Subjective Assessment of Eight CT Features in the Prediction of Dysthyroid Optic Neuropathy.

Purpose: To evaluate the subjective assessment of 8 orbital CT features for predicting dysthyroid optic neuropathy (DON).

Methods: Scan montages from 137 orbits without DON and 121 with DON were each graded independently by 3 observers for 8 imaging features: namely, degree of apical crowding, extraocular muscle enlargement, expansion of orbital fat, clarity of the superior orbital fissure, fat prolapse through the superior orbital fissure, medial wall bowing, general orbital vascular congestion, and dilation of the superior ophthalmic vein. Gradings were analyzed individually and also averaged across observers.

Marked Enlargement of a Single Extraocular Muscle: Clinical and Imaging Patterns in the Prediction of Malignancy.

Purpose: To evaluate clinical presentation, imaging patterns, histopathology, and predictors of malignancy in patients with enlargement of a single extraocular muscle.

Methods: Retrospective review, with imaging categorized into 3 groups: single-muscle only (SMO), single excessively-enlarged muscle, and single-muscle with lacrimal gland enlargement (SMLG). Histopathology was classified as specific or nonspecific myositis, atypical thyroid eye disease, malignancy, or other diagnosis.

Reproducibility of the Unaided Subjective Assessment of Orbital Computed X-Ray Tomographic Features in Thyroid Eye Disease.

Purpose: To assess the reproducibility of subjective interpretation of computed x-ray tomography for 8 features associated with thyroid eye disease.

Methods: Patients with confirmed thyroid eye disease had 3 distinct orbital computed x-ray tomography sections presented as anonymized montages to 3 masked observers (#1 orbital radiologist, #2 general radiologist, and #3 orbital surgeon). Eight features were graded: superior orbital fissure clarity, degree of orbital fat prolapse through the superior orbital fissure, loss of fat space at the apex, muscle enlargement, increase in orbital fat volume, vascular congestion, superior ophthalmic vein size, and lamina papyracea bowing.

Oncocytic Carcinoma Ex-Pleomorphic Adenoma of the Lacrimal Gland.

Oncocytic carcinoma is a rare malignant neoplasm of oncocytic cells, such cells being characterized by abundant granular eosinophilic cytoplasm, invasive growth, and pronounced cellular pleomorphism. It may arise de novo, or through malignant transformation of a pre-existing benign oncocytoma. Oncocytic carcinoma most commonly occurs in the salivary glands, with rare involvement of the ocular adnexa where it mainly affects caruncle, conjunctiva, and lacrimal sac, and only very arises in the lacrimal gland.

Dacryoscintillography in Patients With Symptomatic, but Patent, Lacrimal Drainage Systems.

Purpose: The objective was to relate dacryoscintillographic features to presenting symptoms and signs for watery-eyed patients with patent drainage systems.

Methods: Retrospective case note and imaging review for patients with watering eye(s) and clinical evidence of impaired tear drainage who underwent dacryoscintillography (DSG). Three DSG features were graded, along with 4 symptoms, 7 signs, and the degree of fluid reflux and nasal fluid passage on gentle syringing.

Presentation of Orbital Metastases.

Purpose: The objective was to compare clinical characteristics of patients with and without a known systemic malignancy at the time of diagnosis of orbital metastases.

Methods: Retrospective case note and imaging review for patients with orbital metastases presenting between 1980 and 2022. Patients were classified as having known malignancy at orbital presentation (group I) or without known malignancy (group II).

Clinical Characteristics of Patients With Symptomatic Nasolacrimal Duct Stenosis.

Purpose: The objective was to characterize symptoms and signs for patients with tearing eye(s) and ipsilateral nasolacrimal duct stenosis (NLDS), as defined by delayed fluorescein disappearance test and ocular reflux of saline during gentle irrigation of a patent drainage system.

Methods: Retrospective case-note review of a consistent grading of 4 symptoms and 7 signs, together with estimates of the degree of fluid reflux and nasal fluid passage on gentle saline syringing. Characteristics, including gender differences, were compared for unilateral or bilateral symptoms.

