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Bydžovský J, Diblík P, Holakovský J, Mašek M, Vlachopulos V, Sklenka P, Kuthan P, Mazánek J. RESULTS OF 15 YEARS OF COLLABORATION BETWEEN THE DEPARTMENTS OF OPHTHALMOLOGY AND STOMATOLOGY IN ONCOLOGICAL SURGERY OF THE ORBIT: A DIAGNOSTIC AND THERAPEUTIC APPROACH. Cesk Slov Oftalmol 2020; 76:146-157. [PMID: 33297699 DOI: 10.31348/2020/24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM To report an overview of the most frequent tumors of the orbit, suggest diagnostic approach and possible solution according to experience with own cohort of patients. MATERIAL AND METHODS From patients files from the Department of Ophthalmology and Department of Stomatology, First Medical Faculty, Charles University, and General Faculty Hospital in Prague, Czech Republic, there were selected patients, who underwent the surgery due to the suspicion of malignant development in the orbit during the period 2005 - 2019. From the surgical records we found information about 497 cases. At the Department of Stomatology, there were 282 surgeries under general anesthesia performed, and at the Department of Ophthalmology, there were 215 surgeries, mostly under local anesthesia performed. RESULTS The number of surgeries in men and women was equal; patients of all ages were present. The median of patients age operated on at the Department of Stomatology was 53 years, and at the Department of Ophthalmology 63 years. The most common primary benign tumor was the cavernous hemangioma (9 %), the most common non-tumorous expansion was the dermoid cyst (7 %); the most common malignant tumor was the lymphoma (17,5 %). The last mentioned tumor was the most common diagnosis in the whole cohort as well. CONCLUSION Our cohort of patients is comparable with large cohorts published in the literature concerning age and gender distributions. Differences in frequencies of some lesions may be explained by that our cohort includes patients after the surgery only. The malignant lymphoma is the most common diagnosis indicated to surgical procedure, mostly biopsy. Comparing the two cohorts from our departments 20 years apart, the malignant lymphoma remains the most common indication for surgery, but the incidence of adenomas and adenocarcinomas of the lacrimal gland decreased. It is not the goal of this paper to evaluate all possible orbital affections. Suggested surgical approaches are just recommendations according to years of experience; however, in some situations, to choose an individual surgical approach is necessary.
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Nurieva O, Hubacek JA, Urban P, Hlusicka J, Diblik P, Kuthan P, Sklenka P, Meliska M, Bydzovsky J, Heissigerova J, Kotikova K, Navratil T, Komarc M, Seidl Z, Vaneckova M, Vojtova L, Zakharov S. Clinical and genetic determinants of chronic visual pathway changes after methanol - induced optic neuropathy: four-year follow-up study. Clin Toxicol (Phila) 2018; 57:387-397. [PMID: 30451020 DOI: 10.1080/15563650.2018.1532083] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT Methanol poisoning induces acute optic neuropathy with possible long-term visual damage. OBJECTIVE To study the dynamics and key determinants of visual pathway functional changes during 4 years after acute methanol poisoning. METHODS A total of 42 patients with confirmed methanol poisoning (mean age 45.7 ± 4.4 years) were examined 4.9 ± 0.6, 25.0 ± 0.6, and 49.9 ± 0.5 months after discharge. The following tests were performed: visual evoked potential (VEP), retinal nerve fiber layer (RNFL) measurement, brain magnetic resonance imaging (MRI), complete ocular examination, biochemical tests, and apolipoprotein E (ApoE) genotyping. RESULTS Abnormal VEP P1 latency was registered in 18/42 right eyes (OD) and 21/42 left eyes (OS), abnormal N1P1 amplitude in 10/42 OD and OS. Mean P1 latency shortening during the follow-up was 15.0 ± 2.0 ms for 36/42 (86%) OD and 14.9 ± 2.4 ms for 35/42 (83%) OS, with maximum shortening up to 35.0 ms. No significant change of mean N1P1 amplitude was registered during follow-up. A further decrease in N1P1 amplitude ≥1.0 mcV in at least one eye was observed in 17 of 36 patients (47%) with measurable amplitude (mean decrease -1.11 ± 0.83 (OD)/-2.37 ± 0.66 (OS) mcV versus -0.06 ± 0.56 (OD)/-0.83 ± 0.64 (OS) mcV in the study population; both p < .001). ApoE4 allele carriers had lower global and temporal RNFL thickness and longer initial P1 latency compared to the non-carriers (all p < .05). The odds ratio for abnormal visual function was 8.92 (3.00-36.50; 95%CI) for ApoE4 allele carriers (p < .001). The presence of ApoE4 allele was further associated with brain necrotic lesions (r = 0.384; p = .013) and brain hemorrhages (r = 0.395; p = .011). CONCLUSIONS Improvement of optic nerve conductivity occurred in more than 80% of patients, but evoked potential amplitude tended to decrease during the 4 years of observation. ApoE4 allele carriers demonstrated lower RNFL thickness, longer P1 latency, and more frequent methanol-induced brain damage compared to non-carriers.
