Fronto-orbital mucocele and orbital involvement in occult obstructive frontal sinus disease.

Aims: To describe the clinical features of orbital involvement arising from occult obstructive frontal sinus disease and to highlight key features to aid diagnosis.

Methods: A retrospective review of the case notes of 15 patients who presented to three regional oculoplastics units over a 7-year period were reviewed. Patient demographics, clinical characteristics, relevant medical history, microbiology results, imaging, management and outcomes were assessed.

Are ethnicity, social grade, and social deprivation associated with severity of thyroid-associated ophthalmopathy?

Purpose: Previous studies have extensively investigated the pathophysiology, genetics, and lifestyle risk factors of thyroid-associated ophthalmopathy (TAO). The aim of this study was to investigate the independent contribution of ethnic origin, social grade, and level of social deprivation to TAO severity in a large, multiethnic, and urban population.

Methods: Retrospective case note review of all TAO patients seen at Birmingham and Midland Eye Centre, United Kingdom over a 14-year period.

Patient information in Graves' disease and thyroid-associated ophthalmopathy: readability assessment of online resources.

Background: The Internet is a vital source of information for patients hoping to learn more about their disease. Health literacy of the general population is known to be poor, with the U.S.

Postoperative infection rate after dacryocystorhinostomy without the use of systemic antibiotic prophylaxis.

Purpose: To evaluate the postoperative infection rate after external dacryocystorhinostomy (DCR) without routine systemic antibiotic prophylaxis.

Methods: Retrospective review of case notes, including eye casualty attendances, of 77 patients undergoing 82 consecutive external DCR procedures between 22 December 2006 and 31st December 2009 performed by one of the authors (O. M.

Outcome of deep lateral wall rim-sparing orbital decompression in thyroid-associated orbitopathy: a new technique and results of a case series.

Purpose: To describe a new technique for deep lateral (single) wall orbital decompression surgery, developed by Mr. Geoffrey Rose, for proptosis in patients with thyroid-associated orbitopathy and to analyse the results achieved in our series.

Methods: The study is an interventional, retrospective, non-comparative case series.

High rate of incomplete resection after primary excision of eyelid BCC: multi-staged resection rarely needs more than two procedures.

Purpose: Small, well-demarcated, biopsy-proven periocular basal cell carcinomas (BCC) are often excised in a single stage with immediate reconstruction when histology or location is considered low-risk. We investigated margin clearance in patients undergoing primary excision and immediate reconstruction (PER) versus multi-staged fast paraffin excision (MSE) and reviewed risk factors for incomplete excision.

Methods: Retrospective, interventional, comparative case series of periocular BCCs excised over a 3-year period (2006-2008).

Angiomatous meningioma of orbit mimicking as malignant neoplasm: a case report and literature review.

Angiomatous meningioma is a rare and distinct meningioma variant characterised with predominance of microvascularcomponent.There are few reported cases in literature with limited information on ophthalmic manifestations and radiological findings. There is no consistent feature reported so far of this neoplasm to aid in its diagnosis.

Aspergillus infection of supramid orbital implant and hyperostosis of orbital bone: report of a unique case.

Purpose: The authors report the clinical findings in a patient who developed proptosis fourteen years after an orbital floor fracture repair with a Supramid orbital implant due to hyperostosis of the orbital floor and lateral orbital wall bone secondary to aspergillus infection.

Methods: Clinical, radiological, microbiological and histological findings and the management of this patient are presented.

Results: A 25-year-old male was referred with proptosis and lower lid retraction, fourteen years after a traumatic orbital floor fracture repair with a Supramid implant.

Complications of intracanalicular plugs: a case series.

Purpose: Intracanalicular plugs are commonly used in the management of dry eyes. The authors report 3 cases of complications associated with intracanalicular plugs.

Methods: Clinical findings and the management of these patients are presented.

Optic nerve sheath meningioma in a patient with choroidal malignant melanoma: a case report of a complex neurocristopathy.

Purpose: To describe the clinical findings in a patient who had developed choroidal melanoma and was incidentally found to have meningioma of the optic nerve in the same side.

Methods: Clinical and histopathological findings of the case are reviewed and presented.

Results: The patient had a choroidal melanoma of the left eye for which she had initially declined surgery and 2 years later when she underwent an examination, an optic nerve sheath meningioma was incidentally found histologic examination.

The role of 11beta-hydroxysteroid dehydrogenase 1 in adipogenesis in thyroid-associated ophthalmopathy.

Context: Thyroid-associated ophthalmopathy (TAO) is a sight-threatening autoimmune disease in which de novo adipogenesis has been identified as a fundamental pathogenic mechanism. 11beta-Hydroxysteroid dehydrogenase 1 (11beta-HSD1) increases cortisol bioavailability and is pivotal in mediating glucocorticoid responses in adipose tissue and inflammation.

