Buphthalmos

Buthalmos
  • 文章类型: Journal Article
    背景:虹膜结节通常被认为是1型神经纤维瘤病的临床表现,但其他眼内表现很少见。这项研究的目的是介绍一名患有Phthisic眼的患者,该患者在15年的随访后因美容原因进行了摘除,并回顾了文献中描述的14例摘除患者。
    方法:一名17岁的1型神经纤维瘤病患者因美容原因,接受了Phthisic左眼摘除术,并切除了左侧眼睑皮下肿块病变。他在童年时曾进行过四次手术以减少左侧的眼睑和眼眶质量,并且在10年前发生了视网膜完全脱离。病理上,摘除的眼睛在涉及视网膜神经元层的区域显示出大量的视网膜胶质细胞增生,S-100和胶质纤维酸性蛋白(GFAP)阳性,以及沿脉络膜的纤维化病变,相比之下,S-100和GFAP均为阴性。脉络膜,睫状体,虹膜未显示明显的神经纤维瘤,而巩膜神经纤维瘤存在。
    方法:在文献中回顾了14例患者的眼球摘除,在9例患者中,临床诊断为单侧早发性青光眼的眼病,这些患者经常表现出不同程度的面神经神经纤维瘤病,累及同侧的眼睑和眼眶。病理上,在12例患者的脉络膜中发现了不同程度的神经纤维瘤。一名患者左侧显示脉络膜恶性黑色素瘤,右侧视神经梭形扩大,怀疑视神经胶质瘤。另一名患者的phthisic眼显示出与本患者相似的大量视网膜神经胶质增生。
    结论:总结15例1型神经纤维瘤病患者,包括本患者,由于美容原因,没有视力的白眼或phithisic眼被摘除,大多数患者显示脉络膜神经纤维瘤,包括本患者在内的两名患者显示大量视网膜胶质增生。
    BACKGROUND: Iris nodules are frequently noted as clinical manifestations of neurofibromatosis type 1 but the other intraocular manifestations are rare. The purpose of this study is to present a patient with a phthisic eye who underwent enucleation for a cosmetic reason after 15-year follow-up and also to review 14 patients with enucleation described in the literature.
    METHODS: A 17-year-old man with neurofibromatosis type 1 from infancy underwent the enucleation of phthisic left eye and also had the resection of eyelid subcutaneous mass lesions on the left side for a cosmetic reason. He had undergone four-time preceding surgeries for eyelid and orbital mass reduction on the left side in childhood and had developed total retinal detachment 10 years previously. Pathologically, the enucleated eye showed massive retinal gliosis positive for both S-100 and glial fibrillary acidic protein (GFAP) in the area with involvement of the detached retinal neuronal layer, together with a more fibrotic lesion along the choroid which were, in contrast, negative for both S-100 and GFAP. The choroid, ciliary body, and iris did not show apparent neurofibroma while episcleral neurofibroma was present.
    METHODS: In review of enucleated eyes of 14 patients in the literature, buphthalmic eyes with early-onset glaucoma on the unilateral side was clinically diagnosed in 9 patients who frequently showed varying extent of hemifacial neurofibromatosis which involved the eyelid and orbit on the same side. Pathologically, neurofibromas in varying extent were found in the choroid of 12 patients. One patient showed choroidal malignant melanoma on the left side and fusiform enlargement of the optic nerve on the right side suspected of optic nerve glioma. The phthisic eye in another patient showed massive retinal gliosis similar to the present patient.
    CONCLUSIONS: In summary of the 15 patients with neurofibromatosis type 1, including the present patient, buphthalmic or phthisic eyes with no vision were enucleated for cosmetic reasons and showed choroidal neurofibroma in most patients and massive retinal gliosis in two patients including the present patient.
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  • 文章类型: Case Reports
    描述一种使用先前的非瓣膜性青光眼引流装置修复眼睛中的孔源性视网膜脱离的新技术,Aurolab水性排水植入物(AADI)。
    一名患有双侧原发性先天性青光眼的5岁儿童,左眼出现下视网膜脱离(RD)。左眼有多次手术史,包括两次联合小梁切开术和小梁切除术,AADI植入和随后的人工晶状体抽吸术植入,介绍前18个月。左眼视网膜脱离是通过巩膜扣带技术进行管理的,使用AADI的板作为扣带元件,而无需外植体。
    和重要性:使用预先存在的青光眼引流装置(GDD)处理眼睛中的视网膜脱离具有独特的挑战性。切除GDD可能会导致术后难治性青光眼,需要另一个手术。使用GDD本身的修整板作为屈曲元件有助于使RD沉降并保持眼内压控制。
    UNASSIGNED: To describe a novel technique for repair of rhegmatogenous retinal detachment in an eye with a previous non-valved glaucoma drainage device, the Aurolab Aqueous Drainage Implant (AADI).
