Abstract: Orbital fractures generally do not cause eyelid malposition. Studies have shown that mostly eyelid malposition is mainly due to the choice of surgical approaches of orbital fracture repair. Approaches are divided into transcutaneous and transconjunctival ones. The application of orbital fracture approaches depends on fractures’ range and the surgeons’ preferences. Eyelid malposition after orbital fracture surgery is not only an aesthetic concern but also a functional complication, which will cause eyes discomfort, such as corneal exposure and ocular irritation. Some patients may have multiple types of eyelid malposition. In this review, we summarized the surgical approaches of orbital fractures and the complications including scar, ectropion, retraction, entropion, flattening, laceration and lacrimal canaliculus avulsion and notch deformity that associated with eyelid, especially the lower eyelid. Reports revealed that the scar usually occurred in infraorbital incisions compared with subtarsal and subciliary incisions, and the transconjunctival approach had a higher incidence of entropion and flattening, and less ectropion than the transcutaneous approach. Meanwhile, pathogenesis of eyelid malposition after orbital fracture surgery are discussed. Furthermore, to prevent eyelid malposition complications, doctors should choose the appropriate orbital fracture approach according to the patient’s needs, and delicate tissue management, technical expertise, and meticulous hemostasis are necessary. Conservative treatment with taping, lubricating ointment, and steroid for eyelid malposition complications should be performed first, and then surgical intervention when the conservative treatment fails.

Abstract: Orbital fractures generally do not cause eyelid malposition. Studies have shown that mostly eyelid malposition is mainly due to the choice of surgical approaches of orbital fracture repair. Approaches are divided into transcutaneous and transconjunctival ones. The application of orbital fracture approaches depends on fractures’ range and the surgeons’ preferences. Eyelid malposition after orbital fracture surgery is not only an aesthetic concern but also a functional complication, which will cause eyes discomfort, such as corneal exposure and ocular irritation. Some patients may have multiple types of eyelid malposition. In this review, we summarized the surgical approaches of orbital fractures and the complications including scar, ectropion, retraction, entropion, flattening, laceration and lacrimal canaliculus avulsion and notch deformity that associated with eyelid, especially the lower eyelid. Reports revealed that the scar usually occurred in infraorbital incisions compared with subtarsal and subciliary incisions, and the transconjunctival approach had a higher incidence of entropion and flattening, and less ectropion than the transcutaneous approach. Meanwhile, pathogenesis of eyelid malposition after orbital fracture surgery are discussed. Furthermore, to prevent eyelid malposition complications, doctors should choose the appropriate orbital fracture approach according to the patient’s needs, and delicate tissue management, technical expertise, and meticulous hemostasis are necessary. Conservative treatment with taping, lubricating ointment, and steroid for eyelid malposition complications should be performed first, and then surgical intervention when the conservative treatment fails.

Abstract: A smooth and timely fitting of a visually appealing, custom-made eye prosthesis after the loss of an eye is not only essential from a cosmetic point of view but above all facilitates good social and psychological rehabilitation. Cryolite glass prostheses must be replaced at least once a year, PMMA prostheses polished once a year and renewed every five years. In children, especially in growth phases, the fit of the prosthesis should be checked at least every six months and adjusted, if necessary. Ocularists and ophthalmologists should determine an individual cleaning procedure together with the patient, which depends on both the prosthesis material and external factors. Complications such as allergic, giant papillary, viral, and bacterial conjunctivitis or even blepharoconjunctivitis sicca must be detected and treated at an early stage to avoid discomfort and to maintain the ability of prosthesis wear. In the case of inflammation-induced shrinkage of the conjunctival fornices or post-enucleation socket syndrome, surgical interventions are necessary. In summary, an early supply with an eye prosthesis, adequate treatment of complications, and attention to psychological aspects, form the basis for a successful long-term rehabilitation of anophthalmic patients.

