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Aging of Chinese bony orbit: automatic calculation based on UNet++ and connected component analysis.Surgical and Radiologic Anatomy : SRA May 2022Current research on the aging of bony orbit is usually done manually, which is inefficient and has a large error. In this paper, automatic segmentation of bony orbit...
PURPOSE
Current research on the aging of bony orbit is usually done manually, which is inefficient and has a large error. In this paper, automatic segmentation of bony orbit based on deep learning and automatic calculation of the parameters of the segmented orbital contour (area and height of bony orbit) are presented.
METHODS
The craniofacial CT scanning data of 595 Chinese were used to carry out three-dimensional reconstruction and output the craniofacial images. The orbital contour images are obtained automatically by UNet++ segmentation network, and then the bony orbital area and height were calculated automatically by connected component analysis.
RESULTS
The automatic segmentation method has an Intersection of Union of 95.41% in craniofacial CT images. During the aging, the bony orbital area of males increased with age, while that of females decreased, and the area in male was larger than that in female (P < 0.05). The distance from equal points 10 and 40-90 to the supraorbital rim was significantly larger (P < 0.05). Except for the equal point 90, the distance from equal points to the inferior orbital rim was obviously larger (P < 0.05). In the females, the distance from equal points 50-70 to inferior orbital rim was significantly lower (P < 0.05).
CONCLUSION
The method proposed here can automatically and accurately study image dataset of large-scale bony orbital CT imaging. UNet++ can achieve high-precision segmentation of bony orbital contours. The bony orbital area of Chinese changes with aging, and the bony orbital height changes different between males and females, which may be caused by the different position and degree of orbital bone resorption of males and females in the process of aging.
Topics: Aging; Asian People; China; Female; Humans; Male; Orbit; Tomography, X-Ray Computed
PubMed: 35384466
DOI: 10.1007/s00276-022-02933-8 -
BMC Ophthalmology Jul 2023The grease-guns injury is an uncommon injury to the orbit. We present the twelfth and thirteenth cases of grease-gun injury to the orbit to be reported in the English... (Review)
Review
BACKGROUND
The grease-guns injury is an uncommon injury to the orbit. We present the twelfth and thirteenth cases of grease-gun injury to the orbit to be reported in the English language literature since 1964. Here we discus and review the presentation, investigation, and treatment of this unusual trauma.
CASE PRESENTATION
Case 1 was a 29-year-old man who presented 1 day after a grease-gun injury of the left orbit with severe pain, marked periorbital swelling, and proptosis. Computed tomography (CT) revealed penetration of grease into his left orbit. Following surgical removal, proptosis decreased. The limitation of extraocular movement and loss of visual acuity to finger count was discovered after the initial surgery. Motility gradually returned. Visual acuity recovered after phacoemulsification, capsular tension ring and intraocular lens implantation for traumatic cataract and subluxation. Case 2 was a 6-year-old boy who was referred 2 months after a grease-gun injury for worsening swelling with sinus, necrosis and slight ptosis of the upper left eyelids. This is a case of orbital chronic inflammation from grease-gun injuries masquerading as orbital cellulitis. The imaging findings of CT and magnetic resonance imaging (MRI) are not typical. Surgical exploration and debridement was inevitable and actually relieved the symptoms.
CONCLUSIONS
Grease-gun injuries can damage the orbit in different degrees. Careful history inquiry and taking is important to establish the diagnosis. Imaging examinations using CT or MRI are helpful to determine depth of trauma and foreign bodies in the orbit at diagnosis. We suggest that surgical exploration and debridement is a key step in the management.
Topics: Male; Humans; Child; Adult; Orbit; Firearms; Eye Foreign Bodies; Eye Injuries, Penetrating; Hydrocarbons; Exophthalmos
PubMed: 37452303
DOI: 10.1186/s12886-023-03032-x -
PloS One 2021Age-related distance esotropia (ARDE) involves acquired esotropia at distance and phoria at near. However, distance-independent esotropia (DIE) exists esotropia both at...