    UNASSIGNED: A 5-year-old child with bilateral primary congenital glaucoma presented with an inferior retinal detachment (RD) in the left eye. The left eye had a history of multiple surgical interventions including combined trabeculotomy and trabeculectomy done twice, AADI implantation and subsequently phacoaspiration with IOL implantation, 18 months prior to presentation. The left eye retinal detachment was managed by scleral buckling technique using the plate of the AADI as a buckling element without its explantation.
    UNASSIGNED: AND IMPORTANCE: Management of retinal detachment in eyes with a pre-existing glaucoma drainage device (GDD) is uniquely challenging. Explantation of the GDD would likely result in intractable glaucoma post-operatively, requiring another surgery. Use of the trimmed plate of the GDD itself as the buckling element helped in settling the RD and preserving intraocular pressure control.
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  • 文章类型: Case Reports
    未经授权:报告一例眼部青少年黄色肉芽肿(JXG)病例,角膜混浊,和正常眼压(IOP)在新生儿期和Ahmed青光眼阀(AGV)植入术治疗。
    未经证实:JXG是一种罕见的疾病,主要见于婴儿,但是新生儿的表现非同寻常。尽管自发性前房积血是JXG的常见表现,仅在1例中报告了新生儿期的Buthemos和角膜混浊,在演示时具有较高的IOP值。
    未经证实:16天大的男性患者出现了bopthalmos,弥漫性角膜混浊,右眼IOP值11mmHg。三周后眼压上升到28mmHg,自发性前房积血,抗青光眼药物和外用皮质类固醇均无反应。AGV被植入,术后眼压降至13mmHg。在后续行动中,在全身麻醉下检查时,患者皮肤上发现了许多坚硬的黄色结节。皮肤结节的组织病理学检查与JXG的诊断相符。在随访过程中出现了晶状体半脱位和牙齿畸形,并通过平坦部晶状体切除术进行了处理。经过三个月的沉默,在侧端口入口周围确定了上皮向内生长。不幸的是,向内生长对冷冻治疗没有反应,并导致肺结核。眼球摘除后眼的病理评估显示后节段受累。
    UASSIGNED:眼部JXG可以与Buththalmos一起出现,角膜混浊,和正常的IOP值,在新生儿期没有任何皮肤损伤。新生儿JXG的出现可能与有限的药物治疗反应和侵袭性病程有关。
    未经评估:本病例报告介绍了第二个眼JXG病例,表现为白眼和角膜混浊,文献中第三个经病理证实的JXG后段受累。
    未经批准:DericiogluV,SevikMO,EraslanM,etal.幼年黄色肉芽肿在新生儿期表现为Buthromos和角膜浑浊:一例病例报告。JCurr青光眼Pract2022;16(2):128-131。
    UNASSIGNED: To report an ocular juvenile xanthogranuloma (JXG) case presented with buphthalmos, corneal cloudiness, and normal intraocular pressure (IOP) in the neonatal period and treated with Ahmed glaucoma valve (AGV) implantation.
    UNASSIGNED: JXG is a rare disorder predominantly seen in infants, but the neonatal presentation is extraordinary. Although spontaneous hyphema is a common presenting sign in JXG, buphthalmos and corneal opacity in the neonatal period were reported only in one case, which had high IOP values at presentation.
    UNASSIGNED: Sixteen-day-old male patient presented with buphthalmos, diffuse corneal clouding, and 11 mm Hg of IOP value in the right eye. IOP increased to 28 mm Hg three weeks later, and spontaneous hyphema developed, which did not respond to antiglaucomatous medications and topical corticosteroids. AGV was implanted, and the IOP decreased to 13 mm Hg postoperatively. In the follow-ups, numerous firm yellowish nodules were noticed on the patient\'s skin during the examination under general anesthesia. Histopathological examination of the skin nodules was compatible with the diagnosis of JXG. Lens subluxation and phacodonesis were developed during the follow-up and were managed with pars plana lensectomy. After a silent period of 3 months, epithelial ingrowth was determined around the side port entrance. Unfortunately, the ingrowth did not respond to cryotherapy and resulted in phthisis bulbi. Pathological evaluation of the enucleated phthisic eye revealed posterior segment involvement.
    UNASSIGNED: Ocular JXG can be present with buphthalmos, corneal opacity, and normal IOP values without any skin lesions in the neonatal period. Neonatal presentation of JXG may be associated with limited medical therapy response and aggressive disease course.
