Bioengineered materials are used as a substitute in many fields of medicine,especially in plastic surgery and in burns.In ophthalmic plastic surgery they can be used for covering large tissue defects or as a tarsal pl...Bioengineered materials are used as a substitute in many fields of medicine,especially in plastic surgery and in burns.In ophthalmic plastic surgery they can be used for covering large tissue defects or as a tarsal plate substitute,in cases when it is not possible to use conventional surgical techniques.We have searched PubMed and Web of Science scientific databases.We can generally categorize skin substitutes by the type of tissue used-we distinguish autografts,allografts,and xenografts.There are also completely synthetic substitutes.The aim of our article was to summarize the current state of knowledge and to sum up all the clinical applications of bioengineered materials in the periocular region.There are only a few scientific articles about this topic and lack of prospective randomized studies aimed on use of bioengineered materials in periocular region.Nevertheless,there are many articles describing successful case reports or case reports series.According to literature,bioengineered materials are the most commonly used in big traumas or large surgical defects,especially in oculoplastic tumour surgery.Bioengineered dermal substitutes are not frequently used in the periocular region.Dermal substitutes are useful,when it is not possible to close the defect with any other conventional surgical technique.展开更多
In a comprehensive literature review,PubMed,Embasem and Web of Science were searched for studies examining targeted therapy of ocular malignant melanomas to present and discuss targeted therapy treatment options of oc...In a comprehensive literature review,PubMed,Embasem and Web of Science were searched for studies examining targeted therapy of ocular malignant melanomas to present and discuss targeted therapy treatment options of ocular tumors,mainly conjunctival and uveal melanoma(UM).Conjunctival malignant melanomas showed similarities in clinical and genetic aspects with cutaneous melanomas.Many therapies with checkpoint inhibitors already established for cutaneous melanomas may be a treatment option for conjunctival malignant melanomas with shared traits.Existing targeted therapies are for example checkpoint inhibitors like pembrolizumab or nivolumab.As a corollary,due to marked differences in clinics and genetics between UMs and conjunctival melanomas(CMs)or cutaneous melanomas,it has remained elusive whether the available possibilities of molecular targeted therapy will be an option for the therapy of metastasizing UMs.Possible novel ways of treating UM are being explored.Fotemustine or the inoculation of dendritic cells with tumorous RNA or sunitinib in combination with cisplatin and or tamoxifen may be used in future to treat UM.While CM are treatable using targeted therapies,UM have not been researched enough to find working targeted therapy options.Further research has to be done in order to find acceptable treatment options.展开更多
Basal cell carcinoma(BCC)is by far the most common human skin cancer.In Caucasians,BCCs account for around 90%of periocular malignancies.However,periocular BCCs are usually neglected due to their slow and painless gro...Basal cell carcinoma(BCC)is by far the most common human skin cancer.In Caucasians,BCCs account for around 90%of periocular malignancies.However,periocular BCCs are usually neglected due to their slow and painless growth,unless presenting complaints,e.g.,large size,bleeding,recurrent infections of the tumor,or secondary symptoms resulting from adjacent structures involvement as epiphora,limited eye globe motility as well as globe displacement.Moreover,although the tumor can usually be cured with local excision,local recurrence can occur in up to 20%of eyelid BCC cases.Recurrent BCCs of the eyelid show a poorer overall prognosis than the primary ones.In addition,the management of advanced diseases,such as orbital or intracranial invasion as well as metastatic lesions,is challenging and often involves a multidisciplinary approach.In this paper,we reviewed the recent research progress of pathogenesis,clinical presentation,and therapeutics of periocular BCCs.We introduced the molecular pathogenesis of BCCs[multi-step ultraviolet(UV)-induced carcinogenesis model,genetic predisposition,and epigenetic changes],clinical classification,and tumor-node-metastasis(TNM)clinically stage of eyelid skin BCCs.We also emphasized the treatment of BCCs,i.e.,surgical resection,oculoplastic reconstruction,and alternative therapies(radiation therapy,systemic therapy,topical therapy,and prophylactic therapy).In the end,we proposed that considering the possible iatrogenic damage to the surface of the eye by surgical excision,the treatment of periocular BCCs is recommended to be performed by or in the presence of an oculoplastic surgeon.展开更多