PURPOSE
Age-related distance esotropia (ARDE) involves acquired esotropia at distance and phoria at near. However, distance-independent esotropia (DIE) exists esotropia both at distance and near. Thus, we examined the orbital magnetic resonance imaging (MRI) findings for DIE to assess differences in its characteristics.
METHODS
This study was a retrospective case-control study. We evaluated the efficacy of the standard coronal MRI in patients with acquired esotropia and control patients with optic neuritis. Cases with strabismus in the control group were excluded. DIE was defined as having esotropia both at distance and near, and an angle of more than 10 prism diopters at near. The condition of the lateral rectus-superior rectus band, position of rectus muscles, and the volume ratio of the globe to the whole orbit (G/WO) were examined.
RESULTS
The DIE group consisted of 12 eyes of 6 patients (77.3±7.7 years); ARDE group, 38 eyes of 19 patients (73.1±6.8 years); and control group, 34 eyes of 17 patients (70.9±4.3 years). The ratio of abnormality of the lateral rectus-superior rectus bands was higher in the DIE and ARDE groups than in the control group (p<0.01). The vertical angle of the lateral rectus deviated downwards in the control (-7.5±5.1°), ARDE (-12.2±9.1°), and DIE groups (-18.8±5.7°) (p<0.05). The tilting angle of the lateral rectus was tilted temporally in the control (-12.2±9.1°), ARDE (-20.0±8.6°) and DIE groups (-28.6±5.4°) (p<0.01). G/WO was higher in the DIE (0.28±0.01) and ARDE groups (0.27±0.02) compared to the control (0.25±0.03) group (p<0.01).
CONCLUSION
In comparison with the ARDE and control groups, the DIE group presented with abnormalities of the lateral rectus-superior rectus band, malposition of the lateral rectus, and differences in the G/WO. The DIE group showed a more severe form of ARDE.
Topics: Aged; Aged, 80 and over; Esotropia; Female; Humans; Magnetic Resonance Imaging; Male; Oculomotor Muscles; Orbit; Retrospective Studies; Vision, Binocular
PubMed: 33711045
DOI: 10.1371/journal.pone.0248497 -
Indian Journal of Ophthalmology Oct 2021
Topics: Diagnostic Imaging; Humans; Magnetic Resonance Imaging; Orbit; Orbital Diseases; Radionuclide Imaging
PubMed: 34571589
DOI: 10.4103/ijo.IJO_2447_21 -
Clinics (Sao Paulo, Brazil) 2021To compare the surgical outcomes of inferomedial wall orbital decompression (IM-OD) and balanced medial plus lateral wall orbital decompression (ML-OD) in patients with... (Randomized Controlled Trial)
Randomized Controlled Trial
Ocular motility changes after inferomedial wall and balanced medial plus lateral wall orbital decompression in Graves' orbitopathy: a randomized prospective comparative study.
OBJECTIVES
To compare the surgical outcomes of inferomedial wall orbital decompression (IM-OD) and balanced medial plus lateral wall orbital decompression (ML-OD) in patients with inactive Graves' orbitopathy (GO) with regard to exophthalmos reduction and ocular motility abnormalities.
METHODS
Forty-two patients with inactive GO eligible for OD were randomly assigned to either the IM-OD or ML-OD groups. Pre and postoperative evaluations included Hertel exophthalmometry, sensory, and motor extraocular motility assessment, standardized photographs in the nine gaze positions, and computed tomography (CT) of the orbits. ClinicalTrials.gov: NCT03278964.