    UNASSIGNED: This case report introduces the second ocular JXG case, which presented with buphthalmos and corneal cloudiness, and the third pathologically proven posterior segment involvement of JXG in the literature.
    UNASSIGNED: Dericioglu V, Sevik MO, Eraslan M, et al. Juvenile Xanthogranuloma Presented with Buphthalmos and Corneal Clouding in Neonatal Period: A Case Report. J Curr Glaucoma Pract 2022;16(2):128-131.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    神经纤维性增生-1(NF-1)是最常见的眼部神经皮肤综合征,具有多种眼部表现。报告了三名患有单侧青光眼(buthelmos)的儿童,同侧面部半肥大,和眼睑丛状神经纤维瘤:完成弗朗索瓦综合征三联征,一种罕见的NF1变体。其中2人患有白斑,并被称为视网膜母细胞瘤嫌疑人。组织病理学显示神经节细胞瘤,良性脉络膜肿瘤,与NF-1相关,不需要治疗。了解这种罕见情况避免了视网膜母细胞瘤的误诊,防止激进的管理,以及相关的心理影响。
    Neurofibromtosis-1 (NF-1) is the commonest oculo-neuro-cutaneous syndrome with multiple ocular manifestations. Reporting three children who presented with unilateral glaucoma (buphthalmos), ipsilateral facial hemihypertrophy, and eyelid plexiform neurofibroma: completing the triad of François syndrome, a rare NF1 variant. Two presented with leukocoria and were referred to as retinoblastoma suspects. Histopathology showed ganglioneuroma, a benign choroidal tumor, associated with NF-1, which does not need treatment. Knowledge of this rare condition avoids misdiagnosis of retinoblastoma, prevents aggressive management, and the associated psychological impact.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    我们介绍了一个10个月大的男孩,左眼球突出,玻璃体出血,后来被诊断为Dandy-walker综合征(DWS)伴眼球和玻璃体出血。治疗取决于报告的症状,因此,密切监测和多学科方法至关重要。我们建议即使没有DWS的主要症状,有眼部体征的儿科患者应将DandyWalker畸形(DWM)视为鉴别诊断。
    We present a unique case of a ten-month-old boy with a protruding left globe and vitreous haemorrhaging, and later being diagnosed as a case of a dandy-walker syndrome (DWS) with buphthalmos and vitreous haemorrhage. Treatment is depending on the symptoms reported, thus close monitoring and a multidisciplinary approach are essential. We would like to recommend that even if there are no cardinal symptoms of DWS, paediatric patients with ocular signs should have Dandy walker Malformation (DWM) considered as a differential diagnosis.
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  • 文章类型: Journal Article
    目的:评估不同的术前变量对小梁切开-小梁切除术(CTT)联合手术对原发性先天性青光眼(PCG)患者成功的影响,以预测那些手术失败风险较高的患者,并进行适当的父母咨询。
    方法:对63只眼的PCG患者进行CTT治疗,或CTT在结膜下间隙和巩膜瓣下增加丝裂霉素C(0.2mg/mL)3分钟,或在巩膜瓣和结膜下增加胶原植入物的CTT。报告了手术失败的病例,并根据不同的术前变量进行了评估。
    结果:52例(82.5%)获得完全成功(IOP≤21mmHg)。累积成功概率使用Kaplan-Meier生存分析计算,证明较高的术前眼压(IOP)与较高的失败率相关(术前眼压≥30mmHg为28.6%,而眼压<30mmHg为4.8%),P值=0.007。
    结论:CTT是一种有效的PCG患者手术干预措施,没有视力威胁的并发症。单因素生存分析显示,术前IOP较高的患者手术失败率较高,而其他术前变量则无关紧要。
    OBJECTIVE: To evaluate different pre-operative variables on the success of combined trabeculotomy-trabeculectomy (CTT) surgery in patients with primary congenital glaucoma (PCG) to predict those at higher risk for surgical failure and for proper parent counseling.
    METHODS: Sixty-three eyes of patients with PCG were treated either with CTT without augmentation, or CTT augmented with mitomycin-C (0.2 mg/mL) in both subconjunctival space and under scleral flap for 3 minutes, or with CTT augmented with a collagen implant under both the scleral flap and the conjunctiva. Cases showed surgical failure was reported and evaluated in relation to different pre-operative variables.
    RESULTS: Complete success (IOP ≤21 mmHg) was achieved in 52 cases (82.5%). Cumulative success probability was calculated using Kaplan-Meier survival analysis, proving that higher pre-operative intraocular pressure (IOP) was associated with higher failure rates (28.6% for pre-operative IOP ≥30 mmHg versus 4.8% for IOP <30 mmHg), with P value = 0.007.
