Publications by authors named "Michelle M Maeng"

Purpose: Online health information seekers may access information produced by artificial intelligence language models such as ChatGPT (OpenAI). The medical field may pose a significant challenge for incorporating these applications given the training and experience needed to master clinical reasoning. The objective was to evaluate the performance of ChatGPT responses compared to human oculofacial plastic surgeon (OPS) responses to FAQs about an upper eyelid blepharoplasty procedure.

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Conjunctival melanoma is a rare, life- and sight-threatening ocular malignancy sharing molecular features with cutaneous and mucosal melanoma. Despite current clinical approaches, high recurrence rates and frequent metastases pose significant challenges in management. Immune checkpoint inhibitors such as ipilimumab and nivolumab have revolutionized cutaneous melanoma treatment, but their efficacy in conjunctival melanoma remains largely unexplored.

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Purpose: Outbreaks of mucormycosis were reported worldwide throughout the COVID-19 pandemic. We report clinical outcomes of a treatment protocol for COVID-19-associated rhino-orbital-cerebral mucormycosis (ROCM).

Methods: Patients with biopsy-proven mucormycosis and COVID-19 were included.

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Purpose: To review all cases of Erdheim-Chester disease (ECD) with orbital involvement treated at Bascom Palmer Eye Institute in Miami, Florida from 2014 to 2022 and compare presentations, treatment modalities, and outcomes.

Methods: A retrospective chart review of all patients diagnosed with ECD who presented to Bascom Palmer Eye Institute from 2014 to 2022 was performed. Data collected included demographics, pretreatment history and ophthalmic examination, pathology report, treatment, subsequent examination, and relevant laboratory results.

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Orbital abscesses are rarely encountered in children younger than 1 year. The literature is limited to isolated case reports and a few case series. Most such cases are reported in infants born at term, with the earliest reported gestational birth age at 34 weeks.

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We present 2 cases of sutureless 25-gauge pars plana vitrectomy and fluid-gas exchange, in which incorrect gas concentrations likely led to elevated intraocular pressures and retrobulbar gas. Combined removal of orbital gas with anterior orbitotomy and pars plana vitrectomy was performed in the first case to address expanding intraocular and retrobulbar gas resulting from a suspected error in gas dilution. Vitreous and orbital gas removal by needling was effective in the second case.

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Although primary tumors of the lacrimal gland are rare, adenoid cystic carcinoma (ACC) is the most common and lethal epithelial lacrimal gland malignancy. Traditional management of lacrimal gland adenoid cystic carcinoma (LGACC) involves the removal of the eye and surrounding socket contents, followed by chemoradiation. Even with this radical treatment, the 10-year survival rate for LGACC is 20% given the propensity for recurrence and metastasis.

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Infectious scleritis is a potentially devastating condition that can result in severe vision loss. When traditional management fails, a subpalpebral antibiotic lavage system (SAL) can be considered to bathe the infected area with a high volume and concentration of antibiotics. Several reports show that this method can be curative for infectious scleritis, otherwise refractory to care.

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A 34-year-old man presented with recurrent bilateral periorbital swelling and pain for 16 years after receiving facial fillers of an unknown substance in a hotel room from a stranger claiming to work in a medical office. Exam demonstrated a firm, mildly tender nodule along the right upper cheek. Imaging revealed a tubular hyperdensity in the right premaxillary soft tissues.

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An 89-year-old woman presented with chronic pain and foreign body sensation in a healthy-appearing anophthalmic socket. Computed tomography of the orbits showed hyperdense, cystic lesions superior and posterior to the orbital implant. Orbital exploration was performed; the orbital implant and lesions were removed.

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A healthy middle-aged man sustained extensive burns after a motor vehicle accident, including fourth-degree burns to the ocular adnexa. He had bilateral eyelid necrosis with complete tissue loss to the orbital rim. Progressive corneal thinning occurred bilaterally despite frequent lubrication, weekly amniotic membrane placement, and a Gunderson flap, ultimately requiring evisceration of his OS.

