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Ophthalmic Plastic and Reconstructive...The purpose of this study was to compare the histopathologic inflammation and fibrosis of orbital adipose tissue in orbital inflammatory disease (OID) specimens.
PURPOSE
The purpose of this study was to compare the histopathologic inflammation and fibrosis of orbital adipose tissue in orbital inflammatory disease (OID) specimens.
METHODS
In this retrospective cohort study, inflammation, and fibrosis in orbital adipose tissue from patients with thyroid-associated orbitopathy (TAO), granulomatosis with polyangiitis (GPA), sarcoidosis, nonspecific orbital inflammation (NSOI), and healthy controls were scored by 2 masked ocular pathologists. Both categories were scored on a scale of 0 to 3 with scoring criteria based on the percentage of specimens containing inflammation or fibrosis, respectively. Tissue specimens were collected from oculoplastic surgeons at 8 international centers representing 4 countries. Seventy-four specimens were included: 25 with TAO, 6 with orbital GPA, 7 with orbital sarcoidosis, 24 with NSOI, and 12 healthy controls.
RESULTS
The mean inflammation and fibrosis scores for healthy controls were 0.0 and 1.1, respectively. Orbital inflammatory disease groups' inflammation (I) and fibrosis (F) scores, formatted [I, F] with respective p -values when compared to controls, were: TAO [0.2, 1.4] ( p = 1, 1), GPA [1.9, 2.6] ( p = 0.003, 0.009), sarcoidosis [2.4, 1.9] ( p = 0.001, 0.023), and NSOI [1.3, 1.8] ( p ≤ 0.001, 0.018). Sarcoidosis had the highest mean inflammation score. The pairwise analysis demonstrated that sarcoidosis had a significantly higher mean inflammation score than NSOI ( p = 0.036) and TAO ( p < 0.0001), but no difference when compared to GPA. GPA had the highest mean fibrosis score, with pairwise analysis demonstrating a significantly higher mean fibrosis score than TAO ( p = 0.048).
CONCLUSIONS
Mean inflammation and fibrosis scores in TAO orbital adipose tissue samples did not differ from healthy controls. In contrast, the more "intense" inflammatory diseases such as GPA, sarcoidosis, and NSOI did demonstrate higher histopathologic inflammation and fibrosis. This has implications in prognosis, therapeutic selection, and response monitoring in orbital inflammatory disease.
Topics: Humans; Orbit; Retrospective Studies; Inflammation; Graves Ophthalmopathy; Sarcoidosis; Fibrosis
PubMed: 37279012
DOI: 10.1097/IOP.0000000000002410 -
The British Journal of Ophthalmology Sep 2023To examine whether the specific location of ocular adnexal lymphoma (OAL) and the American Joint Committee on Cancer (AJCC) TNM tumour stage are prognostic factors for...
AIMS
To examine whether the specific location of ocular adnexal lymphoma (OAL) and the American Joint Committee on Cancer (AJCC) TNM tumour stage are prognostic factors for mortality in the main OAL subtypes.
METHODS
Clinical and survival data were retrospectively collected from seven international eye cancer centres. All patients from 1980 to 2017 with histologically verified primary or secondary OAL were included. Cox regression was used to compare the ocular adnexal tumour locations on all-cause mortality and disease-specific mortality.
RESULTS
OAL was identified in 1168 patients. The most frequent lymphoma subtypes were extranodal marginal zone B-cell lymphoma (EMZL) (n=688, 59%); follicular lymphoma (FL) (n=150, 13%); diffuse large B-cell lymphoma (DLBCL) (n=131, 11%); and mantle cell lymphoma (MCL) (n=89, 8%). AJCC/TNM tumour-stage (T-stage) was significantly associated with disease-specific mortality in primary ocular adnexal EMZL and increased through T-categories from T1 to T3 disease. No associations between AJCC/TNM T-stage and mortality were found in primary ocular adnexal FL, DLBCL, or MCL. EMZL located in the eyelid had a significantly increased disease-specific mortality compared with orbital and conjunctival EMZL, in both primary EMZL and the full EMZL cohort. In DLBCL, eyelid location had a significantly higher disease-specific mortality compared with an orbital or lacrimal gland location.
CONCLUSION
Disease-specific mortality is associated with AJCC/TNM T-stage in primary ocular adnexal EMZL patients. Lymphoma of the eyelid has the highest disease-specific mortality in primary EMZL, and in the full cohort of EMZL and DLBCL patients.
Topics: Adult; Humans; Retrospective Studies; Prognosis; Eye Neoplasms; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Follicular; Lymphoma, B-Cell, Marginal Zone; Lymphoma, Mantle-Cell; Orbital Neoplasms; Conjunctival Neoplasms
PubMed: 35512851
DOI: 10.1136/bjophthalmol-2021-320466 -
Clinical Anatomy (New York, N.Y.) Nov 2023The complex anatomy of the orbit generates a complex orbital shape that can only be quantified approximatively by classic linear measurements such as maximum width and...