    CONCLUSIONS: CTT is an effective surgical intervention in PCG patients without sight threatening complications. Univariate survival analysis showed higher rates of surgical failure in patients with higher pre-operative IOP, while other pre-operative variables were irrelevant.
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  • 文章类型: Journal Article
    目的:在青光眼继发下眼睑退缩的眼睑眼睑下垂的病例中,仅矫正上睑是无效的。应进行联合手术以获得满意的结果。
    目的:探讨儿童下睑脱出伴下睑退缩的眼睑眼睑矫正手术后的结局。
    方法:对4例患者的6只眼进行了回顾性分析,包括下眼睑牵开器缩回结合边缘旋转和tc骨固定。边缘反射距离-2,眼睑,临床症状的解决,并在6~12个月的随访期间评估并发症.
    结果:在所有情况下,眼睑和眼睑矫正,畏光和溢光症状缓解,角膜上皮修复。在随访期间,边缘反射距离-2下降并保持正常,但在术后6个月内略有消退。
    结论:儿童下睑下垂常与下睑退缩有关。下睑牵开器后退结合睑缘旋转与睑板固定从根本上解决了眼睑张力高的问题,下眼睑回缩,并降低复发率。
    OBJECTIVE: In cases of epiblepharon with lower eyelid retraction secondary to glaucoma, correcting epiblepharon alone is ineffective. Combined surgery should be performed to obtain satisfactory outcomes.
    OBJECTIVE: To investigate outcomes after surgery to correct epiblepharon with lower eyelid retraction secondary to buphthalmos in children.
    METHODS: A retrospective analysis of six eyes in four patients was performed included lower lid retractor recession combined with marginal rotation with tarsal fixation. The margin reflex distance-2, lagophthalmus, resolution of clinical symptoms, and complications were assessed during 6 to 12 months of follow-up.
    RESULTS: In all cases, epiblepharon and lagophthalmus were corrected, symptoms of photophobia and epiphora were relieved, and the corneal epithelium was repaired. The margin reflex distance-2 decreased and remained normal during the follow-up period, but slightly regressed within 6 months postoperatively.
    CONCLUSIONS: Epiblepharon caused by buphthalmos in children is often associated with lower eyelid retraction. Lower lid retractor recession combined with marginal rotation with tarsal fixation fundamentally solves the problems of high eyelid tension, lower eyelid retraction, and epiblepharon and reduces the recurrence rate.
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  • 文章类型: Journal Article
    在不存在升高的眼内压的情况下,巨大角膜和前巨大眼球(巨大角膜谱)病症通常由角膜直径>12.5mm定义。临床特征与角膜角球重叠,但与白斑和严重(球形)圆锥角膜不同。角膜巨谱疾病和角膜角球主要是先天性疾病,通常具有综合征性关联;两者都可以呈现大而薄的角膜,造成诊断困难,然而,只有角膜角化球是典型的进行性。分子遗传学提供了对潜在病因的重要见解。尽管如此,仔细的临床评估仍然是诊断的内在因素.由于巨大角膜谱系疾病中的睫状环增大和小带减弱以及角膜角球的角膜极度变薄,手术治疗可能具有挑战性。在这次审查中,关于角膜直径测量的既定文献,巨大角膜的诊断,前巨眼和角膜角球,与严重圆锥角膜的分化,概述和讨论了最近的分子遗传学研究和治疗这些罕见疾病的关键手术方式。
    Megalocornea and anterior megalophthalmos (megalocornea spectrum) disorders are typically defined by corneal diameter > 12.5 mm in the absence of elevated intraocular pressure. Clinical features overlap with keratoglobus but are distinct from buphthalmos and severe (globus) keratoconus. Megalocornea spectrum disorders and keratoglobus are primarily congenital disorders, often with syndromic associations; both can present with large and thin corneas, creating difficulty in diagnosis, however, only keratoglobus is typically progressive. Molecular genetics provide significant insight into underlying aetiologies. Nonetheless, careful clinical assessment remains intrinsic to diagnosis. Surgical management can be challenging due to the enlarged ciliary ring and weakened zonules in megalocornea spectrum disorders and the extreme corneal thinning of keratoglobus. In this review, the established literature on measurement of corneal diameter, diagnosis of megalocornea, anterior megalophthalmos and keratoglobus, differentiation from severe keratoconus, recent molecular genetics research and key surgical modalities in the management of these rare disorders are outlined and discussed.
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