Orbital Disease: Present Status and Future Challenges

Front cover......Page 1
Contents......Page 6
Introduction......Page 14
Contributors......Page 16
1 Orbital Inflammatory Disease: Classification and New Insights......Page 22
ROLE OF BIOPSY......Page 23
THE ROLE OF IMMUNE MEDIATORS IN SPECIFIC INFLAMMATIONS......Page 29
DIRECTED TREATMENTS OF DISTINCT ORBITAL INFLAMMATIONS......Page 30
ABSTRACT......Page 36
3 Bacterial Infections of the Orbit: Current Status and Future Challenges......Page 46
ACKNOWLEDGEMENTS......Page 52
4 Inflammation: Definitions, Regulatory Mechanisms, and Contributions to Disease......Page 54
CHALLENGES IN THE TREATMENT OF INTRAOCULAR INFECTIONS......Page 66
MICROBIOLOGIC DIAGNOSIS......Page 67
NEW ANTIMICROBIALS AND PHARMACOLOGIC PRINCIPLES OF ANTIMICROBIAL THERAPY......Page 72
EMERGING ANTIBIOTIC RESISTANCE......Page 76
HISTORICAL PERSPECTIVE......Page 86
CURRENT APPROACH......Page 92
LYMPHOMAS OF THE OCULAR ADNEXA AND EYE......Page 93
FUTURE DIRECTIONS......Page 95
INCIDENCE AND EPIDEMIOLOGY......Page 98
ETIOLOGY AND RISK FACTORS......Page 99
TREATMENT......Page 101
SPECIAL COMMENTS ON LYMPHOMA ASSOCIATED WITH THE EYE......Page 103
8 Epithelial Lacrimal Gland Tumors: Pathologic Classification and Current Understanding......Page 108
ABSTRACT......Page 116
STEPS TOWARD TUMOR SPECIFIC THERAPY......Page 117
CANCER SPECIFIC MOLECULAR TARGETS......Page 118
DNA ARRAY ANALYSIS......Page 121
WHICH MOLECULAR TARGETS?......Page 122
WHAT IS THE FUNDAMENTAL ‘‘CAUSE’’ OF CANCER?......Page 123
BUREAUCRATIC OBSTACLES IN DRUG DEVELOPMENT......Page 124
CONCLUSIONS......Page 125
10 Malignant Lacrimal Gland Tumors......Page 128
11 The Management of Optic Nerve Sheath and Sphenoid Wing Meningiomas......Page 138
THERAPEUTIC RECOMMENDATIONS......Page 141
SPHENOID WING MENINGIOMAS......Page 144
12 Gliomas of the Anterior Visual Pathway......Page 150
Association with Neurofibromatosis......Page 151
RADIOGRAPHIC IMAGING......Page 152
ULTRASOUND......Page 154
HISTOPATHOLOGY......Page 156
TREATMENT AND PROGNOSIS......Page 157
BACKGROUND......Page 160
Precise Tumor Localization......Page 161
Conformal Treatment Planning and Delivery......Page 163
SUMMARY......Page 167
ABSTRACT......Page 168
HOW ARE THE CLINICAL FEATURES OF GRAVES’ OPHTHALMOPATHY EVOKED?......Page 169
CONSEQUENCES OF RESTRICTED EXTRAOCULAR MUSCLE MOTION......Page 170
WHY DO GAGS ACCUMULATE IN THE ORBIT IN GRAVES’ DISEASE?......Page 171
IS GRAVES’ OPHTHALMOPATHY DEFINITELY AN AUTOIMMUNE DISEASE?......Page 172
COULD GRAVES’ ORBITOPATHY BE AN INFECTIOUS DISEASE?......Page 173
ABSTRACT......Page 178
INTRODUCTION......Page 180
CLINICAL SUBJECTS AND METHODS Patients......Page 181
RESULTS EMAb Studies from a Single Center......Page 183
Prospective Study of Graves’ Disease Patients......Page 185
DISCUSSION......Page 186
ACKNOWLEDGEMENTS......Page 187
16 Phenotypic Attributes of Orbital Fibroblasts Underlie Their Susceptibility in Graves’ Disease......Page 190
COMPLEX ACTIVITIES OF HUMAN FIBROBLASTS ARE GENERALLY UNDERAPPRECIATED......Page 191
ORBITAL FIBROBLASTS ARE COMPRISED OF DISCRETE SUBPOPULATIONS OF CELLS......Page 192
ORBITAL FIBROBLASTS SYNTHESIZE HIGH LEVELS OF PGE2 WHEN TREATED WITH PROINFLAMMATORY CYTOKINES......Page 193
PROINFLAMMATORY CYTOKINES ENHANCE HYALURONAN SYNTHESIS IN ORBITAL FIBROBLASTS......Page 194
ORBITAL FIBROBLASTS DISPLAY CELL-SURFACE CD40 AND RESPOND TO CD154......Page 196
FIBROBLASTS FROM SEVERAL ANATOMIC REGIONS CAN EXPRESS THE THYROTROPIN RECEPTOR......Page 197
ACKNOWLEDGEMENTS......Page 198
INTRODUCTION......Page 204
Iris, Trabecular Meshwork, Schlemm’s Canal, and Ciliary Body......Page 207
Retina, RPE, and Choroid......Page 210
Optic Nerve......Page 212
EXTRAOCULAR MUSCLES AND ORBITAL FIBROCYTES (Fig. 3)......Page 213
CHOROID PLEXUS AND ARACHNOID GRANULATIONS (Fig. 4)......Page 214
