Ultrasound, Dacryocystorhinography and Morphological Examination of Normal Eye and Lacrimal Apparatus of the Donkey (Equus asinus)

The study investigated normal macromorphological and ultrasonographic features of the eye and lacrimal gland, as well as normal dacryocystorhinography of the donkey (Equus asinus) in Egypt. A total of 36 donkeys of different ages, weights, and sexes were included in the study: 21 live animals for ultrasonography and dacryocystorhinography, and 15 cadaver skulls for morphological anatomy of the lacrimal apparatus. The ultrasound biometric values of the eye were 33.7 ± 1.7 mm for axial globe length (AGL), 39.8 ± 2.1 mm for globe diameter (GD), 10.8 ± 0.7 mm for lens thickness (LT), 3.2 ± 0.7 mm for anterior chamber depth (ACD), and 19.3 ± 1.6 mm for vitreous chamber depth (VCD). The lacrimal gland was recognized as a hypoechogenic structure with an anechoic core, located at the dorsolateral aspect of the orbit, and ovoid in shape. The mean NLD length was 193.0 ± 9.8 mm by radiography and 206.0 ± 20.4 mm by gross assessment. One NL orifice (NLO) was noticed on each side, with a diameter of 3.0 ± 0.1 mm and located 12.1 ± 2.1 mm from the dorsal commissure of the nostril. These results may act as the baseline for proper management of conditions of the eye and lacrimal apparatus in the donkey in the future.

Proptosis Revealing a Rare Lacrimal Gland Tumor: A Case of Chondroid Syringoma in a 35-year-old Patient

Lacrimal gland chondroid syringoma is a very rare tumor with classic clinico-radiological symptoms that should be familiar to clinicians for appropriate patients’ management as the tumor has potential for recurrence and malignant transformation. We report herein a case of chondroid syringoma in a 35-year-old patient presenting with progressive painless proptosis for 2 years. He underwent complete surgical removal of the tumor, with subsequent clinical improvement of his symptoms.

The value of SPECT/CT imaging of lacrimal glands as a means of assessing the activity of Graves’ orbitopathy

Background: Graves’ orbitopathy (GO) is an autoimmune disease with mechanical impairment of orbital muscles and lacrimal gland dysfunction. The frequently used methods of assessing GO activity include: Clinical Activity Score (CAS), computed tomography (CT), and magnetic resonance imaging (MRI). These approaches are mainly associated with orbital muscles, however, there are not many studies that focus on the lacrimal gland inflammation of GO patients. Objective: The aim of this study is to assess the usefulness of 99mTc-DTPA SPECT/CT in evaluating the lacrimal gland inflammation in Graves orbitopathy, as compared with other methods. Methods: A retrospective analysis of 48 patients with active GO compared with 33 controls was conducted. All subjects underwent clinical-endocrinological analyses, CAS evaluation, CT scans, and SPECT/CT examination. Lacrimal gland dimensions were determined and analyzed. Results: The lacrimal glands in patients with GO were significantly larger in all measured dimensions (p < 0.001) on CT scans relative to those in controls. Increased lacrimal gland DTPA uptake ratios (p < 0.001) were displayed in active GO patients compared to controls and were also correlated with TRAb levels. The cut-off value for discriminating active and inactive disease was calculated to be 1.735, with specificity of 82.6% and sensitivity of 74.2%. SPECT/CT uptake ratios and CAS values were positively correlated in all GO patients. SPECT/CT uptake ratios were also positively correlated with CT measurements including lacrimal gland volume and coronal width in GO patients. Conclusions: These data indicated that lacrimal gland SPECT/CT images can serve as a good tool for assessing the inflammation and disease activity of GO.

Clinical analysis of 109 cases of lacrimal gland pleomorphic adenoma

AIM: To monitor the prognosis of patients with lacrimal gland pleomorphic adenoma (LGPA) following surgical resection within the past 10y. The factors affecting patient prognosis are analyzed and the experience of surgical treatment is summarized. METHODS: In this retrospective, comparative case series, clinical records from 109 cases of LGPA treated chiefly at the same institution between November 2009 and May 2019 were reviewed. All 109 patients underwent surgery, histopathological examination, and imaging examination. For patients who underwent surgery for the first time, LGPA could be resected completely, including tumor and capsule tissues, using a surgical approach via the eyebrow arch or double eyelid crease. RESULTS: The ratio of males to females was 1:1.60, the ages ranged from 19 to 74 years old with a mean age of 43.64±13.07 years old, and the ratio of left to right eyes was 1:1.37. A total of 109 patients underwent surgical excision and five of these received radiotherapy after malignant transformation. Of these patients, 15 were lost to follow up within the April 1, 2020 deadline and 1 was diagnosed as a recurring pathology. The 5-year recurrence rate for 86 patients who underwent initial surgery was 7.27%. Single factor analysis revealed that the course of disease, bone destruction, invasion of surrounding tissues, tumor size, capsule integrity, and expression of Ki-67 were statistically significant (P<0.05). Binomial Logistic regression analysis showed that capsule integrity was a risk factor influencing recurrence (P=0.008). CONCLUSION: LGPA has a risk of recurrence and potential for malignant transformation. Complete removal of the tumor and capsule in the initial surgery is a key factor in preventing recurrence.