RESULTS
Exophthalmometry reduction was statistically significant in both groups (p<0.001), but was greater in the ML-OD group (p=0.010). New-onset esotropia occurred in 11.1% and 23.5% of patients who underwent IM-OD and ML-OD, respectively, with no statistically significant difference in the frequency of pre and postoperative strabismus in either group. The mean increase in preoperative esotropia was 24±6.9 and 12±8.8 prism diopters in patients who underwent IM-OD and ML-OD, respectively. In the IM-OD group, abduction and elevation worsened at the first (p<0.05) and third (p<0.05) postoperative visits but were restored at 6 months. The versions did not change postoperatively with ML-OD. The preoperative CT-measured medial rectus muscle area predicted new-onset strabismus (p=0.023). Significant postoperative medial rectus muscle enlargement occurred in both groups (p<0.001). Restriction in elevation and abduction was significantly associated with enlarged inferior (p=0.007) and medial rectus muscle areas (p=0.002).
CONCLUSIONS
IM-OD is as safe as ML-OD with regard to new-onset strabismus, and represents a good alternative for patients who do not require significant exophthalmos reduction. ML-OD offers greater exophthalmos reduction and smoother postoperative recovery. Patients with preoperative enlarged medial rectus muscle on CT are at risk for new-onset esotropia, and preoperative esotropia is likely to increase after OD.
Topics: Decompression, Surgical; Graves Ophthalmopathy; Humans; Orbit; Prospective Studies; Retrospective Studies
PubMed: 33852655
DOI: 10.6061/clinics/2021/e2592 -
Experimental Eye Research Jun 2021Most studies of the effect of acute elevation of intraocular pressure (IOP) on ocular blood-flow have utilized optical coherence tomography (OCT) to characterize retinal...
Most studies of the effect of acute elevation of intraocular pressure (IOP) on ocular blood-flow have utilized optical coherence tomography (OCT) to characterize retinal and choroidal flow and vascular density. This study investigates the effect of acute IOP elevation on blood flow velocity in the retrobulbar arteries and veins supplying and draining the eye, which, unlike the retinal and choroidal vasculature, are not directly compressed as IOP is increased. By cannulation of the anterior chamber of 20 Sprague-Dawley rats, we increased IOP in 10 mmHg steps from 10 to 60 mmHg and returned to 10 mmHg. After 1 min at each IOP (and 3 min after return to 10 mmHg), we acquired 18 MHz plane-wave ultrasound data at 3000 compound images/sec for 1.5 s. We produced color-flow Doppler images by digital signal processing of the ultrasound data, identified retrobulbar arteries and veins, generated spectrograms depicting flow velocity over the cardiac cycle and characterized changes of vascular density and perfusion in the orbit overall. Systolic, diastolic and mean velocities and resistive and pulsatile indices were determined from arterial spectrograms at each IOP level. Baseline mean arterial and mean venous velocities averaged 30.9 ± 10.8 and 8.5 ± 3.3 mm/s, respectively. Arterial velocity progressively decreased and resistance indices increased at and above an IOP of 30 mmHg. Mean arterial velocity at 60 mmHg dropped by 55% with respect to baseline, while venous velocity decreased by 20%. Arterial and venous velocities and resistance returned to near baseline after IOP was restored to 10 mmHg. Both vascular density and orbital perfusion decreased with IOP, but while perfusion returned to near normal when IOP returned to 10 mmHg, density remained reduced. Our findings are consistent with OCT-based studies showing reduced perfusion of the retina at levels comparable to retrobulbar arterial flow velocity change with increased IOP. The lesser effect on venous flow is possibly attributable to partial collapse of the venous lumen as volumetric venous outflow decreased at high IOP. The continued reduction in orbital vascular density 3 min after restoration of IOP to 10 mmHg might be attributable to persisting narrowing of capillaries, but this needs to be verified in future studies.
