Idiopathic Orbital Inflammation Associated with Panuveitis in an Adult and a Review of the Literature

Purpose:To report an unusual case of idiopathic orbital inflammation associated with panuveitis. Case report:We report a case of a 47-year-old female with a history of uveitis who presented with abrupt and painful prop tosis with complete vision loss unresponsive to antibiotic therapy.B-scan ultrasonography and magnetic resonance imaging both showed retinal detachment and an orbital space-occupying mass. The patient underwent orbitotomy and the diagnosis of idiopathic orbital inflammation was confirmed by histopathology. Anterior uveitis is rarely seen in idiopathic orbital inflammation in adults. We report for the first time an unusual case of idiopathic orbital inflammation associated with panuveitis. Conclusion:Inflammation involving both the eye and the orbit is rarely seen in adults. Idiopathic orbital inflammation and panuveitis may share a similar mechanism in this case. (Eye Science 2013; 28:40-43)

Ocular Surface Characteristics and Impression Cytology in Patients with Active versus Inactive Thyroid Eye Disease

Purpose:To compare the clinical findings, tear film function and impression cytology between patients with active and inactive Thyroid Eye Disease (TED). Methods:.A total of 56 patients with TED and 30 controls were recruited in this prospective observational cohort study. TED patients were divided into active TED and inactive TED types according to a seven-point modified formulation of the Clinical Activity Score (CAS). All participants underwent full eye examinations including Ocular Surface Disease Index (OSDI) score, tear film break-up time (TBUT), fluorescein staining and Schirmer I test. Thirty nine patients with thyroid-associated orbitopathy.(TAO) received Nelson's grade with conjunctival impression cytology. Proptosis, palpebral fissure width and lagophthalmos were assessed. Results:.Ocular surface parameters including proptosis, palpebral fissure width and lagophthalmos did not differ between active and inactive TED patients(P>0.05). Both active and inactive TED patients obtained higher fluorescein staining scores, lower TBUT scores and significantly lower Schirmer test scores than those of controls (P<0.001 for all). Additionally, the TBUT score was significantly lower and the OSDI score significantly higher in the active TED group compared with those in the inactive TED group (P<0.001 for both). Impression cytology revealed a higher proportion of grade 2-3 changes in the active TED group compared with the inactive TED group(P<0.001). Conclusion:.Orbital inflammation in TED patients may lead to decreased tear film stability and ocular surface squamous metaplasia.

The Experiment Research of Subconjunctival Injections with Etoposide for the Treatment of Retinoblastoma Mice

Purpose: To evaluate the efficacy of subconjunctival injections of Etoposide for retinoblastoma(RB) mice.Method: Twenty-five RB mice were divided into 5 groups for the study(G0～G4). GO for control group received 0.9% sodium chloride injection subconjunctival. G1: 5 RB mice for systemic delivery received 6 systemic administration of Etoposide 150 μg and Cyclosporin A (CSA)1.0mg at 3 days intervals, respectively. G2～G4:5 RB mice in each group received 6 subconjunctival delivery of Etoposide in 50、75、150μg at 3 days intervals, respectively.To observe the changes of the volume of RB in anterior chamber and the part of conjunctiva for injections of chemotherapeutic drugs. All eyes and conjunctiva and scleras of the part for drugs injections were obtained at 6 weeks after experiment for histopathologic examination. The findings under the light microscope were analysed with software to measure the areas of RB in anterior chambers and the tumor inhibition rate.Results:The volume of RB in anterior chambers for G1 and G2 increase quickly and none of the mice exhibited tumor control. The RB volume increase slowly in G3 and exhibit tumor control in G4. The areas of tumors in G0～G4 are 0.710,0.659,0.634,0.515,0.235 mm2, respectively. The rate for tumor inhibition in G0～G4 are 0.0%,7.18%, 10.70% ,27.43% ,66.90%, respectively. There are statistical significant difference between the G1 and G4 for the volumes of tumors and the rate of tumor inhibition.The pathologic examination of subconjunctiva and sclera for the injective sites showed no pathologic changes.Conclusions: There are significant effects for the method of subconjunctival delivery of Etoposide in RB control, demonstrating a positive dose-related relationship. Subconjunctival injection of Etoposide reached better efficacy in controlling and inhibiting RB cells than systemic delivery of Etoposide for the same dose. The pathologic results showed the subconjunctival delivery of etoposide were safety for conjunctiva and sclera. It would be one of effective and safety method of chemotherapy for RB.

Folded technique of self-adherent wrap improves clinical outcomes for wounds after orbital tumour extirpation:a single-center,prospective randomized controlled trial

Background:Using a randomized controlled trial(RCT),to assess the efficacy of the folded technique of self-adherent wrap to eyes after orbital tumour extirpation and compare it with the classic technique.Methods:A single-centre,prospective,randomized,controlled study was conducted among 128 patients who underwent orbital tumour extirpation in this study.The folded and classic techniques of applying self-adherent wraps were randomly allocated to patients(1:1).The primary endpoint was the interface pressure on the affected eye.Secondary efficacy endpoints were the interface pressure above and below the ear of the affected side,above the ear of the non-affected side,and discomfort scores.Postoperative complications were observed for 24 hours.Results:The interface pressure with the folded technique on the affected eye was neither inferior nor superior to the classic technique(1.33±0.07 vs.1.41±0.09 mmHg,P=0.480).Most importantly,the pressure at three other points outside of the affected eye,including above and below the ear of the affected side,and above the ear of the non-affected side,were significantly higher when using the classic technique than when using the folded technique(P=0.041,0.019,and 0.047,respectively).Discomfort scores were higher in the classic technique group than in the folded technique group(2.93±0.30 vs.1.52±0.19,P≤0.001).Conclusions:Findings demonstrated the advantages of using folded technique to apply self-adherent wrap for wounds after orbital tumour extirpation with lower interface pressure outside of the affected eye and patient discomfort scores,without influencing pressure on the affected eye comparing with the classic technique.