Systemic sarcoidosis manifested as unilateral eyelid retraction.
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Eyelid Diseases↗
Biomedical subjects
Raed Behbehani
Publications and source records attributed to Raed Behbehani.
Headache and vision loss in a 41-year-old man.
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Adult↗
Simultaneous endoscopic antrostomy and orbital reconstruction in silent sinus syndrome.
PURPOSE: To review the surgical outcome of five cases of silent sinus syndrome (SSS) who were treated with simultaneous endoscopic antrostomy and orbital implant placement. Patients with SSS often present with cosmetic change to their facial appearance (enophthalmos, hypoglobus, deep upper lid sulcus). DESIGN: Retrospective case series. METHODS: Chart review was performed for cases of SSS who were seen between 1995 and 2003 in two tertiary eye care centers. The age, affected side, presenting symptoms and duration, history of trauma, smoking, and chronic sinusitis, degree of enophthalmos and hypoglobus were recorded. RESULTS: All patients had a satisfactory post-operative result with correction of the enophthalmos, hypoglobus, and deep upper lid crease deformity. There were no untoward effects such orbital implant infection, diplopia, vision loss or hematoma. CONCLUSION: Simultaneous endoscopic antrostomy and orbital implant placement can achieve a satisfactory outcome in cases of SSS with significant enophthalmos and hypoglobus. Orbital implant placement carries minimal risks and should not be delayed only to potentially avoid infection, diplopia, or visual loss, as these events are unlikely.
Adult↗
Nonarteritic anterior ischemic optic neuropathy in patients with sleep apnea while being treated with continuous positive airway pressure.
PURPOSE: To report three cases of nonarteritic anterior ischemic optic neuropathy (NAION) that occurred in patients with sleep apnea syndrome (SAS) while being treated with continuous positive airway pressure (CPAP). DESIGN: A prospective, noncomparative case series. METHODS: Prospective review of 108 patients with NAION diagnosed between 2002 and 2003 to identify any patients who developed NAION while being treated for SAS with CPAP. RESULTS: One patient had bilateral sequential NAION and two patients had unilateral NAION despite treatment with CPAP for SAS. All the patients were being treated with CPAP for a period ranging from 4 months to 6 years before the onset of NAION. CONCLUSIONS: In this series, CPAP did not prevent the development of NAION in SAS patients. Larger observational studies are needed to study the benefit of CPAP in preventing NAION in patients with SAS.
Continuous Positive Airway Pressure↗
Orbital radiotherapy for thyroid-related orbitopathy.
PURPOSE OF REVIEW: Orbital radiotherapy has been one of the primary treatment modalities for moderate to severe thyroid-related orbitopathy. In this review the authors discuss the role of orbital radiotherapy in this disease with particular emphasis on questions raised by recent studies. RECENT FINDINGS: Despite its widespread use, until recently there have been few well-designed, randomized clinical trials on the role of orbital radiotherapy for thyroid-related orbitopathy. Although most the literature points to a favorable effect of orbital radiotherapy, recent studies have provided us with conflicting results. SUMMARY: Orbital radiotherapy remains a safe and a widely used treatment option for severe and progressive thyroid-related orbitopathy. More randomized clinical trials are needed, especially to examine the role of orbital radiotherapy for severe thyroid-related orbitopathy characterized by severe congestion and/or compressive optic neuropathy with and without the use of corticosteroids. There is a wide consensus among clinicians that this subgroup of patients is the most frequent one to which orbital radiotherapy is offered.
Chemotherapy, Adjuvant↗
The antiphospholipid antibody syndrome: diagnostic aspects.
PURPOSE OF REVIEW: The antiphospholipid antibody syndrome is an important cause of arterial and/or venous thrombosis. In this review the authors discuss recent trends in the clinical and laboratory diagnosis of this syndrome that are of relevance to ophthalmologists. RECENT FINDINGS: The diagnostic criteria of antiphospholipid antibody syndrome have been reviewed and revalidated recently. Few prospective studies have been conducted to determine the prevalence of antiphospholipid antibodies in patients with retinal vascular occlusion and the spectrum of ophthalmologic findings in patients with established antiphospholipid syndrome. New antibody tests for antiphospholipid antibody syndrome are available with increased sensitivity and specificity, but lack of standardization, and interassay and interlaboratory variation makes it difficult to determine their clinical value. SUMMARY: Ophthalmologists should be familiar with the spectrum of clinical manifestation of antiphospholipid syndrome, the diagnostic criteria of this disease, and be able to carry out a basic laboratory workup for this entity. A high index of suspicion for this disorder is also important in making the diagnosis.
Antiphospholipid Syndrome↗
Foggy vision.
A 53-year-old man with history of "foggy vision" was referred for neuro-ophthalmic consultation. His examination showed a right homonymous hemianopia detected with automated perimetry. Brain magnetic resonance imaging showed extensive enhancement of the structures in the sellar region and patchy meningeal enhancement. Blood workup was unremarkable. He eventually had bronchoscopy, which confirmed the diagnosis of sarcoidosis.
Azathioprine↗