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Orbit (Amsterdam, Netherlands) Feb 2021: To study acute dacryocystitis in a pediatric age group, focusing on patients' demographic profiles, clinical presentation, and management outcome. : A retrospective...
: To study acute dacryocystitis in a pediatric age group, focusing on patients' demographic profiles, clinical presentation, and management outcome. : A retrospective case series of all acute dacryocystitis in pediatric patients (0-17 years) from two tertiary-care eye centres in Riyadh, Saudi Arabia was conducted. Demographic profile, risk factors, initial clinical presentation, management regimens, and final outcome were analysed. : A total of 51 patients were included in the study. The mean age of presentation was 3.9 ± 4 years (1 month-13 years). Thirty-eight patients (74.5%) reported symptoms of congenital nasolacrimal duct obstruction (NLDO) prior to presentation, four patients (7.8%) had congenital dacryocystocele, two (3.9%) had a history of traumatic NLDO, and ten (19.6%) had an attack of acute dacryocystitis in the absence of NLDO or any other known risk factors. Four patients (7.8%) progressed to orbital cellulitis while another three (5.8%) had lacrimal sac fistula secondary to acute dacryocystitis. Systemic antibiotics were the initial management in all 51 patients. Twenty-five (49%) underwent probing after the resolution of the acute attack while 12 (23.5%) patients underwent dacryocystorhinostomy (DCR). : Early recognition and urgent management for acute dacryocystitis are required to prevent further potential complications and achieve excellent outcomes. Congenital NLDO is the main risk factor for the development of acute dacryocystitis in the pediatric age group. In a small set of patients, acute dacryocystitis can develop despite the presence of a patent lacrimal drainage system on clinical evaluation with lack of tearing and discharge before and after the attack of acute dacryocystitis.
Topics: Child; Child, Preschool; Dacryocystitis; Dacryocystorhinostomy; Humans; Lacrimal Duct Obstruction; Nasolacrimal Duct; Retrospective Studies
PubMed: 31994430
DOI: 10.1080/01676830.2020.1717548 -
American Journal of Ophthalmology Case... Sep 2020Immunoglobulin G4-related disease is a systemic fibroinflammatory disease of unknown etiology. Immunoglobulin G4-related ophthalmic disease (IgG4-ROD) can manifest in...
PURPOSE
Immunoglobulin G4-related disease is a systemic fibroinflammatory disease of unknown etiology. Immunoglobulin G4-related ophthalmic disease (IgG4-ROD) can manifest in multiple ways, but lacrimal sac involvement is rare. We present the first case in Chinese population of lacrimal sac IgG4-ROD.
OBSERVATIONS
Lacrimal sac IgG4-ROD is rare, and only 9 cases were reported in literature. Despite reported cases in Asian population, mainly in Japan, there was none from the Chinese population or South Asia. Our index case is a 67-year-old Chinese male, who presented with a left insidious nasolacrimal duct swelling mimicking dacryocystocele. Lacrimal sac IgG4-ROD was diagnosed with radiological, serological, pathological and immunohistochemical evidence. The under-reporting of this disease entity may suggest a benign course of such.
CONCLUSIONS AND IMPORTANCE
This is the first reported case of biopsy proven lacrimal sac definite IgG4-ROD in Chinese patient on English literature. With the limited cases reported in literature, the pathology of Immunoglobulin G4 immune process in lacrimal sac demands further investigation.
PubMed: 32642596
DOI: 10.1016/j.ajoc.2020.100789 -
Journal of Clinical Ultrasound : JCU Sep 2021
Topics: Cleft Lip; Cleft Palate; Female; Humans; Pregnancy; Pregnancy Trimester, Third; Prenatal Diagnosis; Ultrasonography, Prenatal
PubMed: 34046901
DOI: 10.1002/jcu.23023 -
Orbit (Amsterdam, Netherlands) Jun 2020Retrobulbar orbital abscess in children is a rare condition, and diagnosis and management can be challenging. We report the case of a 5-week-old male infant with...