Objective: In this study we characterize 11beta-HSD1 as a determinant of the adipogenic and inflammatory pathways in TAO orbital fat (OF) compared with normal OF.

Incidence of endophthalmitis following vitreoretinal surgery.

Aim: The purpose of this study was to investigate the incidence of postvitreoretinal surgery endophthalmitis in a UK tertiary referral centre.

Methods: Two cases that met the clinical criteria of endophthalmitis following conventional 20-gauge vitreoretinal surgery were included in this retrospective, noncomparative, consecutive case series.

Results: The incidence of endophthalmitis between 1 April 1997 and 30 November 2004 was 0.

Bicanalicular obstruction in lichen planus: a characteristic pattern of disease.

Purpose: Lichen planus, an idiopathic mucocutaneous inflammatory disease, has only once been reported to cause lacrimal drainage obstruction. The authors present a series of patients with epiphora resulting from systemic lichen planus and describe the characteristic pattern of lacrimal canalicular blockage.

Design: Retrospective noninterventional case series.

Characterisation of 11beta-hydroxysteroid dehydrogenase 1 in human orbital adipose tissue: a comparison with subcutaneous and omental fat.

Glucocorticoids (GCs) have a profound effect on adipose biology increasing tissue mass causing central obesity. The pre-receptor regulation of GCs by 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) that activates cortisol from cortisone has been postulated as a fundamental mechanism underlying the metabolic syndrome mediating adipocyte hyperplasia and hypertrophy in the omental (OM) depot. Orbital adipose tissue (OF) is the site of intense inflammation and tissue remodelling in several orbital inflammatory disease states.

Postcataract endophthalmitis: incidence and microbial isolates in a United Kingdom region from 1996 through 2004.

Purpose: To investigate the incidence of endophthalmitis after cataract surgery, analyze the microbiologic spectrum of infecting organisms, and assess the diagnostic utility of an anterior chamber paracentesis and vitreous biopsy.

Setting: United Kingdom tertiary referral center used by 13 operating suites.

Methods: A retrospective noncomparative consecutive series comprised 105 postcataract endophthalmitis cases.

Use of a novel topical hemostatic sealant in lacrimal surgery: a prospective, comparative study.

Purpose: FloSeal Matrix is a new, two-component (collagen granules and thrombin), topical hemostatic sealant. We prospectively evaluated the role of FloSeal Matrix in achieving hemostasis in dacryocystorhinostomy (DCR) surgery and its intraoperative characteristics (ease of use). We hypothesize that FloSeal will efficiently control bleeding in patients and eliminate the need for postoperative intranasal dressing.

Multiplex bead immunoassay analysis of aqueous humor reveals distinct cytokine profiles in uveitis.

Purpose: To extensively characterize the complex network of cytokines present in uveitis aqueous humor (AqH), and the relationships between cytokines and the cellular infiltrate.

Methods: AqH from noninflammatory control subjects and patients with idiopathic, Fuchs' heterochromic cyclitis (FHC), and herpes-viral or Behçet's uveitis were analyzed for IL-1beta, -2, -4, -5, -7, -8, -10, -12, -13, -15, TNFalpha, IFNgamma, CCL2 (MCP-1), CCL5 (RANTES), CCL11 (Eotaxin), TGFbeta2, and CXCL12 (SDF-1), using multiplex bead immunoassays. The cellular infiltrate was also determined for each sample.

Inhibition of T cell apoptosis in the aqueous humor of patients with uveitis by IL-6/soluble IL-6 receptor trans-signaling.

A fundamental mechanism of immune privilege in the eye is the induction of T lymphocyte apoptosis. Intraocular inflammation in uveitis implies compromise of immune privilege. This study sought to determine whether apoptosis of T cells is actively inhibited in patients with uveitis and by what pathways this may occur.

Primary anti-phospholipid antibody syndrome (APS): current concepts.

Primary anti-phospholipid syndrome (APS) is a thrombophilic state characterized by recurrent arterial and venous thrombosis, recurrent pregnancy loss, and the presence of circulating anti-phospholipid antibodies that may be responsible for thrombophilia and pregnancy morbidity. Ophthalmologic features are present in 15-88% of the patients with primary APS, thus ophthalmologists are one of the first physicians to whom the patient will present. An accurate diagnosis may save the patient from recurrent, potentially life-threatening thrombosis.

The danger of wearing an anorak.

Campaigns to reduce road traffic accidents have paid little attention to the way headgear could interfere with vision. Binocular visual field measurement was undertaken in six healthy volunteers wearing four different types of anorak. All four anoraks greatly reduced the horizontal and superior field of vision.