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Article Synopsis
  • - A 59-year-old woman developed severe eye issues (iritis and uveitis) about three weeks post eyelid surgery, leading to a diagnosis of acute exogenous endophthalmitis.
  • - She underwent procedures such as vitreous aspiration and a vitrectomy, which identified the infection as caused by Streptococcus pseudoporcinus; her vision improved but was still significantly impaired due to a macular hole.
  • - The case highlights the need for surgeons to take precautions during eyelid surgery to prevent complications and stresses the importance of evaluating any postoperative vision loss.
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Orbital sarcoid is a rare entity and may be the first manifestation of systemic sarcoidosis. We report a case of orbital sarcoidosis where diagnosis was complicated by a history of lower eyelid blepharoplasty. The patient presented with progressive swelling of the left lower eyelid, which was assumed to be a late complication of her surgery.

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Purpose: To measure orbital cavernous hemangioma size using 3 segmentation methods requiring different degrees of subjective judgment, and to evaluate interobserver agreement using these methods.

Methods: Fourteen patients with orbital cavernous hemangiomas were included in the study. Pretreatment T2-weighted MRIs were analyzed by 2 observers using 3 methods, including 1 user-dependent image segmentation method that required high degrees of subjective judgment (ellipsoid) and 2 parameter-dependent methods that required low degree of subjective judgment (GrowCut and k-means clustering segmentation).

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Indolent lymphomas have the potential to transform into more aggressive phenotypes. This phenomenon is best exemplified by the transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma into diffuse large B-cell lymphoma. However, it is less common to find multiple small cell lymphomas in the orbit, particularly mantle cell lymphoma.

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Article Synopsis
  • Cutaneous T-cell lymphoma (CTCL) can be hard for doctors to identify because it looks a lot like other skin conditions.
  • In this case, a patient had CTCL come back, but it was only on their eyelid and was incorrectly thought to be a simple rash from something touching the skin.
  • The authors believe this is the first time a case like this has been reported, where CTCL only appeared as an eyelid rash.
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Article Synopsis
  • Adult orbital xanthogranulomatous disease is a rare condition that affects the area around the eyes and can happen on its own or with other diseases.
  • There isn’t a clear way to treat it, but doctors usually keep an eye on it without jumping straight to treatment.
  • In one case, a patient had this disease for 10 years and their symptoms got better on their own without any treatment, which is pretty unusual and suggests that sometimes just watching it is fine.*
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Purpose: To study the effect of periocular steroid use on intraocular pressure (IOP).

Methods: Charts of adult patients with atopic dermatitis or eczema treated with topical periocular steroid creams and ointments from January 1st, 2007 to October 1st, 2017 were reviewed. Patients with the following were excluded: glaucoma, ocular hypertension, known systemic/topical/injectable steroid history, and lack of documented IOP prior to or during treatment with periocular steroid ointment.

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Superficial subcutaneous lipomas are benign, slow-growing neoplasms comprised mature adipose cells that may be surrounded by a fibrous tissue capsule. While found commonly on the body, simple lipomas are rarely described in the eyelids. Reports of two eyelid lipomas in the literature describe the anatomy to be posterior to the orbital septum.

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Dermoid cysts are histologically defined as surface epithelium encapsulating an inner lumen. They are well described in the literature as discrete, single masses, either circumscribed or dumbbell-shaped, with or without a longstanding fistula. Chronic granulomatous inflammation is often a feature of dermoid cysts, contributing to local soft tissue and bony destruction.

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Article Synopsis
  • Cosmetic tourism, where people go abroad for beauty procedures, can lead to infections caused by atypical mycobacteria, which may be expensive and dangerous.
  • A study looked at patients who got these infections after surgery outside the U.S. and found that the average medical cost for treatment was over $98,000.
  • The overall costs from these infections, including lost work, were much higher than any savings from getting cheaper surgeries abroad, suggesting that the risks often outweigh the benefits.
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