Abstract: A smooth and timely fitting of a visually appealing, custom-made eye prosthesis after the loss of an eye is not only essential from a cosmetic point of view but above all facilitates good social and psychological rehabilitation. Cryolite glass prostheses must be replaced at least once a year, PMMA prostheses polished once a year and renewed every five years. In children, especially in growth phases, the fit of the prosthesis should be checked at least every six months and adjusted, if necessary. Ocularists and ophthalmologists should determine an individual cleaning procedure together with the patient, which depends on both the prosthesis material and external factors. Complications such as allergic, giant papillary, viral, and bacterial conjunctivitis or even blepharoconjunctivitis sicca must be detected and treated at an early stage to avoid discomfort and to maintain the ability of prosthesis wear. In the case of inflammation-induced shrinkage of the conjunctival fornices or post-enucleation socket syndrome, surgical interventions are necessary. In summary, an early supply with an eye prosthesis, adequate treatment of complications, and attention to psychological aspects, form the basis for a successful long-term rehabilitation of anophthalmic patients.

Background: To measure the anterior and posterior segment structural features of acute primary angle-closure (APAC) eyes.

Methods: A total of 36 subjects with unilateral APAC were recruited in this study. The ocular biometric characteristics were measured by anterior segment optical coherence tomography (AS-OCT) and swept source optical coherence tomography (SS-OCT), respectively at baseline, 2 weeks, and 1 month after surgical intervention.

Results: At baseline, when compared with the fellow eyes, APAC-affected eyes showed significantly greater corneal thickness (P=0.004), shallower anterior chamber depth (ACD) (P<0.001), smaller anterior chamber area (ACA) (P=0.013), angle opening distance at 750 μm from the scleral spur (AOD750) (P=0.002), trabecular–iris space area at 750 μm from the scleral spur (TISA750) (P=0.033), angle recess area (ARA) (P=0.014), and iris area (IARE) (P=0.003), less iris curvature (ICURVE) (P=0.003), and larger lens vault (LV) (P=0.030). After intervention, the corneal thickness was significantly decreased at 1 month (P<0.001), while ACD, ACA, and AOD750 were significantly increased at 2 weeks and 1 month (all P<0.017). Changes in ACD were correlated with decreasing LV (P<0.05). The posterior segment parameters did not change over the 4-week period.

Conclusions: When compared with the fellow eyes, APAC-affected eyes had greater corneal thickness, shallower anterior chamber, narrower angle, less ICURVE, and larger LV. After intervention, the corneal thickness was decreased, while the shallower anterior chamber was relieved to some extent.

Background: To measure the anterior and posterior segment structural features of acute primary angle-closure (APAC) eyes.

Methods: A total of 36 subjects with unilateral APAC were recruited in this study. The ocular biometric characteristics were measured by anterior segment optical coherence tomography (AS-OCT) and swept source optical coherence tomography (SS-OCT), respectively at baseline, 2 weeks, and 1 month after surgical intervention.

Results: At baseline, when compared with the fellow eyes, APAC-affected eyes showed significantly greater corneal thickness (P=0.004), shallower anterior chamber depth (ACD) (P<0.001), smaller anterior chamber area (ACA) (P=0.013), angle opening distance at 750 μm from the scleral spur (AOD750) (P=0.002), trabecular–iris space area at 750 μm from the scleral spur (TISA750) (P=0.033), angle recess area (ARA) (P=0.014), and iris area (IARE) (P=0.003), less iris curvature (ICURVE) (P=0.003), and larger lens vault (LV) (P=0.030). After intervention, the corneal thickness was significantly decreased at 1 month (P<0.001), while ACD, ACA, and AOD750 were significantly increased at 2 weeks and 1 month (all P<0.017). Changes in ACD were correlated with decreasing LV (P<0.05). The posterior segment parameters did not change over the 4-week period.

Conclusions: When compared with the fellow eyes, APAC-affected eyes had greater corneal thickness, shallower anterior chamber, narrower angle, less ICURVE, and larger LV. After intervention, the corneal thickness was decreased, while the shallower anterior chamber was relieved to some extent.

Background: To investigate the microstructural features of parapapillary gamma zone and beta zone and their relationship with three-dimensional optic disc shape in non-myopic eyes.

Methods: This cross-sectional study included 62 non-myopic eyes with parapapillary gamma or beta zone and 70 control eyes. On the spectral domain optical coherent tomography (SD-OCT) images, we measured the area of gamma zone and beta zone, the length of border tissue, and related disc parameters. The disc ovality index, disc rotation degrees around three axes, Bruch’s membrane opening (BMO) ovality ratio were calculated based on the SD-OCT images.

