We describe the techniques and outcome of three different approaches to transfer the posterior 2/3 temporalis muscle pedicle flap for orbital socket reconstruction following total orbital exenteration. A retrospective interventional series of 9 patients operated between February of 2000 and 2006. We describe three different techniques, namely supraorbital, transorbital and transorbitectomy approach. All patients were followed for minimum of 3 years and muscle trophism with periorbital contour was clinically studied for outcome. There were 6 males and 3 females with a mean age of 42 years. Three patients each underwent the three mentioned approaches of socket reconstruction following total orbital exenteration performed mainly for oculo-adenexal malignancies with orbital extension (77.78%). Intraoperative, tumor-free histopathological margins were ensured. Postoperatively, bulky lateral orbital rim was noticed in all 3 patients of supraorbital approach, while progressive temporalis flap atrophy was noticed in all with transorbital approach over a period of 6 months. No such complications were observed in transorbitectomy approach and reasonably good periorbital cosmetic appearance with optimum preservation of muscle trophism was obtained. The mean follow-up period was 7 years. Temporalis muscle flap provides adequate orbital volume restoration in an exenterated socket. It also helps in better skin graft uptake, socket health and appearance. The transorbitectomy approach appeared as a reliable one stage surgical technique with reasonably acceptable anatomical and cosmetic outcome over a long-term follow-up. The choice of posterior portion of temporalis muscle as a flap offers satisfactory temporal fossa appearance.
An 18-year-old boy presented to us with bilateral retinal hemangioblastoma and von Hippel-Lindau disease with history of cerebral capillary hemangioblastoma and embryonic cell carcinoma of left testes. The vision in the right eye was already lost with development of secondary closed angle glaucoma, optic atrophy with subsequent development of bullous keratopathy. The multiple retinal angiomatous lesions in the seeing left eye were treated with various modalities like triple freeze thaw cryopexy, focal lasers and transpupillary thermo therapy in multiple sittings over a period of almost 20 years since detection. One particular angiomatous lesion in the left eye was showing resistance to all the above mentioned modalities and was finally successfully treated with verteporfin and photodynamic therapy to achieve complete regression without any post-treatment complication and with a sustained 20/20 vision till a follow-up of 15 months.
INTRODUCTION: Macular edema is not a disease itself, but, a very common condition in most of the retinal diseases, such as diabetic retinopathy, retinal vein occlusion, hypertensive retinopathy, age-related macular edema, etc. and postocular surgery. OBJECTIVES: We have discussed how macular edema plays an important role in blindness in case of various retinal blood vascular diseases and post-ophthalmic surgery. We have analyzed vast state-of-the-art methods for retinal abnormality detection. METHODS: The proposed method uses a semi-automated macula segmentation approach and Local Binary Pattern features to train k-Nearest Neighbor classifier and performs binary classification. RESULTS: We have achieved 80% accuracy and 90% sensitivity in classifying normal and abnormal retina CONCLUSION: We justified the notion that it will be beneficial to have a method that can analyse the macula region and alert if there is any abnormality near that region to prevent vision loss.
Purpose: The aim of this study was to examine the pathology of retinoblastoma (RB) seeds with supportive evidence by field emission scanning electron microscopy and Raman spectroscopy. Methods: This study was a laboratory-based observational study. Enucleated eyeballs received in the ocular pathology department of a tertiary eye care center in northeast India were included in the cohort after obtaining written informed consent during the surgery. The study was carried out for 6 years (2015–2020). Most of the eyeballs were Group-E RBs. Standard eyeballs sectioning were done by bread loaf techniques. Gross documentations included RB seeds seen in the smallest calotte done with utmost care. Seeds were documented also in permanent sections. Scanning electron microscopy and Raman spectroscopy were carried out in an index case. Results: Out of the total 59 cases, 35 RB cases had different seedings. The mean age at enucleation was 2.9 years. RB seeds were seen in vitreous ( n = 19), subretinal plus vitreous ( n = 7), anterior chamber ( n = 1), over crystalline lens ( n = 3), retinal surface ( n = 1), retinal pigment epithelium (RPE; n = 2), subretinal ( n = 1), calcified seeds ( n = 2). Other characteristics were dusts ( n = 7), clouds ( n = 11), spheres ( n = 4), and unspecified type ( n = 13). Histopathological high-risk factors showed significant choroidal ( n = 22) and optic nerve ( n = 15) involvement. Few cases had extraocular spread. Undifferentiated tumor ( n = 24) was seen with higher evidence of necrosis ( n = 23). Raman spectra differentiated the seeds from the normal tissue on the basis of lipid and protein content. Conclusion: This study highlights the different types of RB seeds with high-risk factors. The morphology of those seeds showed the difference between vitreous and subretinal seeds under advanced microscopic observations.
Purpose: To study the clinical profile on non-arteritic ischemic optic neuropathy (NAION) and review of literature at a tertiary institute of northeast IndiaMethods: Retrospective analysis the records of all 61 patients diagnosed with NAION between September 2016 and December 2018. All the patients were dealt on an outpatient basis. Standard clinical details and findings were consistent with NAION. Visual field with 30-2 was done and in selected cases. All patient with optic neuritis, arteritic optic neuropathy, trauma, underlying malignancies were excluded from the studyResults: Of the 61 patients in the study, 41 (67.2%) were males and 20 (32.8%) were females. The mean age was 56 years. Duration of reporting to the institute less than 14 days was seen in 7cases (11.47%). Of the 61 patients, the right eye was affected in 30 (49.1%), left eye in 25 (41%) and both eyes in six (9.8%) patients. In this study we found that 18 (29.5%) patients had diabetes, 24 (39.3%) had hypertension, hypercholesterolemia in 13 (21.3%) cases and 18 (29.5%) cases gave a history of smoking. Two (3.27%) cases gave a history of using sildenafil. Associated macular oedema was seen in seven patients (11.47%)Conclusion: Early reporting (< 2weeks) of NAAION cases in a tertiary institute of northeast India was found to be low in the study. Macular edema in isolated cases was important where additional treatment was required. Lifestyle modifications of avoiding smoking and tobacco can be suggested in substance abuse cases.
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