Topics: Animals; Blood Flow Velocity; Choroid; Ciliary Arteries; Female; Intraocular Pressure; Male; Ocular Hypertension; Ophthalmic Artery; Orbit; Rats; Rats, Sprague-Dawley; Regional Blood Flow; Retinal Artery; Tonometry, Ocular
PubMed: 33930396
DOI: 10.1016/j.exer.2021.108606 -
Radiology May 2021
Topics: COVID-19; Humans; Magnetic Resonance Imaging; Orbit; Retrospective Studies; SARS-CoV-2
PubMed: 33595392
DOI: 10.1148/radiol.2021210058 -
Medicine Aug 2023Microcystic adnexal carcinoma (MAC), a rare and low-grade malignant skin tumor, is characterized by a high rate of misdiagnosis and a preponderance for local recurrence,... (Review)
Review
Microcystic adnexal carcinoma (MAC), a rare and low-grade malignant skin tumor, is characterized by a high rate of misdiagnosis and a preponderance for local recurrence, but seldom seen nodal or distant metastasis. Although MAC typically occurs almost in the head and neck region, primary eyelid or orbital MAC is very rare. To explore the unique characteristics of the eyelid and orbital MAC, we reviewed the relevant literature. Based on its distinctive anatomical location and the aggressive behavior, eyelid or orbital MAC not only exhibit a high rate of misdiagnosis and local recurrence, but also lead to serious complications such as disfigurement after orbital exenteration, paranasal sinuses or intracranial invasion, even death. Misdiagnosis of MAC commonly result from its rarity and nonspecific clinical and histopathological presentation. To reduce or avoid misdiagnosis, it is important to increase awareness for MAC and obtain a full-thickness biopsy specimen in histopathological analysis. Due to its extensive invasive growth pattern, MAC has a high rate of local recurrence, so complete excision with clear margins and long-term follow-up of patients with MAC are necessary. About those serious complications of the eyelid and orbital MAC, early and accurate diagnosis, complete excision is very important. Moreover, an interprofessional team consisting of ophthalmologist, otolaryngologist, neurologist, dermatologist, pathologist, radiologist is needed to evaluate and treat this disease. In summary, increasing awareness, early and accurate diagnosis, complete excision, long-term follow-up, and a multidisciplinary team is crucial for management of the eyelid and orbital MAC.
Topics: Humans; Orbit; Orbital Neoplasms; Skin Neoplasms; Eyelids
PubMed: 37565854
DOI: 10.1097/MD.0000000000034709 -
Indian Journal of Ophthalmology Jul 2023: A good anesthesia not only makes the patient comfortable during surgery, but also has a huge impact on the postoperative recovery. It also makes the operating surgeon...
BACKGROUND
: A good anesthesia not only makes the patient comfortable during surgery, but also has a huge impact on the postoperative recovery. It also makes the operating surgeon carry out each step of the surgery precisely and beautifully. The art of giving a good local anesthesia is to be learnt and practiced not only by anesthetists, but also by the practicing ophthalmologists.
PURPOSE
: This video gives an overview of anatomy in terms of the nerve supply of the orbit, the surface marking, and the techniques of giving regional and nerve blocks.
SYNOPSIS
: In this video, we describe the anatomy, the surface marking, the technique of regional anesthesia including peribulbar, retrobulbar, and subtenon blocks and of nerve blocks, specifically of facial, frontal nerve and its branches, infraorbital, nasociliary, infratrochlear, and dorsal nasal nerves, with their application in ocular plastic surgery.
HIGHLIGHTS
: This video highlights the essence of providing appropriate and good anesthesia so that the surgeon works in an optimal field with maximum comfort to the patients. Video link https://youtu.be/h8EgTMQAsyE.
Topics: Humans; Anesthetics, Local; Anesthesia, Local; Nerve Block; Ophthalmologic Surgical Procedures; Orbit
PubMed: 37417157
DOI: 10.4103/IJO.IJO_1366_23 -
Der Ophthalmologe : Zeitschrift Der... Jan 2021
Topics: Exophthalmos; Humans; Neoplasms; Orbit; Orbital Neoplasms; Tomography, X-Ray Computed
PubMed: 32076838
DOI: 10.1007/s00347-020-01060-2