A Rare Orbital Pathology: A Large Orbital Dermatofibrosarcoma Protuberans.

Dermatofibrosarcoma protuberans (DFSP) is a rare sarcoma of the dermis. It is a malignant, locally aggressive, and infiltrative tumor with frequent recurrence. In this case, a 44-year-old woman presented with a 15-year history of a swelling in the medial canthus of the right eye that caused tearing. Imaging revealed a septated mass isodense to soft tissue that had eroded the medial wall of the orbit. Macroscopic examination showed an elastic, gray-brown, encapsulated, irregular mass measuring 45x35x22 mm. The surgical margins were positive, so adjuvant radiotherapy was started. The patient was followed for 2 years without recurrence. According to the literature, this mass is the largest orbital DFSP treated by globe-sparing primary resection.

Approach of Family Physicians to Pediatric Eye Screening in Diyarbakir

Objectives: In Turkey, preventive medicine services are the responsibility of family physicians and vision screening is a key component of this responsibility. In this study, we aimed to investigate the approach of family physicians to vision screening in infants and children. Materials and Methods: Data were collected using a 16-item questionnaire administered to 100 family physicians working in the center and provinces of Diyarbakir. Results: The results indicated that 88 (88%) physicians declared knowing what the red reflex test was, while 12 physicians declared that they had never heard of it. Only 16 (16%) physicians performed the test routinely and 36 (36%) physicians performed it only in suspicious cases. Ten (10%) physicians indicated that they did not refer the patients to an ophthalmologist even though they did not perform the red reflex test. Moreover, 5 (5%) physicians did not have an ophthalmoscope and 12 (12%) physicians reported not knowing how to use an ophthalmoscope. Forty (40%) of the physicians measured preschool visual acuity at least once. Sixty-six (66%) physicians referred younger children who could not express their vision problems to an ophthalmologist. Four (4%) physicians declared that they would delay surgery in children with strabismus until they were old enough for surgery. Ninety-three (93%) physicians suggested that educational seminars about vision screening would be beneficial. Conclusion: Educational seminars about vision screening may have favorable outcomes. The medical devices in family medicine centers should be improved. Vision screening can be added to the negative performance-based compensation system in order to increase physicians' attention to vision screening. To implement detailed eye screening programs like those in developed countries, an infrastructure should be established for this screening program.

SUBTENON AMIKACIN INJECTION FOR THE TREATMENT OF NOCARDIA ASTEROIDES ORBITAL CELLULITIS IN A PATIENT WITH A HISTORY OF SCLERAL BUCKLING.

PURPOSE: To evaluate the use of subtenon amikacin injection for the treatment of Nocardia asteroides orbital cellulitis in a patient with a history of scleral buckle surgery. METHODS: Case report. RESULTS: A 79-year-old diabetic woman presented with an 8-month history of diplopia, discharge, and swelling around her left eye. She had a scleral buckle surgery in this eye about 15 years ago. Examination of the left eye showed a visual acuity of 20/80, swollen and ptotic upper eyelid, chemotic conjunctiva, and limited extraocular motility. Magnetic resonance imaging showed an abscess under the scleral buckle. The scleral buckle was removed, and the abscess under the scleral buckle was drained. N. asteroides grew on the culture. Despite 4 months of the systemic trimethoprim/sulfamethoxazole and the topical fortified amikacin therapy, her infection worsened. After 5 monthly subtenon amikacin injections, the infection regressed dramatically, and her vision improved to 20/70. She used the systemic trimethoprim/sulfamethoxazole for 10 more months. After a 1-year follow-up, her external examination was normal, except for the left upper eyelid ptosis. CONCLUSION: Subtenon amikacin injection can be added to the regimen for N. asteroides orbital cellulitis, of which surgical drainage, systemic and topical antibiotic therapies are not enough to control infection.

Serum Cytokine Levels in Behçet's Disease.

BACKGROUND: The aim of this study is to investigate and compare the serum levels of various cytokines in patients with Behçet's Disease and healthy controls. METHODS: Thirty-five patients with Behçet's disease and 29 age and sex-matched healthy controls were included in the study. The patients were separated into groups with active and inactive disease. Serum IL-2, IL-6, IL-8, IL-10, IL-17A, and IFN-γ levels were determined using the enzyme-linked immunosorbent assay method. Cytokine levels of the two patient groups and healthy controls were compared using SPSS 15.0. RESULTS: Ten patients with active disease and 25 patients with inactive disease were present. Serum IL-8 levels of active BD patients were higher compared to inactive patients (P = 0.048) and healthy controls (P = 0.02). IL-8 levels were correlated with the duration of symptoms (r = 0.490, P = 0.003) and time passed since diagnosis (r = 0.579, P ˂ 0.001). CONCLUSION: Behçet's disease involves complex interactions of cells of the immune system, mainly T lymphocytes and neutrophils. Further studies on the cytokine profile in Behçet's disease will aid in elucidation of its pathogenesis.