Xanthoma of the Corneoscleral Limbus: A Case Report

We describe a case of xanthoma on the corneoscleral limbus in a 21-year-old man. It was characterized by a localized, round, elevated, yellowish mass on the right superonasal limbus with 6mm in size. There was no correlation with systemic or metabolic diseases such as hyperlipidemia and the microscopic examination revealed scanty fibrous element.

Xanthoma of the Corneoscleral Limbus: A Case Report

We describe a case of xanthoma on the corneoscleral limbus in a 21-year-old man. It was characterized by a localized, round, elevated, yellowish mass on the right superonasal limbus with 6mm in size. There was no correlation with systemic or metabolic diseases such as hyperlipidemia and the microscopic examination revealed scanty fibrous element.

A Case of Mucoepidermoid Carcinoma of the Lacrimal Gland

Mucoepidermoid carcinoma occurs commonly in salivary gland, but rarely in lacrimal gland. In literature about ten or more cases of mucoepidermoid carcinoma of the lacrimal gland have been described. A 73-year-old woman had noted upper lid swelling and lacrimation of the left eye for 2 months. Computed tomographic scan demonstrated a large homogenous mass on superotemporal portion of the left orbit. The mass extended into the left temporal fossa, middle cranial fossa, and ethmoidal sinus with bone destruction. Histopathologically, the mass was proved to be a intermediate grade mucoepidermoid carcinoma of the lacrimal gland.

A Case of New Vessels on the Optic Disc(NVD) Associated with Idiopathic Thrombocytopenic Purpura(ITP)

The most common ocular finding of the idiopathic thrombocytopenic purpura(ITP) is superficial retinal hemorrhages in both eyes. But the descriptions of new vessel on the optic disc(NVD) associated with ITP are scarcely found in literatures. A 17-year-old girl who managed for ITP complained of visual distrubance of the right eye and floaters of the left eye. On fundoscopy the right eye was failed to examine due to thick vitreous hemorrhage and the left eye showed NVD and preretinal hemorrhage. After panretinal photocoagulation of the left eye, NVD was regressed.

Histopathological Study of Extraocular Musele followinr Posterior Fixation Suture in Rabbits: Pathogenesis of Musele Fibrosis

The authors observed the histological and ultrastructural findings in a study of the fibrosis of the extraocular muscles following a posterior fixation suture in rabbits. the early findings demonstrated hyalinosis, clumping of the nuclei of muscle cells and collagenization of the muscle tissue. However, there was no evidence of collagen tissue in the degenerated muscle fiber, reserving cell membrane and basement membrane ultrastructurally. The late findings showed splitting and irregular stain of the muscle fibers, many nuclei of presumed muscle cell and filamentous structure at the collagen tissue in the extracellular space. Electron microscopic study showed atrophy and angulation with distortion of the myofibrillar matrix, along with other cytoplasmic degenerative phe nomena in the muscle fibers. Clumps of the well-arranged microfibrils(Mf) and irregularly arranged Mf with fine granular materials(FGM) were adjacent to the immature collagen fibrils. Many of the Mf and FGM were closely associated, and the number of the Mf and FGM decreased with the degree of maturity of the collagen fibrils. The anatomical structure of the myofibrill was identified as that of the Mf. From these findings, it would appear that formation of collagen fiber occurs in the extracellular space and that Mf and FGM are primarily responsible for the formation of the collagen fibils.

Diagnosis of Idiopathic Inflammatory Pseudotumor of the Orbit

For an accurate diagnosis we analyzed 15 cases of clinically suspected idiopathic inflammatory pseudotumor(pseudotumor). The patients were 11 men and 4 women(mean age, 45.9 years). They were followed up for an average of 22 months. The final diagnosis was drawn collectively with clinical symptoms and signs, orbital computed tomography(CT), pathologic finding, and response to corticosteroids. In most instances the pathologic reading was reactive lymphoid hyperplasia(RLH). The final diagnosis was not constantly correlated with the pathologic reading; 5 were pseudotumor,6 RLH, and 4 undetermined. It could be concluded that the pseudotumor in the case which presented acute in flammatory symptoms and sings, involved the entire orbit in CT scan, or was cured by corticosteroid therapy. In the cases of no significant inflammatory sings it was difficult to differentiate pseudotumor from RLH with CT scan, pathologic finding, or response to corticosteroids. Although CT-guided fine needle biopsy often provides an insufficient specimen for pathologic diagnosis, it seems a useful diagnostic method, which is a simple and noninvasive technoque. At least the other orbital tumors or granulomatous lesions could be excluded by CT-guided fine needle biopsy.

