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Orbital inflammation

Oded Sagiv, Thomas J Kandl, Sudip D Thakar, Bradley A Thuro, Naifa L Busaidy, Maria Cabanillas, Camilo Jimenez, Ramona Dadu, Paul H Graham, J Matthew Debnam, Bita Esmaeli
PURPOSE: To describe thyroid eye disease (TED)-like orbital inflammatory syndrome in 3 cancer patients treated with immune checkpoint inhibitors. METHODS: All consecutive patients treated by the senior author who were receiving immune checkpoint inhibitors and developed TED-like orbital inflammation were included. RESULTS: Three cancer patients treated with immune checkpoint inhibitors developed orbital inflammation. The first patient was treated with a combination of a cytotoxic T-lymphocyte antigen-4 inhibitor and a programmed cell death protein 1 inhibitor and developed TED-like orbital inflammation with normal thyroid function and antibody levels...
June 19, 2018: Ophthalmic Plastic and Reconstructive Surgery
Peerooz Saeed, Shahzad Tavakoli Rad, Peter H L T Bisschop
PURPOSE: Dysthyroid optic neuropathy (DON) is a serious complication of Graves orbitopathy that can result in irreversible and profound visual loss. Controversy exists regarding the pathogenesis and management of the disease. The authors provide an overview of the current understanding of DON and present a therapeutic guideline. METHODS: A review of the literature. RESULTS: The mechanism of DON appears to be multifactorial: direct compression of the optic nerve by enlarged extraocular muscles, stretching of the optic nerve by proptosis, orbital pressure, vascular insufficiency, and inflammation...
June 19, 2018: Ophthalmic Plastic and Reconstructive Surgery
José Lorenzo Romero-Trevejo, Navin Rachwani-Parshotam, María Josefa Morillo-Sánchez
A 44-year-old man was referred for evaluation of pain and temporal floaters after receiving a rebounded bullet impact to his right eye. Typical funduscopic findings, together with the confirmed presence of an intraorbital metallic foreign body, led to the diagnosis of chorioretinitis sclopetaria. Conservative management was performed as no severe symptoms were observed. The favorable clinical outcome was confirmed in subsequent reviews. Chorioretinitis sclopetaria is characterized by a proliferative chorioretinal inflammation as a consequence of the expansive wave caused by the entrance of a bullet between the eyeball and the orbit...
June 2018: Arquivos Brasileiros de Oftalmologia
Tomás Ortiz-Basso, Rodolfo L Vigo, Mariano Sidelnik, Mariana S Vazquez-Durand, María F Shokida, Eduardo J Prémoli, Ricardo García-Mónaco
PURPOSE: To evaluate if parabulbar triamcinolone reduces orbital swelling in patients with Graves ophthalmopathy. METHODS: This is a prospective study of a series of patients with active and moderate Graves ophthalmopathy. Short tau inversion recovery magnetic resonance was used to evaluate the intensity of the extraocular rectus muscles and orbital fat, before and after the treatment with parabulbar triamcinolone. RESULTS: The signal intensity ratio of the sum of the OD rectus muscles was 3...
June 18, 2018: Ophthalmic Plastic and Reconstructive Surgery
Anja Eckstein, Joachim Esser, Michael Oeverhaus, Peerooz Saeed, Hinke Marijke Jellema
PURPOSE: To review the authors' current understanding of motility dysfunction in patients with thyroid eye disease and to summarize appropriate evaluation and available management options. METHODS: Data were retrieved from a systematic search of the literature. RESULTS: Diplopia is one of the most disabling symptoms for Graves orbitopathy patients. It occurs in moderate-to-severe Graves orbitopathy stages and does not respond well to available anti-inflammatory treatment...
June 13, 2018: Ophthalmic Plastic and Reconstructive Surgery
Ivan Vrcek, Evan Wotipka, Marie Somogyi, Tanuj Nakra
We present a case of a 36-year-old man who developed rapid onset of proptosis and orbital compartment syndrome resulting in no light perception vision. He was treated with surgery and subsequent rituximab therapy with some recovery of vision and motility. Though the range of presentations of idiopathic orbital inflammation is broad, such rapid evolution of proptosis with complete vision loss is very uncommon.
July 2018: Proceedings of the Baylor University Medical Center
Byung-Chul Lee, Nari Shin, Jin Young Lee, Insung Kang, Jae-Jun Kim, Seung Eun Lee, Soon Won Choi, Gill A Webster, Kyung-Sun Kang
Human adult stem cells, including umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs), have recently been considered a promising alternative treatment for inflammatory bowel disease (IBD) due to their unique immunomodulatory properties and ability to promote tissue regeneration. However, despite many years of research and pre-clinical studies, results from clinical trials using these cells have been diverse and conflicting. This discrepancy is caused by several factors, such as poor engraftment, low survival rate, and donor-dependent variation of the cells...
