Superior rectus/levator complex in acquired anophthalmic socket repaired with spheric implant—a computed tomography scan and topographic study

AIM:To determine whether the levator palpebrae superioris(LPS)/superior rectus(SR)muscle complex,can influence the position of the upper lid and fornix in acquired anophthalmic sockets.METHODS:This comparative non-randomized and non-interventional study included retrospective data of 21 patients with unilateral acquired anophthalmic sockets repaired with spheric implants.High-resolution computed tomography(CT)measurements of the LPM/SR muscle complex and clinical topographic position of the upper lid,superior and inferior fornix depth in primary gaze position were evaluated.Demographic data were presented as frequency and percentage proportions and quantitative variables comparing the socket measurements with the normal contralateral orbit was statistically analyzed using non-parametric tests considering P<0.05.RESULTS:The anophthalmic orbits had a significantly shorter LPS length(P=0.01)and significantly thicker SR(P=0.02)than the normal orbit.Lagophthalmos was present in anophthalmic sockets but not in normal orbits(P=0.002),while levator function was normal in both(P>0.05,all comparisons).The superior fornix depth was similar in the anophthalmic socket and the contralateral normal orbit(P=0.192)as well the inferior fornix depth(P=0.351).CONCLUSION:Acquired anophthalmic sockets repaired with spheric implants have shorter LPS,thicker SR,and more lagophthalmos than normal orbits.The relationship of the LPS and SR with other orbital structures,associated with passive or active forces acting in the final position of the lids and external ocular prosthesis should be further investigated.

Orbital inflammatory disease:Pictorial review and differential diagnosis

Orbital inflammatory disease(OID) represents a collec tion of inflammatory conditions affecting the orbit. OID is a diagnosis of exclusion, with the differential diagno sis including infection, systemic inflammatory conditions and neoplasms, among other conditions. Inflammatory conditions in OID include dacryoadenitis, myositis, cel lulitis, optic perineuritis, periscleritis, orbital apicitis, and a focal mass. Sclerosing orbital inflammation is a rare condition with a chronic, indolent course involving dense fibrosis and lymphocytic infiltrate. Previously though to be along the spectrum of OID, it is now considered a distinct pathologic entity. Imaging plays an importan role in elucidating any underlying etiology behind orbita inflammation and is critical for ruling out other condi tions prior to a definitive diagnosis of OID. In this re view, we will explore the common sites of involvemen by OID and discuss differential diagnosis by site and key imaging findings for each condition.

Idiopathic orbital lipogranuloma

Dear Editor,We are writing this letter to present a very rare case of idiopathic orbital lipogranuloma.Lipogranuloma is a granulomatous inflammatory soft tissue reaction,consisting of lipid deposition and/or an oil-like substance commonly