Primary Systemic Amyloidosis involved the Conjunctiva

Amyloid may involve the conjunctiva without deposits of the skin of the eyelid in primary localized amyloidosis, but extremely rare in primary systemic amyloidosis. We describe the clinicopathologic features of a case of primary systemic amyloidosis which invloved the conjunctiva and larynx. A 58-years-old woman presented a conjuctival mass of the left eye. Slit lamp microscopy showed a pinkish, flat elevated mass on the bulbar conjunctiva, fornix, and upper tarsal conjunctiva. There was no history of antecedent ocular or systemic diseases. She had undergone total laryngectomy for laryngeal amyloidosis. Microscopically, a pale amorphous eosinophilic material was deposited in the subcojunctival tissue. The deposit showed metachromasia with crystal violet, and dichroism and birefringence in polarized light following Congo red staining. Electron microscopically amyloid was comprised of linear add non-branching fibrils, which were about 11nm in width.

A Case of Ocular Ischemic Syndrome

Ocular ischemic syndrome, characterized by rubeosis iridis, anterior uveitis, retinal arterial narrowing, retinal hemorrhage, cherry red spot, and neovascularization of the disc and/ or retina, is due to anterior and posterior segment ischemia caused by carotid artery obstruction. A 67-year-old man presented a typical ocular ishemic syndrome. The patient complained marked visual disturbance of the both eyes and headache for 15 days. On slit-lamp examination, there were no abnormal findings of the cornea, iris, and lens. Funduscopic finding revealed bilateral edema of the optic disc, marked attenuation of the arteriole with focal constriction, and dilatation of the veins. Fluorescein angiography showed prolonged arm-to-retinal circulation and retinal arteriovenous transit time, multiple microaneurysms, and staining retinal vessels of the both eyes. About 1+1/2 months later, iritis, rubeosis iridis, and cataract of both eyes were noticed. In carotid angiogram the left internal carotid artery was completely occluded, and the right internal carotid artery was incompletely occluded. About 7 months later, he died of CVA.

Lens Dislocation during Extracapsular Cataract Extraction in Exfoliation Syndrome: A Case Report

The authors present a case of lens dislocation during planned extracapsular lens extraction in a 80-year-old man with exfoliation syndrome. The other eye underwent intracapsular lens extraction without complications such as lens dislocation or vitreous loss. In review of literatures the cause of lens dislocation is due to increased fragility of zonule in exfoliation syndrome.

Infiltrating Orbital Granular Cell Tumor: A case report

Granular cell tumor is an uncommon neoplasm with uncertain histogenesis that rarely occurs in the orbit. Although it is regarded as a benign lesion, one case of malignancy has been recorded. The authors present a case of recurred, infiltrating orbital granular cell tumor in a 39-year-old woman. On light microscopic examination, the tumor cells showed the characteristic findings of granular cell tumor, but there were hyperchromatic and pleomorphic nuclei with unusual mitotic figures, suggesting a malignant nature.

Tuberculous Periostitis of the Orbit: A Case Report

The authors present a case of tuberculuos periostitis of the orbit which is extremely rare in nowadays. An 18-year-old man who had pulmonary and hepatic tuberculosis complained pain and erythematous swelling of periorbital region. Skull X-ray films showed multiple punched-out lesions on cranial vault. CT scan of the orbit revealed a homogenous mass on lateral orbital wall. The lesion was extended into the intracranial cavity with bony destruction and thickening of dura matter. The cold abscess of lower lid was drained by skin incision and Acid-fast bacilli was isolated from direct smear and culture.

Metastatic Hepatocellular Carcinoma of the Orbit: A Case Report

A 50-year-old man had orbital pain, diplopia, proptosis of left eye, hypesthesia on the left forehead and pain of left extremities of one month's duration. Four months prior to visit, he had undergone 131I-Lipiodol therapy for hepatocellular carcinoma of the liver. CT scan showed a homogenous, well-defined mass on superotemporal portion of the left orbit. The mass extended into anterior cranial fossa with bony destruction. Orbital CT-guided fine needle biopsy was performed. And pathologic findings confirmed metastatic hepatocellular carcinoma.

