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Chong Chen, Kun Liu, Yupeng Xu, Pengwei Zhang, Yan Suo, Yi Lu, Wenyuan Zhang, Li Su, Qing Gu, Huamao Wang, Jianren Gu, Zonghai Li, Xun Xu
Anti-vascular endothelial growth factor (VEGF) therapies are widely used for the treatment of neovascular fundus diseases such as diabetic retinopathy. However, these agents need to be injected intravitreally, because their strong hydrophilicity and high molecular weight prevent them from penetrating cell membranes and complex tissue barriers. Moreover, the repeated injections that are required can cause infection and tissue injury. In this study, we used in vivo-directed evolution phage display technology to identify a novel dodecapeptide, named CC12, with the ability to penetrate the ocular barrier in a noninvasive (via conjunctival sac instillation) or minimally invasive (via retrobulbar injection) manner...
September 30, 2016: Biomaterials
Jordan V Chervenkoff, Saul N Rajak, Dinesh Selva, Garry Davis
This case report discusses the case of a 23-year-old male patient who experienced retrobulbar pain, diplopia, proptosis, and mild lower eyelid bruising after consuming 3,4-methylenedioxy-methamphetamine. The symptoms settled over 10 days and vision returned to normal without intervention. The authors discuss the differential diagnosis relevant to the presenting complaints and propose several mechanisms linking 3,4-methylenedioxy-methamphetamine use to spontaneous nontraumatic intraorbital hematoma.
October 20, 2016: Ophthalmic Plastic and Reconstructive Surgery
Kristin E Hirabayashi, Evan Kalin-Hajdu, Frank L Brodie, Robert C Kersten, Matthew S Russell, M Reza Vagefi
A 68-year-old immunocompromised man with rhino-orbital-cerebral mucormycosis was treated with retrobulbar injections of amphotericin B deoxycholate in conjunction with intravenous antifungals and endoscopic sinus debridement. Transient episodes of orbital inflammation were noted after retrobulbar injections, but progression of orbital infection was halted and visual acuity restored with eventual hospital discharge. To the authors' knowledge, clearance of orbital mucormycosis with retrobulbar amphotericin B injections has not been previously reported...
October 20, 2016: Ophthalmic Plastic and Reconstructive Surgery
Nina Marie Rzechorzek, Colin Smith, Tobias Schwarz, Tiziana Liuti, Richard Elders, Samantha Woods, Jessica Lawrence, Katia Marioni-Henry
A dog presented with a retrobulbar mass, diagnosed histopathologically as malignant spindle cell neoplasia. Emergence of analogous findings in the contralateral orbit prompted extended immunohistochemistry of the original mass and reassignment to idiopathic sclerosing orbital inflammation. Early incisional biopsy with extended immunohistochemical analysis should be considered for canine orbital tumors.
October 2016: Clinical Case Reports
Y Hayashi, Yoshiki Ishii, J Nagasawa, S Arai, H Okada, F Ohmi, T Umetsu, Y Machida, K Kurasawa, A Takemasa, S Suzuki, T Senoh, T Sada, K Hirata
Sarcoidosis is a chronic granulomatous disease that can affect multiple organs. The lungs, eyes, and skin are known to be highly affected organs in sarcoidosis. There have been reports based on random muscle biopsy that 32-80% of systemic sarcoidosis comprises noncaseating granulomas; however, muscle involvement in sarcoidosis is generally asymptomatic and has an unknown frequency. We describe a case of acute to subacute sarcoid myositis of the skeletal and extraocular muscles. Typical ophthalmic involvement (manifested by infiltration of the ocular adnexa, intraocular inflammation, or infiltration of the retrobulbar visual pathways) and extraocular sarcoid myositis (as with the present case) is infrequently reported...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Quraish Ghadiali, Larissa K Ghadiali, William M Schiff, Jeffrey G Odel
PURPOSE: To report a case series of two patients with contralateral anesthesia after retrobulbar block. METHODS: Retrospective review of two cases and review of the literature. RESULTS: Two patients of one practitioner received contralateral anesthesia after retrobulbar block for posterior segment surgery. Patient 1 suffered from transient contralateral akinesia, whereas Patient 2 experienced transient contralateral amaurosis. CONCLUSION: Posterior spread of anesthetics is a rare but potentially serious complication of retrobulbar anesthesia caused by spread of anesthetics along the optic nerve sheath...