ACKNOWLEDGMENT......Page 217
INTRODUCTION......Page 224
METHODS......Page 225
RESULTS Demographics......Page 226
Historical Features......Page 227
Clinical Features......Page 228
Progress and Duration of Inflammatory Features......Page 229
DISCUSSION......Page 230
19 Prognostic Factors......Page 234
20 Relationship Between Thyroid Disorders and Orbitopathy, Including Management Factors......Page 244
GRAVES’ HYPERTHYROIDISM AND GRAVES’ OPHTHALMOPATHY: ONE OR TWO DISEASE ENTITIES?......Page 245
GENETIC AND ENVIRONMENTAL FACTORS INVOLVED IN PHENOTYPIC APPEARANCE OF GRAVES’ DISEASE......Page 247
INFLUENCE OF THYROID FUNCTION ON GRAVES’ OPHTHALMOPATHY......Page 248
EFFECT OF ANTITHYROID DRUGS, THYROIDECTOMY, AND RADIOACTIVE IODINE ON GRAVES’ OPHTHALMOPATHY......Page 249
PREVENTION OF GRAVES’ OPHTHALMOPATHY BY EARLIER DIAGNOSIS AND TREATMENT OF GRAVES’ HYPERTHYROIDISM?......Page 252
CLINICAL UTILITY OF MEASURING DISEASE ACTIVITY IN GRAVES’ OPHTHALMOPATHY......Page 258
CLINICAL ACTIVITY SCORE......Page 261
ORBITAL ECHOGRAPHY......Page 262
ORBITAL OCTREOSCAN......Page 263
ORBITAL MAGNETIC RESONANCE IMAGING......Page 264
URINARY GLYCOSAMINOGLYCANS......Page 265
SERUM CYTOKINES......Page 266
CONCLUSION......Page 267
BACKGROUND......Page 274
INDIVIDUAL SECTION MEASUREMENTS Vision......Page 275
Inflammation......Page 277
Strabismus......Page 278
DISCUSSION......Page 279
INTRODUCTION......Page 282
SEVERE GRAVES’ OPHTHALMOPATHY......Page 283
Glucocorticoids......Page 284
Orbital Radiotherapy......Page 285
Orbital Radiotherapy Combined with Glucocorticoids......Page 286
Plasmapheresis......Page 287
Intravenous Immunoglobulins......Page 288
Cytokine Antagonists......Page 289
Colchicine......Page 290
INTRODUCTION......Page 294
SURGICAL INTERVENTION DURING ACTIVE ORBITOPATHY......Page 296
STABLE ORBITOPATHY......Page 297
Preferred Decompression Techniques......Page 300
EYE MUSCLE SURGERY......Page 301
LID PROCEDURES......Page 302
25 Graves’ Orbitopathy: New and Future Treatment......Page 306
PATHOPHYSIOLOGY OF THE DISEASE......Page 307
MEDICAL THERAPY......Page 310
IMPROVEMENTS IN ORBITAL DECOMPRESSION......Page 314
STRABISMUS SURGERY......Page 315
26 Management Controversies and Preferences in Thyroid Orbitopathy: Panel Discussion and Question Period......Page 322
PANELISTS’ PRESENTATIONS Colum Gorman......Page 323
Michael Kazim......Page 324
John Kennerdell......Page 325
Daphne Khoo......Page 326
Claudio Marcocci......Page 327
Jack Rootman......Page 329
Wilmar Wiersinga......Page 330
QUESTION AND ANSWER SESSION Question 1 (from R. Goldberg)......Page 331
Question 2 (from M. Potts)......Page 332
Question 2 (continued)......Page 333
Question 3 (continued)......Page 334
Answer......Page 335
Answer......Page 336
Answer......Page 337
Answer......Page 338
Question 7 (from P. Dolman)......Page 339
Answer......Page 340
INTRODUCTION......Page 342
ANATOMY OF ORBITAL REGION VENOUS STRUCTURES AND RELATIONSHIP WITH DVVMs......Page 343
CLINICAL MANIFESTATIONS OF DVVMs......Page 345
INVESTIGATION OF DVVMs......Page 346
OPTIONS FOR TREATMENT WITH EMPHASIS ON NEW TECHNIQUE......Page 351
FUTURE CONSIDERATIONS......Page 353
CONCLUSION......Page 354
INTRODUCTION......Page 356
CAROTID-CAVERNOUS SINUS FISTULAS......Page 357
DISTENSIBLE VENOUS ANOMALIES......Page 366
PREOPERATIVE EMBOLIZATION OF TUMORS......Page 368
FUTURE DIRECTIONS......Page 370
ABSTRACT......Page 374
Advances in Medical Imaging......Page 375
Virtual Reality Surgical Simulation......Page 379
Surgical Robotics......Page 381
HUMAN BODY MODELS......Page 382
PRESENT COMPUTER-AIDED SURGERY AND SIMULATION......Page 383
FUTURE COMPUTER-AIDED ORBITAL SURGERY......Page 385
SUMMARY......Page 387
ACKNOWLEDGMENTS......Page 388
30 The Future of Orbital Surgery......Page 392
Index......Page 402
Back cover......Page 410