2018: Frontiers in Immunology
Jonathan J Dutton
PURPOSE: To review and summarize the clinical findings in thyroid eye disease (TED) related to the unique anatomical structures of the eyelids and orbit. METHODS: A PubMed search was performed searching for anatomical relationships between eyelid and orbital anatomy and the clinical findings of TED. RESULTS: The major clinical findings associated with TED are varied. They typically involve both the eyelid and the orbit. In the eyelid, usual findings include upper eyelid retraction, contour abnormalities, eyelid edema, prolapsed orbital fat, conjunctival injection and chemosis, caruncular edema, and meibomian gland dysfunction...
May 10, 2018: Ophthalmic Plastic and Reconstructive Surgery
Linda Cambier, Jorge F Giani, Weixin Liu, Takeshi Ijichi, Antonio K Echavez, Jackelyn Valle, Eduardo Marbán
Hypertension often leads to cardiovascular disease and kidney dysfunction. Exosomes secreted from cardiosphere-derived cells (CDC-exo) and their most abundant small RNA constituent, the Y RNA fragment EV-YF1, exert therapeutic benefits after myocardial infarction. Here, we investigated the effects of CDC-exo and EV-YF1, each administered individually, in a model of cardiac hypertrophy and kidney injury induced by chronic infusion of Ang (angiotensin) II. After 2 weeks of Ang II, multiple doses of CDC-exo or EV-YF1 were administered retro-orbitally...
June 4, 2018: Hypertension
Katharine S Dempsey, Norman C Charles, Irina Belinsky
A 74-year-old man presenting with proptosis and orbital inflammation was found on magnetic resonance imaging to have a unilateral intraconal mass. Biopsy revealed a high-grade malignant tumor that was interpreted as squamous cell carcinoma. Positron emission tomography-computed tomography imaging subsequently identified a primary lesion in the esophagus. Esophageal squamous cell carcinoma is a rare cause of orbital metastasis, with only 4 previously reported cases. The authors discuss an approach to orbital malignancies of obscure origin...
May 18, 2018: Ophthalmic Plastic and Reconstructive Surgery
Sathyadeepak Ramesh, Sasha Hubschman, Robert Goldberg
BACKGROUND: Orbital fractures are one of the most common sequelae of facial trauma. OBJECTIVE: The objective of this study was to summarize published data for resorbable implants in orbital reconstruction, including polymer composition, degradation characteristics, osteoconductivity, and complications such as enophthalmos, diplopia, and peri-implant inflammation. A literature search of the National Library of Medicine was performed via PubMed using the keyword resorbable orbital implant...
May 30, 2018: Annals of Plastic Surgery
Thomas Stahnke, Ngoy Kilangalanga, Steffi Knappe, Rudolf F Guthoff, Andreas Erbersdobler
Carcinoma of the conjunctiva is a malignant tumor which is mostly detected and surgically treated at an early stage because of medical or cosmetic problems. Exceptions of this rule may occur in developing countries, where patients do not have access to standard medical care systems. We report the case of a conjunctival carcinoma in an African patient with an unusually late presentation. Because of local medical shortcomings, and considering the severe, transmural inflammation of anterior ocular structures, an exenteration was performed although the orbit was not deeply involved with the tumor...
2018: Case Reports in Ophthalmological Medicine
Bahareh Hassanzadeh, Jeffrey DeSanto, Jorge C Kattah
Ipilimumab is a novel anti-melanoma agent known to infrequently cause multi-organ autoimmunity. We report a case of pituitary hypophysitis and orbital inflammation followed by an orbital apex syndrome. A 64-year-old woman with a history of skin melanoma, receiving ipilimumab treatment, was seen for near total loss of vision in the right eye and proptosis. Headache of 3-month duration preceded the onset of diplopia followed by severe loss of vision in the right eye. Neuro-ophthalmologic examination was consistent with an orbital apex syndrome...
June 2018: Neuro-ophthalmology
Krishnan Ravindran, Philip Schmalz, Nurhan Torun, Michael Ronthal, Yu-Ming Chang, Ajith J Thomas
The Tolosa-Hunt syndrome is a rare clinical condition characterized by painful opthalmoparesis associated with idiopathic granulomatous inflammation of the orbital apex and cavernous sinus. Historically, this condition was thought to result from arteritic changes in the internal carotid artery and cavernous sinus. Modern digital angiographic techniques were unavailable when THS was initially described, and few reports exist on its high-resolution angiographic findings. Painful ophthalmoparesis, especially of the oculomotor nerve, warrants vascular imaging because of the concern for an underlying aneurysm...