October 5, 2016: Retinal Cases & Brief Reports
Joel M Fahling, L Kendall McKenzie
BACKGROUND: The oculocardiac reflex is a decrease in heart rate caused by ocular compression or traction upon the extraocular musculature. Multiple instances of this phenomenon have been described in anesthesia, trauma, craniofacial, and ophthalmology literature, but there is a sparsity of documentation in the emergency medicine literature. CASE REPORT: We describe the observation and management of the oculocardiac reflex in a 26-year-old man with retrobulbar hematoma and intraocular trauma caused by a self-inflicted gunshot wound...
October 8, 2016: Journal of Emergency Medicine
Jun-Feng Mao, Xiao-Bo Xia, Xiang-Bo Tang, Xue-Yong Zhang, Dan Wen
AIM: To investigate clinical features of optic nerve sheath meningioma (ONSM) that was misdiagnosed, and to find methods to reduce the misdiagnoses. METHODS: Retrospective series study. Twenty-five misdisgnosed patients with unilateral ONSM were collected from Jan. 2008 to Jan. 2015 and the clinical records reviewed. RESULTS: Patients were misdiagnosed with acute papillitis most frequently (n=17), immediately followed by optic atrophy (n=8), ischemic optic neuropathy (n=5), acute retrobulbar optic neuritis (n=5), optic disc vasculitis (n=3)...
2016: International Journal of Ophthalmology
Ana Licina, Sharan Sidhu, Jing Xie, Crispin Wan
BACKGROUND: Vitrectomy surgery is one of the commonest ophthalmic procedures performed across the world. It may be performed using general or local anaesthesia encompassing regional or topical anaesthesia depending on a number of factors, including patient suitability, and patient, surgeon or anaesthetist preference. There have so far been no evidence-based recommendations on the best form of anaesthesia for this intervention. There is no clear collated evidence base as to the best type of anaesthesia to reduce harm, and provide best surgical conditions and optimal outcome for patients...
September 19, 2016: Cochrane Database of Systematic Reviews
Neerav Lamba, Douglas P Dworak, Shyam A Patel, Rohini Chennuri
A 29-year-old male with acquired immunodeficiency syndrome presented with a week of left eye blurriness, which then progressed to complete vision loss. On exam, the left pupil was nonreactive to light, and fundoscopy showed significant optic nerve edema. CT and MRI of the left orbit showed a mass lesion compressing the posterior aspect of the sclera with diffuse thickening and contrast enhancement of the retrobulbar portion of the left optic nerve. The lesion demonstrated low T1 and intermediate T2 intensities and heterogeneous contrast enhancement and measured 17...
2016: GMS Ophthalmol Cases
Kareem Sioufi, Emil Anthony T Say, Hilary M Gray, Carol L Shields
PURPOSE: To report a case of optic nerve meningocele simulating massive, recurrent extraocular extension of choroidal melanoma. METHOD: Case report. RESULTS: A 53-year-old white man with choroidal melanoma in his left eye of 7.3-mm thickness was treated with plaque radiotherapy and transpupillary thermotherapy. On 1-year follow-up examination, visual acuity was 20/20 in the right eye and 20/30 in the left eye. The regressed choroidal melanoma scar in the left eye measured 1...
September 8, 2016: Retinal Cases & Brief Reports
Paweł Daszkiewicz, Dariusz Dziedzic, Piotr Daszkiewicz
Shot wounds become a growing clinical concern in the civilian setting, due to increasing popularity of air guns among minors. We present a pediatric case of a shot wound to the orbit with sparing of the eyeball and retention of airgun pellet in the retrobulbar space. The pellet was removed 3 months after injury via lateral orbitotomy. Pathophysiology and ballistics of shot wounds are briefly reviewed and current views on the management strategy of shot wounds with retained projectile are discussed.
2016: Neurologia i Neurochirurgia Polska
A Ujam, M Perry
Current guidelines for the urgent management of patients with orbital compartment syndrome include immediate lateral canthotomy and cantholysis, followed by surgical decompression. Medical treatment is also advocated to 'buy time' while preparing the patient for theatre. This consists of high-dose steroids, mannitol, and acetazolamide diuretics to reduce swelling and orbital pressure. It is generally recognized that late or delayed intervention is associated with poor outcomes including blindness. With early presentation, given the potential risk to sight, there is generally a low threshold for treating suspected cases...
