Periocular Reconstruction Utilizing the Integra Dermal Regeneration Template.

Purpose: To describe the use of the Integra dermal regeneration template (DRT) for periocular reconstruction following Mohs micrographic or surgical excision of cutaneous malignancy.

Methods: This is a retrospective study of adult patients who underwent periocular reconstruction using DRT from 2017 to 2023 at a single academic institution. All patients had a postexcision defect involving at least 1 periocular subunit, including brow, temple, cheek, nasal sidewall, medial and/or lateral canthal areas.

Adjunct botulinum toxin for cicatricial pemphigoid.

Cicatricial changes secondary to conjunctivitis associated with pemphigoid can include subconjunctival fibrosis, forniceal shortening, symblepharon with resultant entropion and trichiasis. This can ultimately lead to limbal stem cell deficiency and irreversible corneal keratopathy. Herein, we present a case series of three patients at a single academic institution between 2022 and 2024 that underwent botulinum toxin-A injection for lower eyelid cicatricial entropion as a temporizing treatment due to active cicatrizing conjunctivitis.

The Utility of Preoperative Phenylephrine Testing in Müller Muscle Conjunctival Resection Surgery for Involutional Ptosis.

Purpose: Phenylephrine testing prior to Müller muscle conjunctival resection has traditionally been used to predict postoperative outcomes. The purpose of this study is to determine if preoperative phenylephrine testing impacts postoperative changes in eyelid position.

Methods: In this multicenter cross-sectional cohort study, 270 eyelids of participants with involutional ptosis and levator function >12 mm who underwent Müller muscle conjunctival resection were divided into 2 comparison groups.

Medical, Environmental, and Social Determinants Associated With Periocular Cutaneous Malignancies in the United States Using the All of Us National Database.

Objective: To identify common factors associated with periocular cutaneous malignancies using the National Institutes of Health (NIH) database.

Methodology: In this case-control study, we extracted electronic health records and sociodemographic data for 385 cases of periocular cutaneous malignancies from the nationwide database. Controls ( = 1540) were matched to the demographic characteristics of the 2020 United States Census.

Teprotumumab for Thyroid Eye Disease-related Strabismus.

Purpose: To assess and quantify teprotumumab's effect on thyroid eye disease-related strabismus by change in measured horizontal and vertical deviations and change in extraocular motility.

Methods: We reviewed a series of patients with thyroid eye disease-related strabismus treated with teprotumumab. Exclusion criteria included age under 18 years, strabismus of alternate etiology, or thyroid eye disease-related reconstructive surgery during the treatment course.

Teprotumumab-related Cutaneous Hypersensitivity Reactions.

The authors report 4 cases of cutaneous hypersensitivity reactions developing in the course of teprotumumab treatment for thyroid eye disease. The onset of the cutaneous hypersensitivity reaction was also observed during the treatment course in all cases, between the second and fifth infusions. Teprotumumab-related cutaneous reactions suggest a possible immunogenic component of the monoclonal antibody and highlight the importance of close monitoring during treatment.

Transcutaneous retrobulbar amphotericin B for rhino-orbital-cerebral mucormycosis: a multi-center retrospective comparative study.

Purpose: To assess whether transcutaneous retrobulbar amphotericin B injections (TRAMB) reduce exenteration rate without increasing mortality in rhino-orbital-cerebral mucormycosis (ROCM).

Methods: In this retrospective case-control study, 46 patients (51 eyes) with biopsy-proven ROCM were evaluated at 9 tertiary care institutions from 1998 to 2021. Patients were stratified by radiographic evidence of local orbital versus extensive involvement at presentation.

Orbital floor reconstruction via autologous radial forearm free flap with palmaris longus tendon.

We describe reconstruction of the orbital floor following suprastructure maxillectomy for resection of maxillary squamous cell carcinoma utilizing an osteocutaneous radial forearm free flap and palmaris longus tendon.

Peripheral ulcerative keratitis secondary to severe hidradenitis suppurativa.

Purpose: To describe a unique case of peripheral ulcerative keratitis secondary to isolated, severe hidradenitis suppurativa (HS).