A Clinical Study on Therapeutic Effect of the Argon Laser Photocoagulation on Central Serous Chorioretinopathy

In selected cases of central serous chorioretinopathy the pigment epithelial defect can be sealed with laser photocoagulation. The authors analyzed the effectiveness of laser photocoagulation on visual improvement and duration of the disease in laser treated group, as compared to untreated group, which represented na tural course of the disease. A verage healing time was 5.2 weeks in treated group and 13.9 weeks in untreated group, which revealed statistically significant difference between two groups(p<0.01). No difference was noted in visual outcome between two groups. The initial visual acuity was influenced by the type of dye leaking, the distance of leaking point from center of fovea and the size of sensory retinal detachment in fluorescein angiography. But the final visual acuity was only ihfluenced by the size of sensory retinal detachment. The number and location of leaking point did not influence the initial and final visual acuity in both treated and untreated group.

A Case of Sclerocornea

Sclerocornea is an uncommon congenital anomaly characterized by non progressive, noninflammatory, and unilateral or bilateral opacities of the peripheral, central, or entire cornea with deep or superficial vascularization. Sclerocornea may be a part of the mesodermal dysgenesis syndrome. Many ocular and systemic abnormalities have been described in association with sclerocornea. The authors present a case of sclerocornea of both eyes in a 26-year-old male with familial tendency. In this patient cornea plana, esotropia, and amblyopia were associated with sclerocornea.

A Case of Orbital Atypical Lipoma

Atypical lipoma is benign tumor which is common in neck and thigh, but extremely rare in orbit. Fatty tumors histologically containing atypical multivacuolated lipoblasts have, in the past, all too often received the automatic diagnosis of liposarcoma. With the recent recognition of tumors having such cellular atypia, but benign course, and for which the terms atypical lipoma have been used, it is hoped that needless radical surgical procedure will not be performed. We experienced a case of orbital atypical lipoma of 14-year-old girl. Computed tomography showed a large, homogenous low density, primarilyextraconal mass. The tumor was excised nearly totally from orbit through transcranial approach.

A Clinical Study on the Occlusion of the Retinal Vein

In general, occlusion of the retinal vein causes marked dlminished visual acuity and poor recovery in elderly persons. Author studied 59 cases of occlusion of retinal vein in the views of sexual and age distribution, laterality, early and later visual acuity, combined systemic and ocular diseases, complications, treatment, and especially findings of fundus fluorescein angiography. The results were as follows: 1. There was no statistical significance in the difference of sexual and age distribution, and laterality of affected eye. 2. The incidence of central retinal vein occlusion is 2.3 times of that of branch retinal vein occlusion. And 78% of all branch retinal vein occulusion affected in superotemporal branch, and remainders in inferotemporal branch. In one case the occlusion had occured at superotemporal and superonasal branch. 3. The early and later visual acuity was poor in central retinal vein occlusion, inferotemporal branch vein occlusion, and superotemporal branch vein occlusion in order. 4. The improvement of visual acuity more than one line in test chart was 52.5% on the average; central retinal vein occlusion(27.8%), inferotemporal branch vein occlusion (55.5%), and superotemporal branch vein occlusion(65.6%). 5. The combined systemic diseases were hypertension, arteriosclerosis, diabetes mellitus etc, and the occular diseases were open-angle glancama and iritis. 6. The causes of poor visual acuity were cystoid macular edema, vitreous hemorrhage, optic nerve damage, complicated neovascular glaucoma, and preexisting open-angle glaucoma. 7. The fundus fluorescein angiography showed delayed filling time, marked dilatation and engorgement of affected vein, dye leakage from affected vein or radial peripapillary capillaries, capillaries, capillary nonperfusion, microaneurysms, cystoid macular edema, collateral circulation, and retinal neovascularization.

A Case of Inverse Duane's Retraction Syndrome

The retraction syndrome in its classic form is characterized that severe limitation of abduction, slightly limitation of adduction, globe retraction and narrowing of the palpebral fissure on adduction, frequently associated elevation or depression in adduction, and convergency insufficiency. While many authors reported this type, there were few reports about inverse Duane's retraction syndrome, as exotropia in primary position, severe limitation of adduction. globe retraction and narrowing palpebral fissure on abduction. So the authors present a case of inversed Duane's retraction syndrome.

A Case of Osteopetrosis with Optic Atrophy

The authors experienced a case of osteopetrosis with optic atrophies and nystagmoid movements, exceedingly rare disease, in 12 year-old girl for 5 years without fracture in long bone. On the X-ray studies: 1. The skull bone showed moderately increased osteosclerotic changes in base of the skull and narrowings in optic foramina. 2. The findings of the extremities showed flask shaped deformities and cortical thickness in both femurs. and transverse line and epiphyseal separations in mid-tibia.