ObjectivesTo assess the tumour dimensions in uveal melanoma patients using 7-T ocular MRI and compare these values with conventional ultrasound imaging to provide improved information for treatment options.Materials and methodsTen uveal melanoma patients were examined on a 7-T MRI system using a custom-built eye coil and dedicated 3D scan sequences to minimise eye-motion-induced image artefacts. The maximum tumour prominence was estimated from the three-dimensional images and compared with the standard clinical evaluation from 2D ultrasound images.ResultsThe MRI protocols resulted in high-resolution motion-free images of the eye in which the tumour and surrounding tissues could clearly be discriminated. For eight of the ten patients the MR images showed a slightly different value of tumour prominence (average 1.0 mm difference) compared to the ultrasound measurements, which can be attributed to the oblique cuts through the tumour made by the ultrasound. For two of these patients the more accurate results from the MR images changed the treatment plan, with the smaller tumour dimensions making them eligible for eye-preserving therapy.ConclusionHigh-field ocular MRI can yield a more accurate measurement of the tumour dimensions than conventional ultrasound, which can result in significant changes in the prescribed treatment.

LOD and ZOD had different spatial profiles that, apart from scaling factors, showed similarity to in vitro literature data. Supplementation with Z caused LOD to decrease and ZOD to increase. These results strongly suggest that the optical densities of L and Z can be assessed in vivo by fundus reflectometry, opening new ways of investigating the putative protective roles of L and Z in retinal disease.

PurposeOrbital inflammation can be idiopathic or in the context of a specific disease and it can involve different anatomical orbital structures. On imaging, inflammatory disease is frequently mistaken for infection and malignant tumors, and its underlying cause is often not determined. Through this article we aim to improve orbital inflammation diagnosis and underlying inflammatory diseases recognition.MethodsThe imaging protocols and characteristics of orbital inflammation were reviewed.ResultsA decision tree for the evaluation of these patients is provided. First, a combination of clinical and radiological clues is used to recognize inflammation, in particular to differentiate it both from orbital infection and tumor. Subsequently, different radiological patterns are recognized, often allowing the differentiation of the several orbital inflammatory diseases.ConclusionThe use of adequate imaging protocols and subsequent evaluation allow the recognition of an orbital lesion as inflammatory and the diagnosis of the underlying inflammatory disease. All in all, a proper treatment can be established, and at times, a biopsy can be avoided.

Although quantitative MRI can be instrumental in the diagnosis and assessment of disease progression in orbital diseases involving the extra‐ocular muscles (EOM), acquisition can be challenging as EOM are small and prone to eye‐motion artefacts. We explored the feasibility of assessing fat fractions (FF), muscle volumes and water T2 (T2 water ) of EOM in healthy controls (HC), myasthenia gravis (MG) and Graves' orbitopathy (GO) patients. FF, EOM volumes and T2 water values were determined in 12 HC (aged 22‐65 years), 11 MG (aged 28‐71 years) and six GO (aged 28‐64 years) patients at 7 T using Dixon and multi‐echo spin‐echo sequences. The EOM were semi‐automatically 3D‐segmented by two independent observers. MANOVA and t‐tests were used to assess differences in FF, T2 water and volume of EOM between groups ( P < .05). Bland–Altman limits of agreement (LoA) were used to assess the reproducibility of segmentations and Dixon scans. The scans were well tolerated by all subjects. The bias in FF between the repeated Dixon scans was −0.7% (LoA: ±2.1%) for the different observers; the bias in FF was −0.3% (LoA: ±2.8%) and 0.03 cm 3 (LoA: ± 0.36 cm 3 ) for volume. Mean FF of EOM in MG (14.1% ± 1.6%) was higher than in HC (10.4% ± 2.5%). Mean muscle volume was higher in both GO (1.2 ± 0.4 cm 3 ) and MG (0.8 ± 0.2 cm 3 ) compared with HC (0.6 ± 0.2 cm 3 ). The average T2 water for all EOM was 24.6 ± 4.0 ms for HC, 24.0 ± 4.7 ms for MG patients and 27.4 ± 4.2 ms for the GO patient. Quantitative MRI at 7 T is feasible for measuring FF and muscle volumes of EOM in HC, MG and GO patients. The measured T2 water was on average comparable with skeletal muscle, although with higher variation between subjects. The increased FF in the EOM in MG patients suggests that EOM involvement in MG is accompanied by fat replacement. The unexpected EOM volume increase in MG may provide novel insights into underlying pathophysiological processes.

ABSTRACT.Purpose: To report our experience in endoscopic dacryocystorhinostomy in treating nasolacrimal duct obstruction over a 14-year period. Methods: Retrospective case series carried out over a 14-year period from 1999 to 2014. A total of 624 endoscopic dacryocystorhinostomy procedures were performed in 442 patients who were diagnosed with persistent epiphora. Participants: In total, 624 procedures in a total of 442 patients (<18 yo: 36 and >18 yo: 406) were included. Patients' records were assessed for demographics, intra-and postoperative complications, outcome and follow-up. Results: In total, 442 patients underwent an endoscopic dacryocystorhinostomy. There were 342 females (77.3%) and 100 males with a mean age of 50.2 years. All patients presented with epiphora: 33 congenital (7.5%), 357 acquired (80.7%) and 52 functional cases (11.8%). The adult dacryocystorhinostomy (n = 577) had an anatomical success of 90.1%. Children's group (<18 yo) n = 36 with a total of 47 procedures and an anatomical success of 91.5%. Functional cases (all adults -n = 52) showed a 91% benefit after operation. In 624 DCRs, we found a complication rate of 3.2%. Conclusion: Endoscopic dacryocystorhinostomy offers good success rates with a safety profile and efficacy equivalent to the traditional external approach is an effective treatment with good outcome results in adults and children with persistent or functional epiphora.