The complex anatomy of the orbit generates a complex orbital shape that can only be quantified approximatively by classic linear measurements such as maximum width and height. There is no global three-dimensional quantification of variations in orbital shape. The purpose of this study was to develop a method to quantify a global three-dimensional orbital shape variation in a healthy population and to test a series of explanatory factors. We investigated the hypotheses that orbital shape is related to gender(H1), orbital size(H2) and/or age(H3). Medical computed tomography(CT) images of 60 adult individuals were studied. The study sample consisted of 30 males and 30 females with a mean age of 25.1 years. Four anatomical landmarks and 140 semi-landmarks were measured on both positive and negative 3D reconstructed orbits and analyzed with geometric morphometrics. A principal component analysis(PCA) was computed to define a morphological space. Shape variation was visualized using vector distance maps and diagrams. The greatest variation was seen in the length of the superior orbital fissure. There was a gradient in terms of orbital shape ranging from short, wide orbits to tall, narrow orbits. The analysis did not highlight any significant age-, gender- or size-related impact in terms of orbital shape variation. Future avenues to explore include the study of other potential explanatory factors such as the different embryological origins of the orbital bones, the passage of vessels and nerves, and ethnic origins. This method can also be applied to the study of pathological orbits.
Topics: Adult; Male; Female; Humans; Imaging, Three-Dimensional; Orbit; Head; Tomography, X-Ray Computed; Zygoma
PubMed: 36648017
DOI: 10.1002/ca.24007 -
Cancers Apr 2024Breast cancer remains a leading cause of cancer-related mortality and morbidity worldwide. Ocular and periocular metastasis present as a rare but clinically significant...
BACKGROUND
Breast cancer remains a leading cause of cancer-related mortality and morbidity worldwide. Ocular and periocular metastasis present as a rare but clinically significant manifestation. This study aims to explore demographics and clinical aspects of ocular and periocular metastasis in breast cancer patients.
METHODS
A retrospective cohort study comprising 45 breast cancer patients with ocular or periocular metastasis treated between 2013 and 2023. Patient demographics, tumor characteristics, diagnostic methods, treatment modalities, visual outcomes, and survival data were analyzed.
RESULTS
Among 9902 breast cancer patients, 0.5% developed ocular or periocular metastasis, constituting 2.4% of metastatic cases. The median age was 50 years. Ocular metastasis timing varied: 5% before breast cancer, 24% concurrent, 22% within a year, and 49% after. The most common presentations included incidental MRI findings (42%) and vision decline (31%). Metastasis involved the orbit (47%), choroid (40%), optic nerve (11%), and iris (2%), with 44% having bilateral involvement. Predictive factors included invasive lobular carcinoma (ILC) ( < 0.0001) and brain metastasis ( < 0.0001), with ILC exhibiting a sixfold higher likelihood of ocular metastasis than invasive ductal carcinoma (IDC). Primary treatment was radiation therapy (89%), yielding a 55% maintenance of excellent vision (<0.5), with 93% developing dry eye disease. Patients with ocular metastasis faced an increased risk of disease-related mortality ( < 0.0001), with 71% succumbing within 10 months post-diagnosis.
CONCLUSIONS
Ocular metastasis in breast cancer is rare (0.5%) but signifies poor outcome. It is linked to ILC and concurrent brain metastasis. Primary treatment involves radiation therapy, with a favorable visual prognosis.
PubMed: 38672600
DOI: 10.3390/cancers16081518 -
Pediatric Radiology May 2024Orbital pathologies can be broadly classified as ocular lesions, extraocular soft-tissue pathologies (non-neoplastic and neoplastic), and bony and traumatic lesions. In...
Orbital pathologies can be broadly classified as ocular lesions, extraocular soft-tissue pathologies (non-neoplastic and neoplastic), and bony and traumatic lesions. In this paper, we discuss the key imaging features and differential diagnoses of bony and traumatic lesions of the pediatric orbit and globe, emphasizing the role of CT and MRI as the primary imaging modalities. In addition, we highlight the adjunctive role of ocular sonography in the diagnosis of intraocular foreign bodies and discuss the primary role of sonography in the diagnosis of traumatic retinal detachment.
