Ruiz A, Schellini S. Tungiasis infestation of dermis fat graft in an anophthalmic socket. Saudi J Ophthalmol 2019; 33:102-104. [PMID: 30930673 PMCID: PMC6424711 DOI: 10.1016/j.sjopt.2018.06.005] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 05/12/2018] [Accepted: 06/29/2018] [Indexed: 11/29/2022] Open
Abstract
A patient with an anophthalmic socket with a dermis-fat graft (DFG) developed inflammation and a foul odour in the right socket. The DFG was surgically removed and Tungiasis infestation was detected. This is the first case to report Tungiasis infestation in a DFG in an anophthalmic socket.
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Affiliation(s)
- Alicia Galindo-Ferreiro
- King Khaled Eye Specialist Hospital, Al Urubah Branch Rd, Umm Al Hamam Al Gharbi, Riyadh 12329, Saudi Arabia,Department of Ophthalmology, Rio Hortega University Hospital, Dulzaina St, 2, 47012 Valladolid, Spain,Corresponding author at: Department of Ophthalmology, Rio Hortega University Hospital, Dulzaina St. 2, 47012 Valladolid, Spain.
| | - Dalal AlEssa
- King Khaled Eye Specialist Hospital, Al Urubah Branch Rd, Umm Al Hamam Al Gharbi, Riyadh 12329, Saudi Arabia
| | - Sahar M. Elkhamary
- King Khaled Eye Specialist Hospital, Al Urubah Branch Rd, Umm Al Hamam Al Gharbi, Riyadh 12329, Saudi Arabia,Department of Diagnostic Radiology, Mansoura Faculty of Medicine, El Gomhouria St, Mansoura, Dakahlia Governorate, Egypt
| | - Deepak P. Edward
- King Khaled Eye Specialist Hospital, Al Urubah Branch Rd, Umm Al Hamam Al Gharbi, Riyadh 12329, Saudi Arabia
| | - Alberto Galvez-Ruiz
- King Khaled Eye Specialist Hospital, Al Urubah Branch Rd, Umm Al Hamam Al Gharbi, Riyadh 12329, Saudi Arabia
| | - Silvana Schellini
- King Khaled Eye Specialist Hospital, Al Urubah Branch Rd, Umm Al Hamam Al Gharbi, Riyadh 12329, Saudi Arabia,Department of Ophthalmology, Faculdade de Medicina de Botucatu – UNESP, São Paulo, Via Domingos Sartori, s/n – Distrito de Rubião Junior, Botucatu, SP 18607-621, Brazil
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Sánchez-Tocino H, Villanueva Gómez A, Gordon Bolaños C, Alonso Alonso I, Vallelado Alvarez A, García Zamora M, Francés Caballero E, Marcos-Fernández MÁ, Schellini S, Galindo-Ferreiro A. The effect of light and outdoor activity in natural lighting on the progression of myopia in children. J Fr Ophtalmol 2018; 42:2-10. [PMID: 30573292 DOI: 10.1016/j.jfo.2018.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 02/28/2018] [Revised: 04/25/2018] [Accepted: 05/03/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate potential risk factors for the progression of myopia. METHODS Prospective study. Myopic progression was evaluated by cycloplegic autorefraction and axial length (AL) every 6 months in children 6 to 15 years old. Univariate analysis and multiple logistic regression were applied. RESULTS Around 82 children with median age of 10.3±2.3 years. Myopia progressed by -0.816±0.6 D over 18 months. Increased myopic spherical equivalent refraction (SER) was correlated with increase in AL (P<0.001). Univariate analysis found SER to be significantly associated with: age, especially between 6 and 9.4 years old (P=0.001), parental myopia (P=0.028), and less time spent outdoors (P=0.009). There was a significantly greater increase in SER during months with the least daylight hours (P<0.001). CONCLUSION Outdoor activities and daylight have a protective effect against increased AL and progression of myopia. Younger children with significant myopia should be monitored closely, especially those around 6 years old with myopic parents.
