1/13. Histological findings in the eyelids of AIDS patients.PURPOSE: The eyelids of 15 AIDS patients (17 specimens) were examined histologically at postmortem. methods: Formalin-fixed, paraffin-embedded and haematoxylin-eosin stained sections were examined by conventional light microscopy. The presence of calcific deposits was confirmed by special stains and elemental analysis (X-ray energy dispersive spectroscopy). RESULTS: 6 cases had abnormal microscopical findings. In two cases deposits of calcium oxalates were observed in the wall of dermal blood vessels and in epithelial cells of sweat and sebaceous glands, respectively. Precipitates of calcium phosphate were observed in the superficial substantia propria of the palpebral conjunctiva in an additional patient. Other histological findings in the remaining three patients included flat warts, an unusual elastotic degeneration of the forniceal palpebral conjunctiva and more common lesions (chalazion, Demodex folliculorum infestation of the eyelashes, trichilemmal cyst). CONCLUSION: The presence of microscopical lesions in nearly half of this small series demonstrates that the eyelids may be affected subclinically in AIDS patients.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/13. melkersson-rosenthal syndrome: new clinicopathologic findings in 4 cases.OBJECTIVE: To define the clinicopathologic features of eyelid involvement in melkersson-rosenthal syndrome (MRS). methods: Four patients with eyelid edema consistent with MRS were evaluated clinically, including diagnostic imaging in 2 patients. Eyelid tissue from these patients was examined by light microscopy and immunohistochemistry. polymerase chain reaction for herpes simplex virus was performed in 1 case. RESULTS: The 3 men and 1 woman ranged in age from 33 to 74 years. All patients had insidious, painless, nonpitting eyelid edema. Three patients had unilateral edema; one had bilateral, asymmetric involvement. Ipsilateral lip edema was present in 1 case. Computed tomography demonstrated periorbital heterogeneous thickening that corresponded to the microscopic finding of scattered granulomas. All 4 patients demonstrated epithelioid granulomas inside and adjacent to dilated lymphatic vessels. polymerase chain reaction testing was negative for herpes simplex virus. CONCLUSIONS: Isolated eyelid swelling that mimics thyroid-associated ophthalmopathy may occur in MRS. Computed tomography may be useful in the diagnosis. biopsy should be performed in all cases of unexplained nonpitting eyelid edema. In the eyelid, MRS is characterized histopathologically by a granulomatous lymphangitis, a finding that seems to be unique to this condition.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/13. Rhabdomyomatous mesenchymal hamartoma of the eyelid: report of a case and literature review.PURPOSE: To report a rare case of rhabdomyomatous mesenchymal hamartoma and to compare its features with those cases previously reported. DESIGN: Interventional case report and literature review. INTERVENTION: Complete ophthalmologic and systemic examinations followed by excisional biopsy and histopathologic examination. MAIN OUTCOME MEASURES: Clinical examination features and histopathologic findings. RESULTS: A 6-month-old Latino male presented with a congenital, elevated, smooth, flesh-colored right lower eyelid lesion. An ipsilateral right limbal dermoid and an upper eyelid coloboma were also present. Excisional biopsy of the eyelid lesion revealed randomly oriented mature striated muscle tissue with associated adipose tissue, blood vessels, pilosebaceous units, and peripheral nerves, findings consistent with rhabdomyomatous mesenchymal hamartoma. Of the 24 reported cases (including the current case), eight had associated congenital anomalies. CONCLUSIONS: Although rhabdomyomatous mesenchymal hamartomas are rare and benign, they may be associated with other congenital anomalies and anomaly syndromes. As a result, we recommend systemic evaluation of patients diagnosed with this entity.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/13. molluscum contagiosum, involving the upper eyelids, in a child infected with hiv-1.BACKGROUND: infection with molluscum contagiosum has been reported in pediatric and adult patients with acquired immune deficiency syndrome (AIDS), but rarely affecting eyelids. We have studied the viral phenotype, hiv-1 plasma viremia, p24 antigenemia, alterations of cellular immune function, and the ophthalmological status in a 5-year old human immunodeficiency virus type 1 (hiv-1)-infected girl, who developed multiple molluscum lesions, bilaterally involving upper eyelids with extension over the face and nose. methods: Detailed ophthalmological examination and immunological and virological studies were performed in a pediatric patient with hiv-1 vertical infection having extensive infection with molluscum contagiosum. RESULTS: The pediatric patient was emetropic; tricomegalia was present bilaterally, and alteration of the microvessels of the conjunctiva (microangiopathy) was observable in both eyes and structural (fibrilar) degeneration of the vitreous architecture in both eyes. There was no ophthalmoscopic sign of infectious retinitis or retinal microangiopathy. She had lymphopenia, very low percentage and absolute number of CD4 T cells but increased percentage of CD8 T cells. The in vitro lymphocyte proliferative response to phytohemagluttinin (PHA) was depressed as compared to healthy controls. She had high levels of viral HIV rna in her plasma and of p24 antigen in her serum, and the phenotype of the isolated hiv-1 was determined to be syncytium-inducing (SI). CONCLUSION: Although healthy persons may develop molluscum contagiosum, usually unilateral, as far as we are aware this report is the first to document a case of molluscum contagiosum with bilateral eyelid involvement in an hiv-1-infected pediatric patient. Our observations suggest that this type of infection may be present in HIV-infected children, associated with high viral load and possibly an SI viral phenotype, severe immunoregulatory abnormalities, and poor clinical status.