Retrobulbar orbital abscess in children is a rare condition, and diagnosis and management can be challenging. We report the case of a 5-week-old male infant with retrobulbar orbital abscess secondary to acute dacryocystitis developed from a dacryocystocele. The patient presented with respiratory difficulty, sepsis and progressive clinical findings suggestive of post-septal cellulitis. He was successfully treated with endonasal incision of subturbinate dacryocystoceles followed by probing of the lacrimal ducts. Congenital dacryocystocele must be considered a differential diagnosis in infants with respiratory difficulty and may develop into a vision- and life-threatening condition requiring immediate intervention.
Topics: Abscess; Anti-Bacterial Agents; Combined Modality Therapy; Dacryocystitis; Eye Infections, Bacterial; Humans; Infant; Male; Orbital Diseases; Staphylococcal Infections
PubMed: 31509038
DOI: 10.1080/01676830.2019.1663883 -
Journal Francais D'ophtalmologie Jun 2023
Topics: Infant, Newborn; Humans; Lacrimal Duct Obstruction; Cysts; Canaliculitis; Respiratory Distress Syndrome
PubMed: 37085373
DOI: 10.1016/j.jfo.2022.06.009 -
Ophthalmic Plastic and Reconstructive... 2020
Topics: Cysts; Humans; Lacrimal Duct Obstruction; Nasolacrimal Duct
PubMed: 31876647
DOI: 10.1097/IOP.0000000000001542 -
Indian Journal of Ophthalmology Jul 2022
Topics: Canaliculitis; Cysts; Eye Abnormalities; Humans; Lacrimal Duct Obstruction; Twins, Monozygotic
PubMed: 35791172
DOI: 10.4103/ijo.IJO_259_22 -
Ophthalmic Plastic and Reconstructive...To determine the risk factors impacting the surgical success of primary monocanalicular stent intubation for congenital nasolacrimal duct obstruction (CNLDO).
PURPOSE
To determine the risk factors impacting the surgical success of primary monocanalicular stent intubation for congenital nasolacrimal duct obstruction (CNLDO).
METHODS
This is a retrospective interventional case series of patients 18 years and younger treated more than a 12-year period with monocanalicular stent intubation with inferior turbinate fracture for CNLDO by a single surgeon. Patients with dacryocystoceles, dacryocystitis, Down syndrome and previous tear duct surgery were excluded. An intraoperative grading scale of tear duct stenosis, date of stent removal, stent length, and postoperative symptoms were recorded. Surgical success was defined as the complete resolution of symptoms.
RESULTS
One thousand four hundred sixty-nine stents were placed in 1,001 pediatric participants (533 unilateral, 468 bilateral). The mean age at surgery was 1.86 years (0.1-18.07). The mean follow up was 34.99 months (0.43-134.3) with mean in-office stent removal at 3.41 months (0.63-36.9). Early stent loss occurred in 14.8% intubations (217/1,469). The overall success rate was 92.4% (1,357/1,469 eyes). Subjects less than the age of 4 years had a success rate of 92.8% (1,296/1,397) compared with 84.7% (61/72) in children more than 4. In multivariable analysis, bilateral surgery, severe tear duct stenosis, and early stent loss were significantly associated with higher risk of surgical failure.
CONCLUSIONS
Severe tear duct stenosis, early stent loss, and bilateral surgery were significant risk factors for surgical failure. While the success rate stratified by age at surgery suggested a lower success after the age of 4. Primary monocanalicular stent intubation is an effective and safe treatment for CNLDO sparing a child the need for multiple staged surgeries.
Topics: Child; Child, Preschool; Constriction, Pathologic; Dacryocystorhinostomy; Humans; Infant; Intubation; Intubation, Intratracheal; Lacrimal Duct Obstruction; Nasolacrimal Duct; Retrospective Studies; Risk Factors; Stents; Treatment Outcome
PubMed: 35502807
DOI: 10.1097/IOP.0000000000002182 -
Ophthalmic Plastic and Reconstructive... 2020
Topics: Cysts; Humans; Lacrimal Duct Obstruction; Nose
PubMed: 31876649
DOI: 10.1097/IOP.0000000000001548 -
Ultrasound in Obstetrics & Gynecology :... Jan 2020
Topics: Adult; Cysts; Female; Humans; Imaging, Three-Dimensional; Lacrimal Duct Obstruction; Magnetic Resonance Imaging; Nasal Cavity; Pregnancy; Pregnancy Trimester, Third; Prenatal Diagnosis
PubMed: 31614033
DOI: 10.1002/uog.21898