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Orbital Inflammatory Syndromes
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Jaspreet Sukhija, Savleen Kaur
Sarcoidosis is a multisystem granulomatous inflammatory disease that affects the respiratory tract, skin, and eyes. Ocular involvement is reported in up to 50% of affected patients and is characterized by noncaseating granulomas of the conjunctiva, uveitis, optic neuropathy, or orbital involvement of the lacrimal gland, EOM, or fat. The lacrimal gland is the most common site of involvement, in 42–63% of patients, followed by orbit, eyelid, and lacrimal sac. Relatively nontender inflammation of the lacrimal glands points toward a sarcoidosis. Diagnosis can be made by conjunctival and/or lacrimal gland biopsy. Serum ACE, if elevated, may be helpful in diagnosing sarcoidosis. Treatment involves steroids and sometimes methotrexate or other immunosuppressive medications.16–18
Lymphoma
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Sarah J Vinnicombe, Rodney J Hicks
Involvement of the lacrimal glands is bilateral in 10%–20% of cases; the prognosis is generally good (even with bilateral disease). Lacrimal masses are well demonstrated with CT and MRI (Figure 25.39), but MRI best depicts the presence and extent of intracranial extension. Relapse in the contralateral orbit is not uncommon.
Chemistries of Chemical Warfare Agents
Published in Brian J. Lukey, James A. Romano, Salem Harry, Chemical Warfare Agents, 2019
Terry J. Henderson, Ilona Petrikovics, Petr Kikilo, Andrew L. Ternay Jr., Harry Salem
The first large-scale development, manufacture, and use of CWAs was during World War I. During the war, the chemicals were deliberately released on the battlefield as slow-moving poisonous gas clouds toward entrenched adversary troops to facilitate their demoralization, injury, and death. The types of weapons employed ranged from disabling chemicals, such as tear agents, to lethal agents, such as phosgene, chlorine, and sulfur mustard. The chemistries of seven such chemical weapons are detailed in this section and are ordered according to their intended military-specific use as choking, blood, blister, or tear agents. Choking or pulmonary agents are substances designed to impede a victim’s ability to breathe by causing a build-up of fluids in the lungs, which then leads to suffocation. Blood agents are compounds that are absorbed into the blood and inhibit the ability of blood cells to use and transfer oxygen, ultimately leading to suffocation as with choking agents. Blister agents, or vesicants, cause severe chemical burns, resulting in large, painful water blisters at the affected area. The inhalation of blister agents can lead to blister formation in the respiratory tract, which in extensive cases, can also result in death by suffocation. Finally, tear agents, or lachrymators, are compounds that cause severe eye, respiratory, and skin irritation, pain, bleeding, and even blindness. In the eyes, tear agents stimulate the nerves of the lacrimal gland to produce tears. Today, these agents are sometimes used as riot control agents.
Mapping Resident Immune Cells in the Murine Ocular Surface and Lacrimal Gland by Flow Cytometry
Published in Ocular Immunology and Inflammation, 2023
Baikai Ma, Yifan Zhou, Yuzhe Hu, Hongyu Duan, Zhengze Sun, Pingzhang Wang, Wei Li, Wenling Han, Hong Qi
The core ocular surface is composed of the global cornea, limbus and conjunctiva,1 providing the first barrier of the eye and promising sharp vision. Lacrimal gland, the pivot of lacrimal function unit,2 secretes the majority of aqueous tears and actively participate in ocular surface immune responses. The mucosa localized ocular surface immune system is central to maintaining a normal ocular surface microenvironment in terms of host protection and immune tolerance,3 as well as promoting pathogenic inflammation in specific conditions such as dry eye disease.4 The ocular surface immune system is delicate and complex, including tissue resident immune cells, epithelial cells, stromal cells, goblet cells, matrix and immune molecules in tear film such as interleukins and chemokines.5 Tissue resident immune cells take the core position in maintaining ocular surface immune homeostasis and mediating immune-related ocular diseases. Therefore, clarifying the resident immune cells in ocular surface tissues and lacrimal gland is the bedrock of ocular surface immunology.
Association between blepharophimosis-ptosis-epicanthus inversus syndrome and lacrimal system anomalies
Published in Orbit, 2023
Mansooreh Jamshidian-Tehrani, Kasra Cheraqpour, Alireza Nezamslami
Duarte et al. reported medical records of three Brazilian medical centers and one Portuguese medical center in a cross-sectional study. Twenty-one patients with a mean age of 15 years diagnosed with blepharophimosis were enrolled. Their ocular surface and tear production were evaluated and quantified by using the Schirmer’s test. The lacrimal gland volume was also measured by an orbital CT scan. Their results showed the absence of lacrimal gland bilaterally in nine patients and unilaterally in two patients. They also noticed a significantly smaller size of the lacrimal gland in patients with blepharophimosis compared to the age-matched controls. Furthermore, a significant association between tear deficiency and decreased lacrimal gland volume was recorded in patients with blepharophimosis.13
Unilateral Retinal Arteritis and Macroaneurysm in Sarcoidosis
Published in Ocular Immunology and Inflammation, 2022
Raziyeh Mahmoudzadeh, Anand Gopal, Rebecca Soares, James P. Dunn
Sarcoidosis is a chronic systemic granulomatous inflammatory disorder characterized by formation of non-caseating granulomas, most commonly affecting the lungs, lymph nodes, skin, and eyes. Ocular manifestations range from lacrimal gland involvement to severe vision-threatening bilateral anterior, intermediate, or posterior uveitis, often with retinal vascular abnormalities.1 Classically, sarcoid-associated retinal vasculitis presents as a periphlebitis with “candle wax drippings.”2 However, rare case series have described predominant retinal arterial involvement in patients with ocular sarcoidosis, suggesting an alternate clinical phenotype.3,4 We report a 76-year-old patient with bilateral posterior uveitis with unilateral optic nerve head granuloma and retinal arteritis associated with newly diagnosed sarcoidosis.