November 2016: International Journal of Oral and Maxillofacial Surgery
Brent Siesky, Alon Harris, Joseph Carr, Alice Verticchio Vercellin, Rehan M Hussain, Priyanka Parekh Hembree, Scott Wentz, Michael Isaacs, George Eckert, Nicholas A Moore
PURPOSE: To investigate the relationship of changes in ocular blood flow with optic nerve head (ONH) and retinal morphology in open-angle glaucoma (OAG) patients of African versus European descent (ED) over 4 years. MATERIALS AND METHODS: In this study, 112 patients with OAG were examined at baseline, 79 [59 ED, 20 African descent (AD)] of which were followed for 4 years. Retinal capillary blood flow was assessed with Heidelberg retinal flowmetry. Retrobulbar blood flow was measured by color Doppler imaging...
September 2016: Journal of Glaucoma
Betül Kaskan, Koosha Ramezani, Alon Harris, Brent Siesky, Carine Olinde, Darrell WuDunn, Jennifer Eikenberry, Leslie A Tobe, Lyne Racette
PURPOSE: To investigate differences in ocular blood flow between people of African descent (AD) and European descent (ED) with healthy eyes. MATERIALS AND METHODS: Retrobulbar and retinal capillary blood flow was assessed in 1 eye of 58 participants (24 AD, 34 ED) with healthy eyes with systemic blood pressure lower than 140/90. Retrobulbar blood flow was measured in the ophthalmic artery (OA), central retinal artery (CRA), nasal posterior ciliary artery (NPCA) and temporal posterior ciliary artery (TPCA)...
September 2016: Journal of Glaucoma
Shah Faisal Ahmad Tarfarosh, Mushbiq Manzoor
Brucellosis is a zoonotic disease causing serious public health problems in countries of the Middle-East and developing countries like India. Neurobrucellosis is one of the devastating complications of this re-emerging zoonosis. The objective of this review was to identify the neurological manifestations of Brucellosis in an Indian population and bring into light the effective modalities used for treating neurobrucellosis. A systematic review of the scientific literature reported in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines was conducted...
2016: Curēus
Fábio Caetano Oliveira Leme, Eduardo Toshiyuki Moro, Alexandre Alberto Fontana Ferraz
BACKGROUND AND OBJECTIVES: Peribulbar anesthesia (PBA) has emerged as a safer option compared with intraconal retrobulbar block. Still, PBA may not be considered without risk. Numerous complications have been described when performing this technique. This report aims to describe a rare case of amaurosis and contralateral paralysis while attempting to perform a PBA. CASE REPORT: Male patient, 75-year old, physical status ASA II, undergoing cataract surgery by phacoemulsification with intraocular lens implantation...
August 20, 2016: Revista Brasileira de Anestesiologia
Somen Misra, Akshay Bhandari, Neeta Misra, Pratik Gogri, Shruti Mahajan
Ectopic lacrimal gland, being one of the choristomas, is comprised of lacrimal gland tissue outside the lacrimal gland fossa in the fronto-lateral part of the orbital roof. Ectopic lacrimal gland is a rare condition where the gland may be found in the orbit, eyelids, ocular adnexa or within the globe. Neoplastic transformation of such tissue may occur. A sixty-two-year old male patient presented with right eye proptosis and slight nasal displacement of the globe. Computerized tomography scan revealed a well-defined hypodense lesion of size 19 x 18 x 20 mm supero-lateral to lateral rectus muscle, with mild proptosis and thinning of the right lateral orbital wall...
October 2016: Orbit
A Sadeghi-Tari, M Jamshidian-Tehrani, A Nabavi, S Sharif-Kashani, E Elhami, N Hassanpour, K Ameli Zamani
PurposeTo evaluate the effect of smoking on retrobulbar blood flow parameters by color Doppler imaging in patients with thyroid eye disease.Patients and methodsIn this observational case series, blood flow parameters in the ophthalmic artery, superior ophthalmic vein, central retinal artery, and vein were determined by color Doppler imaging in patients with thyroid eye disease. Patients were grouped as smokers and non-smokers. Never smokers and those who had stopped smoking for at least 1 year before onset of ophthalmopathy were considered as non-smokers...
August 19, 2016: Eye
Pingbo Zhang, Rabia Karani, Randi L Turner, Craig Dufresne, Sara Ferri, Jennifer E Van Eyk, Richard D Semba
The optic nerve is a white matter tract that conveys visual information to the brain. The sclera comprises the white, protective outer layer of the eye. A characterization of the proteome of normal human retrobulbar optic nerve and sclera may facilitate studies of the eye. We conducted a proteomic analysis of optic nerve and sclera from five adults. Proteins were fractionated using SDS-PAGE. After in-gel digestion, peptides were analyzed using LC-MS/MS on an Orbitrap Elite mass spectrometer. We identified 2711 non-redundant proteins in retrobulbar optic nerve and 1945 non-redundant proteins in sclera...
October 2016: Proteomics
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