Ophthalmic Plastic and Reconstructive Surgery最新文献

An uncommon case of bilateral osteophytic periorbital rim bony prominences is described in a 65-year-old woman with a long history of swimming goggles use. The osteophytic growths appeared to be surrounding the supraorbital nerve outlet. A unilateral removal and contouring of the periorbital rim was performed through a lid crease incision. Biopsy findings of the lesion showed hyperostotic growth in the soft tissue. The purpose of this article is to present a novel case and propose a mechanism of bony reactivity to chronic goggle use.

A 77-year-old male developed bilateral palmar rashes during treatment of active thyroid eye disease with teprotumumab that persisted even after completing treatment. This pattern of palmar rash and its persistence following completion of the treatment course has not been previously reported. The presentation highlights the importance of monitoring adverse effects during treatment with teprotumumab, as some may persist beyond treatment.

A 57-year-old woman presented for evaluation of spastic left eyelid closure that began 1 to 2 weeks after receiving injections of poly- l -lactic acid dermal filler to the bilateral temples and cheeks at a local Medspa. External examination revealed a left hemifacial spasm, but the ophthalmology exam was otherwise normal. MRI confirmed the presence of subcutaneous filler in the bilateral temporal and malar regions. The patient was started on oral gabapentin and the frequency of her spasms improved significantly. Months later, she developed a right hemifacial spasm. Her bilateral hemifacial spasm was presumed secondary to compression from persistent filler deposited adjacent to the temporal and zygomatic branches of the facial nerve, with retrograde activation of the other nerve branches. This is the first reported case of hemifacial spasm that may be associated with filler injection.

Purpose: To evaluate the elasticity and size of the lacrimal gland (LG) in patients with moderate-to-severe thyroid eye disease (TED) using strain ultrasound elastography and to compare these results with those of healthy subjects.

Methods: This prospective, comparative case series included the right eyes of 26 patients with bilateral inactive moderate-to-severe TED and 49 healthy subjects, who served as the control group. Schirmer test, tear breakup time, ocular surface disease index, and corneal staining were assessed in both groups. The anteroposterior and transverse diameters of the LG were measured, and the strain index of the LG was calculated as the ratio of the LG to orbital fat tissue.

Results: The anteroposterior diameter of the LG was 4.18 ± 1.02 mm in the TED group and 5.32 ± 1.54 mm in the control group ( p = 0.002). The transverse diameter of the LG was 7.48 ± 1.63 mm in the TED group and 9.46 ± 2.61 mm in the control group ( p = 0.001). The strain index of the LG was 3.91 ± 1.40 in the TED group and 1.03 ± 0.62 in the control group ( p < 0.001). Schirmer test and tear breakup time values were significantly lower, while ocular surface disease index scores and corneal staining scores were significantly higher in the TED group compared with the control group.

Discussion: Strain ultrasound elastography revealed that the LGs of TED patients were stiffer than those of healthy subjects. Additionally, both the anteroposterior and transverse diameters of the LG were smaller in the TED group. These findings suggest that increased LG stiffness and reduced size may contribute to dry eye symptoms.