June 2018: Neuro-ophthalmology
Ang Li, Thomas P Plesec, Linda Mileti, Arun D Singh
PURPOSE: To report a unique case of isolated conjunctival inflammation from IgG4-related disease (IgG4-RD) confirmed by pathology. METHODS: A single interventional case of conjunctival IgG4-RD. RESULTS: A 63-year-old woman presented with a chronic, solitary, vascularized, tan-colored, and raised conjunctival lesion measuring 7.5 × 8.0 × 1.2 mm located at the temporal bulbar conjunctiva. An excisional biopsy was diagnostic of IgG4-RD based on the classic fibrosis pattern, 120 IgG4-positive plasma cells per high-power field, and an overwhelming majority of IgG4-positive cells among IgG plasma cells...
May 23, 2018: Cornea
Sarah Santiloni Cury, Miriane Oliveira, Maria Teresa Síbio, Sueli Clara, Renata De Azevedo Melo Luvizotto, Sandro Conde, Edson Nacib Jorge, Vania Dos Santos Nunes, Célia Regina Nogueira, Gláucia Maria Ferreira da Silva Mazeto
OBJECTIVE: Graves' ophthalmopathy (GO) is an autoimmune disease that leads to ocular proptosis caused by fat accumulation and inflammation, and the main treatment is corticosteroid therapy. Retinoid acid receptor-alpha (RARα) seems to be associated with inflammation and adipocyte differentiation. This study aimed to assess the effect of glucocorticoid treatment on orbital fibroblasts of GO patient treated or not with different glucocorticoid doses. MATERIALS AND METHODS: Orbital fibroblasts collected during orbital decompression of a female patient with moderately severe/severe GO were cultivated and treated with 10 nM and 100 nM dexamethasone (Dex)...
May 17, 2018: Archives of Endocrinology and Metabolism
Pei-Hsuan Lin, Yoshiyuki Kitaguchi, Jacqueline Mupas-Uy, Yasuhiro Takahashi, Hirohiko Kakizaki
Purpose: To report a rescue technique for complete removal of an accidentally ruptured orbital dumbbell deep dermoid cyst. Observations: A 33-year-old female presented with left proptosis with retrobulbar discomfort for 3 months. Computed tomography images showed an orbital dumbbell deep dermoid cyst. A lateral orbitotomy was performed under general anesthesia. The cyst was ruptured during osteotomy of the lateral orbital rim. The cyst was opened vertically from the ruptured site using a Stephen's tenotomy scissors to visually confirm the internal wall of the cyst and to keep the epithelial lining intact while separating the external wall of the cyst from the bone...
June 2018: American Journal of Ophthalmology Case Reports
Mate Szarka, Szabolcs Szilasi, Boglarka Donczo, Daniel Sarkozy, Istvan Rajta, Andras Guttman
On a roundtrip to Mars, astronauts are expectedly exposed to an approximate amount of radiation that exceeds the lifetime limits on Earth. This elevated radiation dose is mainly due to Galactic Cosmic Rays (GCR) and Solar Particle Events (SPE). Specific patterns of the N-glycosylation of human immunoglobulins have already been associated with various ailments such as autoimmune diseases, malignant transformation, chronic inflammation and ageing. The focus of our work was to investigate the effect of low-energy proton irradiation on the IgG N-glycosylation profile with the goal if disease associated changes could be detected during space travel and not altered by space radiation...
May 18, 2018: Electrophoresis
Bradford W Lee, Virender B Kumar, Pooja Biswas, Audrey C Ko, Ramzi M Alameddine, David B Granet, Radha Ayyagari, Don O Kikkawa, Bobby S Korn
Objective: This study utilized Next Generation Sequencing (NGS) to identify differentially expressed transcripts in orbital adipose tissue from patients with active Thyroid Eye Disease (TED) versus healthy controls. Method: This prospective, case-control study enrolled three patients with severe, active thyroid eye disease undergoing orbital decompression, and three healthy controls undergoing routine eyelid surgery with removal of orbital fat. RNA Sequencing (RNA-Seq) was performed on freshly obtained orbital adipose tissue from study patients to analyze the transcriptome...
2018: Open Ophthalmology Journal
Diego Strianese, Fausto Tranfa, Marialuisa Finelli, Adriana Iuliano, Stefania Staibano, Giuseppe Mariniello
Background: Inflammatory myofibroblastic tumor (IMT) is a rare entity characterized by the presence of myofibroblasts and inflammatory cells within a fibrous stroma, which typically occurs in children or young adults. The IMT is considered generally a benign lesion, although about 20% of cases may experience recurrence, and most rarely develop metastasis. Herein, we present the largest series of primary orbital IMT ever reported. Patients and methods: The clinical records of 25 patients, collected between the 1995 and 2015, with biopsy-proven diagnosis of orbital IMT were retrospectively reviewed to determine demographic, clinical, radiologic and pathological features, management, and outcome...
January 2018: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
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