Presentation of Spontaneous Orbital Hemorrhage.

Purpose: To evaluate the presenting features of patients with nontraumatic orbital hemorrhage (NTOH) based on etiopathological factors.

Methods: A retrospective case-note review for demographics and presenting features of patients with nontraumatic orbital hemorrhage. Patients were categorized into 3 groups: group I with known systemic vascular disease, group II with known or newly revealed orbital vascular anomalies, and group III with no known underlying vasculopathy.

Repeated Lacrimal Gland Biopsies.

Purpose: To examine the indications for repeated lacrimal gland biopsies, and the rate of detection of a new diagnosis.

Methods: A single-center, retrospective review of patients who underwent more than 1 lacrimal gland biopsy, either ipsilateral or contralateral, between 2000 and 2022.

Results: One hundred and twenty-three patients (80 female; 65%) had repeated lacrimal gland biopsy.

One-stage Intraconal Volume Modification for Exposed and Nonexposed Ball Implants.

Purpose: To assess long-term outcomes and reinterventions for exposed and nonexposed intraconal orbital implants after single-stage socket revisional surgery.

Methods: Retrospective case-note review of patients with exposed or nonexposed orbital ball implants, who underwent a single-stage ball exchange (Group I) or ball removal with dermis-fat graft (Group II); Group I was subdivided as having either exposed (A) or nonexposed (B) implants. Outcomes were compared with similar cohorts undergoing multistage surgery.

Long-Term Outcome of Staged Socket Surgery for Acquired Anophthalmos.

Purpose: To evaluate long-term outcomes of staged volume rehabilitation for acquired anophthalmos.

Methods: Case-note review of patients who had preceding i) eye removal without implant, ii) eye removal with an intraconal implant, but ball-related problems, or iii) removal of exposed implant. Secondary interventions were a) a first-time ball implant, b) dermis-fat graft, c) ball repositioning, d) ball replacement after prior removal, or e) orbital floor implantation.

Horizontal eyelid shortening alone versus combined procedures for the correction of involutional lower eyelid entropion.

Background: Conventionally, management of involutional entropion involves correcting both vertical and horizontal laxity, however the optimal surgical approach is debated.

Objective: To compare the recurrence rate of horizontal lower eyelid shortening alone with combined surgical approaches for correction of involutional lower eyelid entropion.

Methods And Material: A retrospective, comparative, consecutive case series of patients undergoing surgery for involutional lower eyelid entropion with both horizontal and vertical laxity.

Recurrent superior orbital fissure syndrome associated with VEXAS syndrome.

Purpose: To describe a case of recurrent orbital inflammation and superior orbital fissure syndrome associated with VEXAS (vacuoles, E1 enzyme, X-linked, auto-inflammatory, somatic) syndrome.

Case Presentation: VEXAS syndrome is a recently identified multi-system inflammatory disease of late adult onset. The authors describe the case of a 76-year-old man who presented with recurrent episodes of orbital inflammation, with superior orbital fissure syndrome, dacryoadenitis and orbital myositis.

Long-Term Surgical Outcome for Orbital Solitary Fibrous Tumors.

Purpose: To report long-term outcomes after surgery for orbital solitary fibrous tumors.

Methods: Retrospective review of patients with orbital solitary fibrous tumor, first seen between 1971 and 2022. Primary excisions were grouped as (A) surgically intact, (B) macroscopic, but with cell spillage, or (C) known incomplete excision.

Presentation of orbital solitary fibrous tumours.

Aims: To evaluate presenting features of patients with orbital solitary fibrous tumours (SFTs), based on histological phenotype.

Methods: A retrospective case-note review was performed for demographics and presenting features for patients with orbital SFTs. The tumours were classified as "Group IA" hypocellular SFT phenotype, "Group IB" haemangiopericytoma phenotype and low mitotic activity, and high-grade "Group II" haemangiopericytoma phenotype with high mitotic activity.