Observation: A 31-year-old male with HS presented with a red painful right eye with best corrected visual acuity of count fingers at 3 feet with peripheral corneal thinning, inferior descemetocele, and adjacent infiltrate. Work-up revealed negative corneal cultures and positive ANA, ANCA, and rheumatoid factor without other autoimmune or rheumatologic history or symptomatology.

Giant Deep Orbital Dermoid Cyst Presenting in Infancy.

Orbital dermoid cysts are benign choristomas that are very common in children and occur most often as a lateral or medial mass associated with the frontozygomatic or frontoethmoidal suture line. The authors present an unusual case of an occult giant deep orbital dermoid cyst in infancy that initially presented with a small, benign appearance and central upper eyelid location on clinical exam. Orbitotomy with complete excision prevented further ocular sequelae in this 11-month-old.

Teprotumumab for chronic thyroid eye disease.

Purpose: To describe the treatment of nine patients with chronic, low clinical activity score thyroid eye disease with teprotumumab.

Methods: A retrospective series of patients with chronic thyroid eye disease (TED) and low clinical activity score (CAS) treated with teprotumumab infusion therapy. Inclusion criteria: adults over 18 years of age with TED for greater than 9 months and CAS of 1 or less.

Minimal Dissection Direct Frontalis Muscle Advancement Flap for Congenital Ptosis Repair.

Background: Frontalis flap advancement is an alternative means of congenital ptosis repair from frontalis suspension utilizing autologous fascia or allogenic implants. Variations in technique, including flap division, location and number of skin incisions, and dissection planes, are described in the literature.

Materials And Methods: A retrospective case series of patients with congenital myogenic ptosis treated with simplified, minimal dissection frontalis flap advancement involving a single upper eyelid crease incision with dissection in the preseptal and subcutaneous planes without division to mobilize the frontalis flap.

Isolated bifid medial rectus muscle in adult-onset divergence insufficiency esotropia.

We present the case of a 77-year-old woman with adult-onset divergence insufficiency esotropia in which a bifid medial rectus muscle was identified intraoperatively. The patient had no past ocular, medical, syndromic, or traumatic history associated with this isolated horizontal rectus anomaly. Following identification of the bifid muscle, the original surgical plan was altered to asymmetric recession of the superior and inferior medical rectus heads.

Secondary infection with rhino-orbital cerebral mucormycosis associated with COVID-19.

We report two fatal cases of rhino-orbital-cerebral mucormycosis associated with COVID-19 infection. Both patients had pre-existing diabetes mellitus type 2, were treated with corticosteroids, and developed ketoacidosis. Both patients rapidly declined owing to rapid extension of the infection into the intracranial cavity.

Methodologic Differences Across Studies of Patients With Atrial Fibrillation Lead to Varying Estimates of Stroke Risk.

Background: Guidelines for anticoagulation in atrial fibrillation (AF) assume that stroke risk scheme point scores correspond to fixed stroke rates. However, reported stroke rates vary widely across AF cohort studies, including studies from the same country. Reasons for this variation are unclear.

Stability of High-Quality Warfarin Anticoagulation in a Community-Based Atrial Fibrillation Cohort: The Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study.

Background: Warfarin reduces ischemic stroke risk in atrial fibrillation (AF) but increases bleeding risk. Novel anticoagulants challenge warfarin as stroke-preventive therapy for AF. They are available at fixed doses but are more costly.

GluA2 mRNA distribution and regulation by miR-124 in hippocampal neurons.

AMPA-type glutamate receptors mediate fast, excitatory neurotransmission in the brain, and their concentrations at synapses are important determinants of synaptic strength. We investigated the post-transcriptional regulation of GluA2, the calcium-impermeable AMPA receptor subunit, by examining the subcellular distribution of its mRNA and evaluating its translational regulation by microRNA in cultured mouse hippocampal neurons. Using computational approaches, we identified a conserved microRNA-124 (miR-124) binding site in the 3'UTR of GluA2 and demonstrated that miR-124 regulated the translation of GluA2 mRNA reporters in a sequence-specific manner in luciferase assays.