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/13. Palpebral edema as a cutaneous manifestation of hyperthyroidism.Three cases of palpebral edema associated with Graves' disease are described. These patients had unilateral edema and minimal erythema of the upper eyelid. Notable was that, histologically, dermal edema and dilation of lymphatic vessels were observed, but deposition of mucopolysaccharides was not. In 2 cases, edema of the eyelid was resistant to treatment with an antithyroid drug. Unilateral edema of the upper eyelid is an important cutaneous manifestation that indicates the presence of hyperthyroidism.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/13. Bilateral upper eyelid edema in melkersson-rosenthal syndrome.melkersson-rosenthal syndrome is an uncommon disorder characterized by a triad of facial nerve palsy, orofacial edema, and fissured tongue. A 42-year-old woman with melkersson-rosenthal syndrome presented with painless, nonpitting, bilateral asymmetric upper eyelid edema. The left eyelid was a bit larger than the right eyelid. CT and MRI demonstrated periorbital soft tissue thickening compatible with the microscopic findings of infiltration of lymphocytes, edema, and cystic dilatation of lymphatic vessels. After treatment by systemic doxycycline and corticosteroid, she showed some improvement of the eyelid edema. Isolated bilateral eyelids swelling may be observed in melkersson-rosenthal syndrome. In the case of unexplained nonpitting eyelid edema, biopsy should be performed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/13. Surgical management of recurrent localized eyelid amyloidosis.amyloidosis is a disease of unknown origin characterized by the widespread or localized deposition of amorphous hyaline material, amyloid, in various body tissues, including the ocular and orbital structures. Primary advanced localized amyloidosis involving the eyelid and conjunctiva is a rare cause of diffuse eyelid thickening. Management of these cases is often unsatisfactory because of the diffuse deposition of amyloid tissue and the increased risk of intraoperative hemorrhage, due to the fragile vessels encountered in amyloidosis. The possibility of recurrence also presents challenging treatment dilemmas. Therapeutic options include en bloc removal of the involved eyelid tissue, radiation therapy or, in advanced cases, no treatment. We describe an effective surgical approach that offers a safe, effective, and, most notably, repeatable procedure for the treatment of advanced ocular adnexal amyloidosis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/13. Hemicrania with massive autonomic manifestations and circumscribed eyelid erythema.OBJECTIVES: To describe a unilateral headache that in addition to the typical shortlasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, sweating and rhinorrhea (SUNCT) syndrome - traits with excessive and ipsilateral autonomic phenomena - had circumscribed eyelid erythema and adjacent ocular redness. OBSERVATIONS: A 60-year-old female had excessive, right-sided lacrimation and local pain at 15 years of age. Due to steadily increasing discomfort, with lacrimation and swelling over the outer part of the upper eyelid, the right lacrimal gland was removed at 20 years of age, with a suspicion of lacrimal gland adenoma. Preoperatively, symptomatic side mild-degree eyelid erythema/rhinorrhea were integral parts of the attack. After years with minor complaints, she, in the mid-twenties, experienced more long-lasting pain attacks, and pain soon became the main problem. A marked, distinct erythema on the lateral part of the right-sided eyelids and marked, localized 'eye redness' in the adjacent area were main ingredients of the attacks together with eyelid edema and viscous rhinorrhea. There were visible vessels below the eye, and telangiectasia of the upper eyelid. CONCLUSIONS: This headache has many similarities with SUNCT - but has several, grossly deviating traits: the temporal aspects, excruciatingly intense pain attacks, and above all marked, lateral eye-lid erythema, and adjacent, massive ocular reddening. This constellation probably alienates it from SUNCT.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/13. Parkinsonism and extraocular motor abnormalities with unusual neuropathological findings.Parkinsonian patients with ocular motility abnormalities are usually considered to have progressive supranuclear palsy. However, a number of other conditions have been noted to have the combination of parkinsonism and ocular problems. We report a case of rigid akinetic parkinsonism, oculomotor palsy, and eyelid apraxia with postmortem examination. Our findings are unusual in that there was marked gliosis of the substantia nigra with a large amount of free extracellular neuromelanin despite a 3-year clinical course. Only rare hyaline inclusion bodies and no neurofibrillary tangles were seen in the brainstem. Excessive calcification of the vessels of the globus pallidus were also noted. This case represents another example of the diversity of conditions producing parkinsonism with extraocular motor abnormalities.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/13. orbital pseudotumor, differential diagnosis.A 66-year-old white male presented with complaints of redness of his left eye, blurred vision, lid edema, and an intermittent throbbing pain above his left eye for 4 days. Significant clinical findings included mild hyperemia and edema of the left upper lid, marked engorgement and tortuosity of the conjunctival and episcleral vessels, mild chemosis, and extreme limitation of the extraocular movements of the left eye in all directions of gaze, especially adduction. This eye also showed a measurable proptosis with positive retropulsion. Pupillary responses and color vision were normal in both eyes. A CT scan revealed an enlarged medial rectus muscle, including its tendinous insertion with a normal cavernous sinus. On the basis of the clinical findings and the CT scan, a diagnosis of orbital pseudotumor was made. The patient was treated with high dose systemic prednisone, which resulted in a dramatic improvement of symptoms and signs.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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