Results: The parapapillary gamma zone composed by externally oblique border tissue was found in inferior, nasal and temporal quadrants of the non-myopic eyes. The presence of gamma zone in non-myopic eyes was correlated with smaller disc ovality index, larger rotation degree around vertical and horizontal axes, and larger BMO ovality ratio (P<0.001). Compared with the non-temporal gamma zone group, eyes with temporal gamma zone had a longer axial length and rotated more around vertical axes (P<0.001). Multivariate analysis showed that the area of gamma zone was correlated with the disc ovality index (P<0.001). The presence and area of beta zone was correlated with age (P<0.01).

Conclusions: In non-myopic eyes, the parapapillary gamma zone composed by external oblique border tissue was significantly associated with the disc ovality and disc rotations around vertical and horizontal axes. From a biomechanical perspective, parapapillary gamma zone may contribute to the optic disc stability in association with the structure of BMO.

Background: To investigate the microstructural features of parapapillary gamma zone and beta zone and their relationship with three-dimensional optic disc shape in non-myopic eyes.

Methods: This cross-sectional study included 62 non-myopic eyes with parapapillary gamma or beta zone and 70 control eyes. On the spectral domain optical coherent tomography (SD-OCT) images, we measured the area of gamma zone and beta zone, the length of border tissue, and related disc parameters. The disc ovality index, disc rotation degrees around three axes, Bruch’s membrane opening (BMO) ovality ratio were calculated based on the SD-OCT images.

Results: The parapapillary gamma zone composed by externally oblique border tissue was found in inferior, nasal and temporal quadrants of the non-myopic eyes. The presence of gamma zone in non-myopic eyes was correlated with smaller disc ovality index, larger rotation degree around vertical and horizontal axes, and larger BMO ovality ratio (P<0.001). Compared with the non-temporal gamma zone group, eyes with temporal gamma zone had a longer axial length and rotated more around vertical axes (P<0.001). Multivariate analysis showed that the area of gamma zone was correlated with the disc ovality index (P<0.001). The presence and area of beta zone was correlated with age (P<0.01).

Conclusions: In non-myopic eyes, the parapapillary gamma zone composed by external oblique border tissue was significantly associated with the disc ovality and disc rotations around vertical and horizontal axes. From a biomechanical perspective, parapapillary gamma zone may contribute to the optic disc stability in association with the structure of BMO.

Abstract: Autoimmune retinopathy (AIR) refers to both paraneoplastic and non-paraneoplastic forms of a rare, acquired retinal degeneration thought to be mediated by the production of antiretinal antibodies. However, the mechanisms underlying AIR pathogenesis are incompletely understood, and it remains a diagnosis of exclusion given the lack of definitive testing as well as its protean clinical presentation. This review summarizes the current literature on the epidemiology, diagnosis, and management of AIR, with a focus on non-paraneoplastic disease and the potential role of immunomodulatory therapy. A recent expert consensus statement on diagnosis and management of non-paraneoplastic AIR served as a framework for interpreting the limited data available, a process that was complicated by the small sample sizes, heterogeneity, and retrospective nature of these studies. Additional work is needed to characterize AIR patients on the basis of cytokine and immunogenetic profiling; to establish the pathogenicity of antiretinal antibodies; and to standardize treatment regimens as well as assessment of clinical outcomes.

Abstract: Autoimmune retinopathy (AIR) refers to both paraneoplastic and non-paraneoplastic forms of a rare, acquired retinal degeneration thought to be mediated by the production of antiretinal antibodies. However, the mechanisms underlying AIR pathogenesis are incompletely understood, and it remains a diagnosis of exclusion given the lack of definitive testing as well as its protean clinical presentation. This review summarizes the current literature on the epidemiology, diagnosis, and management of AIR, with a focus on non-paraneoplastic disease and the potential role of immunomodulatory therapy. A recent expert consensus statement on diagnosis and management of non-paraneoplastic AIR served as a framework for interpreting the limited data available, a process that was complicated by the small sample sizes, heterogeneity, and retrospective nature of these studies. Additional work is needed to characterize AIR patients on the basis of cytokine and immunogenetic profiling; to establish the pathogenicity of antiretinal antibodies; and to standardize treatment regimens as well as assessment of clinical outcomes.