ABSTRACT
The authors report a case of a patient with bilateral orbital necrobiotic xanthogranuloma and no associated systemic paraproteinemia. Orbital biopsy showed strong expression of CD20-positive cells. The patient was treated with systemic rituximab monotherapy, with excellent clinical response and marked regression of the orbital lesions on imaging. At the time of writing, the patient has been treated with bimonthly rituximab maintenance therapy for 22 months and has stable clinical and imaging findings with sustained response to treatment and no reported side effects. To the authors' knowledge, this is the first reported case of orbital necrobiotic xanthogranuloma successfully treated with rituximab monotherapy. They hope that this well-documented case will encourage clinicians to consider rituximab monotherapy as a possible treatment option, albeit one entailing an off-label use of this drug, for patients with necrobiotic xanthogranuloma of the orbit.
Subject(s)
Necrobiotic Xanthogranuloma/drug therapy , Orbit/diagnostic imaging , Orbital Diseases/drug therapy , Rituximab/therapeutic use , Biopsy , Humans , Immunologic Factors/therapeutic use , Male , Middle Aged , Necrobiotic Xanthogranuloma/diagnosis , Orbital Diseases/diagnosis , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Ocular surface tumors are commonly encountered by ophthalmologists and ophthalmic pathologists. These tumors have varied clinical manifestations. In this article, we discuss the most commonly encountered non-melanocytic and melanocytic ocular surface tumors, with emphasis on their common clinical features, morphologic patterns, and prognostic factors.
Subject(s)
Eye Neoplasms/pathology , Eye/pathology , Melanoma/pathology , Neoplasms, Glandular and Epithelial/pathology , HumansABSTRACT
The purpose of this study was to determine if adding hyaluronidase to the local anesthesia mixture would decrease or eliminate pain during vitreoretinal surgery. Patients having a reoperation of the vitreoretinal space experienced pain after the administration of local anesthesia. A quasi-experimental design, with a convenience sample of 100 repeat patients and a 0-10 visual analog pain scale, was used to test the hypothesis, "Will the addition of hyaluronidase to the local anesthesia mixture decrease or eliminate pain for patients undergoing vitreoretinal surgery multiple times?" The study found that the addition of hyaluronidase did significantly decrease pain for these patients.
Subject(s)
Anesthetics, Local/administration & dosage , Hyaluronoglucosaminidase/administration & dosage , Pain/drug therapy , Retinal Detachment/surgery , Vitrectomy , Drug Combinations , Humans , Pain Measurement , Surveys and QuestionnairesSubject(s)
Education, Nursing, Continuing , Ophthalmology , Specialties, Nursing/education , Humans , United StatesABSTRACT
The surgical eye nurse found that some patients undergoing vitreoretinal surgery experienced pain after the administration of local anesthesia. This study proposed to determine which local anesthesia technique provides the best comfort level for these patients. A quasi-experimental design, with a convenience sample of 41 patients and a 0-10 visual analog pain scale, was used to test the hypothesis. The findings did support the hypothesis that one particular local anesthesia technique was more significant than the others. However, this study also found that if the conjunctiva is sufficiently anaesthetized with 2% lidocaine jelly, patients experience no pain.