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Affiliation(s)
- Olga Nurieva
- a Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic
| | - Jaroslav A Hubacek
- b Center for Experimental Medicine , Institute for Clinical and Experimental Medicine , Prague , Czech Republic
| | - Pavel Urban
- a Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic.,c Centre for Industrial Hygiene and Occupational Medicine , National Institute of Public Health , Prague , Czech Republic
| | - Jiri Hlusicka
- a Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic
| | - Pavel Diblik
- d Clinic of Ophthalmology, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic
| | - Pavel Kuthan
- d Clinic of Ophthalmology, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic
| | - Petr Sklenka
- d Clinic of Ophthalmology, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic
| | - Martin Meliska
- d Clinic of Ophthalmology, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic
| | - Jan Bydzovsky
- d Clinic of Ophthalmology, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic
| | - Jarmila Heissigerova
- d Clinic of Ophthalmology, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic
| | - Katerina Kotikova
- a Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic
| | - Tomas Navratil
- e Department of Biomimetic Electrochemistry , J. Heyrovský Institute of Physical Chemistry of the Czech Academy of Sciences , Prague , Czech Republic.,f Institute of Medical Biochemistry and Laboratory Medicine, First Faculty of Medicine , Charles University and General University Hospital in Prague , Prague , Czech Republic
| | - Martin Komarc
- g Department of Methodology, Faculty of Physical Education and Sport , Charles University , Prague , Czech Republic
| | - Zdenek Seidl
- h Department of Radiology, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic
| | - Manuela Vaneckova
- h Department of Radiology, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic
| | - Lucie Vojtova
- i First Faculty of Medicine, Institute of Clinical Biochemistry and Laboratory Diagnostics , Charles University and General University Hospital , Prague , Czech Republic
| | - Sergey Zakharov
- a Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine , Charles University and General University Hospital , Prague , Czech Republic
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Zakharov S, Nurieva O, Diblik P, Kuthan P, Sklenka P, Meliska M, Bydzovsky J, Heissigerova J, Urban P, Kotikova K, Navratil T, Komarc M, Seidl Z, Vaneckova M, Pelclova D. Reply. Am J Ophthalmol 2018; 195:247-248. [PMID: 30253843 DOI: 10.1016/j.ajo.2018.08.018] [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] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 08/08/2018] [Indexed: 10/28/2022]
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Nurieva O, Diblik P, Kuthan P, Sklenka P, Meliska M, Bydzovsky J, Heissigerova J, Urban P, Kotikova K, Navratil T, Komarc M, Seidl Z, Vaneckova M, Pelclova D, Zakharov S. Progressive Chronic Retinal Axonal Loss Following Acute Methanol-induced Optic Neuropathy: Four-Year Prospective Cohort Study. Am J Ophthalmol 2018; 191:100-115. [PMID: 29709459 DOI: 10.1016/j.ajo.2018.04.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 12/24/2017] [Revised: 03/03/2018] [Accepted: 04/19/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE To study the dynamics and clinical determinants of chronic retinal nerve fiber layer thickness (RNFL) loss after methanol-induced optic neuropathy. DESIGN Prospective cohort study. METHODS All patients underwent complete ophthalmic evaluation including spectral-domain optical coherence tomography 3 times during 4 years of observation: 4.9 (±0.6), 25.0 (±0.6), and 49.9 (±0.5) months after discharge. PARTICIPANTS Eighty-four eyes of 42 survivors of methanol poisoning, mean age (standard deviation) of 45.7 (±4.4) years; and 82 eyes of 41 controls, mean age 44.0 (±4.2) years. MAIN OUTCOME MEASURES Global and temporal RNFL loss. RESULTS Abnormal RNFL thickness was registered in 13 of 42 (31%) survivors of methanol poisoning and chronic axonal loss in 10 of 42 (24%) patients. Significant decrease of global/temporal RNFL thickness during the observation period was found in the study population compared to the controls (P < .001). The risk estimate of chronic global RNFL loss for arterial blood pH < 7.3 at admission was 11.65 (95% confidence interval 1.91-71.12) after adjusting for age and sex. The patients with chronic axonal degeneration demonstrated progressive visual loss in 7 of 10 cases. The patients with abnormal RNFL thickness had magnetic resonance signs of brain damage in 10 of 13 vs 8 of 29 cases with normal RNFL thickness (P = .003). Signs of brain hemorrhages were present in 7 of 13 patients with abnormal RNFL thickness vs 5 of 29 cases with normal RNFL thickness (P = .015). CONCLUSIONS Methanol-induced optic neuropathy may lead to chronic retinal axonal loss during the following years. Arterial blood pH on admission is the strongest predictor of chronic RNFL thickness decrease. Chronic retinal neurodegeneration is associated with the progressive loss of visual functions and necrotic brain lesions.
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Affiliation(s)
- Olga Nurieva
- Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Pavel Diblik
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Pavel Kuthan
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Petr Sklenka
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Martin Meliska
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jan Bydzovsky
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jarmila Heissigerova
- Clinic of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Pavel Urban
- Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Katerina Kotikova
- Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Tomas Navratil
- Department of Biomimetic Electrochemistry, J. Heyrovský Institute of Physical Chemistry of the Czech Academy of Sciences, Prague, Czech Republic; Institute of Medical Biochemistry and Laboratory Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Martin Komarc
- Department of Methodology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Zdenek Seidl
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Manuela Vaneckova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Daniela Pelclova
- Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Sergey Zakharov
- Toxicological Information Centre, Department of Occupational Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
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