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Affiliation(s)
- H Sánchez-Tocino
- Ophthalmology Department, University Rio Hortega Hospital, C/Dulzaina 2, 47012 Valladolid, Spain.
| | - A Villanueva Gómez
- Ophthalmology Department, University Rio Hortega Hospital, C/Dulzaina 2, 47012 Valladolid, Spain
| | - C Gordon Bolaños
- Ophthalmology Department, University Hospital Complejo Asistencial, Burgos, Spain
| | - I Alonso Alonso
- Ophthalmology Department, University Hospital Complejo Asistencial, Burgos, Spain
| | - A Vallelado Alvarez
- Ophthalmology Department, University Hospital Complejo Asistencial, Burgos, Spain
| | - M García Zamora
- Ophthalmology Department, University Rio Hortega Hospital, C/Dulzaina 2, 47012 Valladolid, Spain
| | - E Francés Caballero
- Ophthalmology Department, University Rio Hortega Hospital, C/Dulzaina 2, 47012 Valladolid, Spain
| | - M Á Marcos-Fernández
- Ophthalmology Department, University Clinic Hospital Valladolid, Valladolid, Spain
| | - S Schellini
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Department of Ophthalmology, Faculdade de Medicina de Botucatu - UNESP, São Paulo, Brazil
| | - A Galindo-Ferreiro
- Ophthalmology Department, University Rio Hortega Hospital, C/Dulzaina 2, 47012 Valladolid, Spain
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Galindo-Ferreiro A, Elkhamary SM, Alhammad F, AlGhafri L, AlWehaib M, Alessa D, Aldossari S, Akaishi P, Khadekar R, AlShaikh O, Schellini SA. Characteristics and management of congenital anophthalmos and microphthalmos at a tertiary eye hospital. Orbit 2018; 38:192-198. [PMID: 30285524 DOI: 10.1080/01676830.2018.1521843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: The purpose of the study is to evaluate demographic data and outcomes of the management of congenital anophthalmia/microphthalmia. Methods: This retrospective, descriptive, cross-sectional study evaluated patients with congenital anophthalmia/microphthalmia managed from 2004 to 2014 at a tertiary hospital in Saudi Arabia. Data were collected on patient age, gender, cause, orbital status, laterality, systemic comorbidities, ocular evaluation, and management (type of surgery, type of orbital implant, and complications). The main outcome measure was the ability to hold the prosthesis. Results: The study sample was composed of 513 eyes/sockets of 365 patients. Two-hundred and seventeen (59.4%) patients were unilateral cases. Forty-one (8%) sockets were due to congenital anophthalmia and 471 (92%) were due to microphthalmia. There were 73.2% isolated cases and 28.5% with systemic involvement. Systemic involvement was more common in bilateral cases. The most commonly associated conditions were central nervous disorders. One-hundred and nineteen (46.7%) cases had parental consanguinity. Two hundred and eighteen eyes/sockets (163 patients) underwent surgery including conjunctival flap (38; 17.4%), evisceration (38; 17.4%), enucleation (16; 7.3%), or procedures to improve the anophthalmic socket volume (45; 20.6%). Volume enhancing procedures included polymethylmethacrylate orbital implants (26; 57.8%), expanders (11; 24.4%), integrated hydroxyapatite or polyethylene implants (2; 4.4%), and dermis-fat graft (6; 13.3%). In most cases, clinical or surgical management resulted in a successful outcome. Conclusion: Anophthalmia/Microphthalmia was detected in 36.5 patients/year. The majority had isolated microphthalmia. Good outcomes were achieved with clinical or surgical management in the majority of cases.