Topics: Child; Child, Preschool; Humans; Infant; Diagnosis, Differential; Eye Injuries; Magnetic Resonance Imaging; Orbit; Orbital Diseases; Tomography, X-Ray Computed; Ultrasonography
PubMed: 38411665
DOI: 10.1007/s00247-024-05882-z -
Ceska a Slovenska Oftalmologie :... 2023The purpose is to acquaint readers with the contribution of imaging methods (IMs) of the orbit, specifically computed tomography (CT) and magnetic resonance imaging... (Review)
Review
The purpose is to acquaint readers with the contribution of imaging methods (IMs) of the orbit, specifically computed tomography (CT) and magnetic resonance imaging (MRI), in the diagnosis of thyroid-associated orbitopathy (TAO). Methods: IMs of the orbit are an indispensable accessory in the clinical and laboratory examination of TAO patients. The most frequently used and probably most accessible method is an ultrasound examination of the orbit (US), which, however, has a number of limitations. Other methods are CT and MRI. Based on the published knowledge implemented in our practice and several years of experience with the diagnosis and treatment of TAO patients, we would like to point out the benefits of CT and MRI in the given indications: visualisation of the extraocular muscles, assessment of disease activity, diagnosis of dysthyroid optic neuropathy and differential diagnosis of other pathologies in the orbit. Our recommendation for an ideal MRI protocol for disease activity evaluation is also included. Conclusion: IMs play an irreplaceable role not only in the early diagnosis of TAO, but also in the monitoring of the disease and the response to the applied treatment. When choosing a suitable IM for this diagnosis, a number of factors must always be taken into account; not only availability, cost and burden for the patient, but especially the sensitivity and specificity of the given method for the diagnosis of TAO.
Topics: Humans; Graves Ophthalmopathy; Orbit; Oculomotor Muscles; Magnetic Resonance Imaging; Tomography, X-Ray Computed
PubMed: 38086700
DOI: 10.31348/2023/10 -
BMC Infectious Diseases Aug 2023Septicemia that leads to ocular involvement mostly presents as endophthalmitis or panophthalmitis. Contrarily, septicemia without intraocular involvement, known as... (Review)
Review
BACKGROUND
Septicemia that leads to ocular involvement mostly presents as endophthalmitis or panophthalmitis. Contrarily, septicemia without intraocular involvement, known as hematogenous orbital cellulitis (HOC), involves only the orbit and is an extremely rare complication of septicemia and a rare type of orbital cellulitis.
CASE PRESENTATION
Four male patients with septicemia presented with orbital involvement without intraocular infection were described in this study. They were 22 (case 1), 15 (case 2), 79 (case 3), and 30 (case 4) years old, with a mean age of 29.75 years. All patients were immunocompromised except for case 2. Cases 1 and 3 had a history of steroid use, whereas case 4 was in a post-chemotherapy myelosuppression phase. Septicemia in case 1 was community-acquired, cases 3 and 4 were hospital-acquired, and case 2 was secondary to acne squeezing. Blood cultures from cases 1, 2, and 3 were positive for Candida albicans, methicillin-resistant Staphylococcus aureus, and Klebsiella pneumoniae, respectively. Case 4 had negative cultures; however, next-generation sequencing reported the presence of Enterococcus faecalis and Rhizopus oryzae. Case 1 had right eye involvement, and both eyes were involved in the other three cases. According to Chandler's classification, case 1 was type 2, case 2 was type 2 (OD) and type 4 (OS), and cases 3 and 4 were type 1 orbital infections. All patients had eyelids erythema, and cases 1 and 2 had mildly decreased visual acuity, proptosis, and painful and restricted ocular motility. Hospital stays ranged from 13 to 43 days (mean, 24 days). All patients received systemic antibiotic therapy based on drug sensitivity and next-generation sequencing results, in combination with multidisciplinary treatment, resulting in complete recovery of ocular and systemic signs and symptoms; no ocular surgical interventions were performed. Extraocular muscle palsy was the last symptom to resolve.
CONCLUSION
HOC is predominantly seen in immunocompromised individuals with a high proportion of hospital-acquired infections and positive cultures for pathogens. Infection control using systemic antibiotics targeted at the causative organism guarantees a favorable prognosis.
Topics: Adult; Humans; Male; Anti-Bacterial Agents; Eye Infections; Methicillin-Resistant Staphylococcus aureus; Orbit; Orbital Cellulitis; Sepsis; Adolescent; Young Adult; Aged
PubMed: 37558992
DOI: 10.1186/s12879-023-08489-1 -
Current Problems in Diagnostic Radiology Jan 2024Paediatric orbital lesions encompass a wide spectrum of benign and malignant entities that can arise from different components of the orbit. Clinical symptoms and signs... (Review)
Review
Paediatric orbital lesions encompass a wide spectrum of benign and malignant entities that can arise from different components of the orbit. Clinical symptoms and signs are often nonspecific, and imaging plays a crucial role in the diagnosis and management. Ultrasonography has a limited role and radiation is a major concern with CT especially in the paediatric population. MRI is the modality of choice that avoids the radiation hazard and provides superior soft tissue contrast. The lesions can be localized using the 'compartment' approach which helps to narrow the list of differentials. MRI also provides critical information for management such as presence of perineural spread and intracranial extension. This article depicts the spectrum of Magnetic Resonance imaging findings encountered in paediatric ocular and orbital lesions.
PubMed: 38281839
DOI: 10.1067/j.cpradiol.2024.01.008 -
Orbit (Amsterdam, Netherlands) Dec 2023
Topics: Humans; Conjunctiva; Lymphangiectasis
PubMed: 34678111
DOI: 10.1080/01676830.2021.1985526