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Affiliation(s)
- Alicia Galindo-Ferreiro
- a Department of Ophthalmology , Rio Hortega University Hospital , Valladolid , Spain.,b Oculoplastics and Orbit Division , King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia
| | - Sahar M Elkhamary
- c Diagnostic Imaging Department , King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia.,d Diagnostic Imaging Department, Mansoura Faculty Of Medicine , Egypt
| | - Fatimah Alhammad
- b Oculoplastics and Orbit Division , King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia
| | - Laila AlGhafri
- b Oculoplastics and Orbit Division , King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia
| | - Manar AlWehaib
- b Oculoplastics and Orbit Division , King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia
| | - Dalal Alessa
- b Oculoplastics and Orbit Division , King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia
| | - Saif Aldossari
- b Oculoplastics and Orbit Division , King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia
| | - Patricia Akaishi
- e Department of Ophthalmology , Faculdade de Medicina da Universidade de São Paulo - USP- Ribeirao Preto , São Paulo , Brazil
| | - Rajiv Khadekar
- b Oculoplastics and Orbit Division , King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia
| | - Osama AlShaikh
- b Oculoplastics and Orbit Division , King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia
| | - Silvana Artioli Schellini
- b Oculoplastics and Orbit Division , King Khaled Eye Specialist Hospital , Riyadh , Saudi Arabia.,f Department of Ophthalmology , Faculdade de Medicina - Universidade Estadual Paulista - UNESP , Botucatu , Brasil
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Galvez-Ruiz A, Galindo-Ferreiro A, Alkatan H. A clinical case of Zellweger syndrome in a patient with a previous history of ocular medulloepithelioma. Saudi J Ophthalmol 2018; 32:241-245. [PMID: 30224891 PMCID: PMC6137698 DOI: 10.1016/j.sjopt.2017.09.004] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 05/02/2017] [Accepted: 09/18/2017] [Indexed: 12/02/2022] Open
Abstract
Peroxisomal biogenesis disorders (PBDs) are autosomal recessive diseases caused by mutations in one of the 14 PEX genes described in the scientific literature. All of these syndromes may be associated with different mutations in the PEX genes, the most frequent being PEX1 for patients with Zellweger syndrome (ZS). In this paper, we present the case of a patient with a peculiar clinical history: evisceration of the left eye (LE) at 4 years of age because of a benign ocular teratoid medulloepithelioma and a progressive loss of visual acuity (VA) in the right eye (RE) beginning at 9 years of age, leading to the diagnosis of ZS. In addition, the patient presented a mutation in the PEX14 gene that has not been previously described in the literature. This case broadens the spectrum of clinical expression in ZS patients because of not only the presence of a benign ocular teratoid medulloepithelioma at 4 years of age but also the late clinical expression of ZS (at 9 years of age).
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Affiliation(s)
| | | | - Hind Alkatan
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Schellini SA, Meneghim RLFDS, Satto L, Cavinatto P, Galindo-Ferreiro A, Khandekar R. Magnitude of visual impairment, blindness and causes in the southwest region of São Paulo state, Brazil. Arq Bras Oftalmol 2018; 81:414-420. [PMID: 30208144 DOI: 10.5935/0004-2749.20180080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/16/2018] [Indexed: 11/20/2022] Open
Abstract
PURPOSES The purpose of this study was to evaluate the magnitude and determinants of bilateral blindness and visual impairment (VI) in the southwest region of São Paulo State, Brazil. METHODS This cross-sectional study conducted during 2013 and 2014 targeted people of all ages in 10 districts in the southwest region of São Paulo State, Brazil. Ophthalmologists in a mobile unit measured visual acuity and examined eyes. Visual acuity was categorized according to the World Health Organization sex-adjusted rates with 95% confidence intervals (CI) were calculated. Number of blindness and visually impaired was projected for the entire study area. RESULTS We examined 2,306 participants. The age- and sex-adjusted frequency of bilateral blindness was 0.26% (95% CI: 0.1-0.4). Females (0.35%) and patients 350 years old (0.58%) had higher rate of blindness compared with males and younger individuals. The rate of severe VI was 9.1% (95% CI: 8.8-10.6) and was higher among males (11.6%) and those 350 years (12.3%). There could be 880 people with bilateral SVI in the study area. Bilateral severe VI was attributed to cataracts in 63% and was attributed to refractive error in 18%. CONCLUSION Visual impairment and blindness in the study population was low and mainly due to cataract and refractive errors. Initiatives should be addressed by health care services to further reduce avoidable blindness in the region.
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Affiliation(s)
- Silvana Artioli Schellini
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.,King Khaled Specialist Eye Hospital, Riyadh, Saudi Arabia
| | - Roberta Lilian Fernandes de Souza Meneghim
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Larissa Satto
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Pedro Cavinatto
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil
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