AIM: To investigate the reliability of a modified threedimensional distraction test(3D-DT) and three-dimensional pinch test(3D-PT) for assessing lower eyelid tension(LET).METHODS: A cross-sectional study was conducted...AIM: To investigate the reliability of a modified threedimensional distraction test(3D-DT) and three-dimensional pinch test(3D-PT) for assessing lower eyelid tension(LET).METHODS: A cross-sectional study was conducted among 97 volunteer s including 97 eyelids with no history of trauma, tumor, or reconstructive surgeries. Six three-dimensional photographs were acquired for each par ticipant, including two photographs obtained in a neutral position(NP), two using a modified 3D-DT with a 15.9-grammes stainless steel eyelid hook performed, and two using 3D-PT.RESULTS: The mean absolute differences between NP, 3D-DT, and 3D-PT measurements varied between 0.07 and 7.42, 0.10 and 13.10, and 0.07 and 15.97, respectively;technical error of measurement varied between 0.05 and 7.81, 0.09 and 10.19, and 0.07 and 12.47, respectively;and relative error measurements varied between 0.10% and 11.50%, 0.16% and 30.51%, and 0.11% and 38.75%, respectively. For intra-rater reliability, the intraclass correlation coefficients(ICCs) were more than 0.80 in seven out of eight measurements obtained in the NP and 3D-DT, whereas those obtained in the 3D-PT were as low as less than 0.30 by rater 1;the ICCs of all the measurements obtained in all the positions(NP, 3D-DT, and 3D-PT) were more than 0.80 by rater 2. For inter-rater reliability six out of eight NP and 3D-DT measurements had an ICC greater than 0.80, whereas those of 3D-PT measurements were less than 0.30. For intra-method reliability, the ICCs of all the NP measurements were more than 0.87, whereas those of the six 3D-DT measurements and four 3D-PT measurements were more than 0.80.CONCLUSION: Our study results prove that the modified 3D-DT, which involves the use of an eyelid hook, can be a highly reliable method for evaluating LET. Furthermore, this novel and simple method may be utilized as the basis for further investigation and routine pre-and postoperative clinical evaluation.展开更多
Objective:This review serves as a comprehensive description and summary of currently available preclinical models of three tumors in ophthalmic oncology:conjunctival melanoma(CM),uveal melanoma(UM),and retinoblastoma....Objective:This review serves as a comprehensive description and summary of currently available preclinical models of three tumors in ophthalmic oncology:conjunctival melanoma(CM),uveal melanoma(UM),and retinoblastoma.Background:Malignant melanomas are the most common tumors of the eye in adults,most often localized in the uvea and conjunctiva.Although the primary tumor can be successfully eliminated in many cases,nearly one in two UMs-and one in three CMs-are fatal to the patient due to metastasis.Effective therapies for metastatic uveal and CMs are unfortunately still not available,so there is an urgent need for new therapeutic strategies to improve prognosis quoad vitam and prolong the survival of melanoma patients.Another widely known tumor of the eye is retinoblastoma,which is the most common pediatric ocular malignancy,occurring in approximately 1 in 15,000-18,000 live births.Overall,it is considered well treatable,with a survival rate of approximately 90%at 3 years,although fatal if untreated.For a long time,enucleation was also considered the treatment of choice,with bilateral cases having one eye irradiated and the eye with the more advanced tumor removed.Since the 1990s,however,systemic chemotherapy has been predominantly used to preserve the quality of life and vision of young patients,although the cellular activity of the retinoblastoma often remains after treatment with chemotherapeutic agents.Prognosis of the disease is immensely depending on the stage and time of diagnosis and is varying between countries due to different developmental status of health care systems.Methods:We review recent advances in the available literature on established preclinical models in CM,UM,and retinoblastoma.In addition,we discuss the advantages and limitations of these models and provide an overview of current alternatives to animal testing in preclinical studies.Conclusions:In the case of all three diseases,further research is needed for improved therapeutic options.Animal models in particular are indispensable for cancer research in order to mimic the extremely complex processes of human carcinogenesis,physiology and progression.Certainly,animal studies do not easily translate to human diseases due to biological differences and limitations.However,they continue to serve as the primary source and link between in vitro testing and clinical studies in patients.In order to minimize animal experiments and possibly even replace them in the future,alternatives such as 3D cell cultures and in silico predictions are useful and insightful additions and require further development.Still,no currently available preclinical model can be fully translated to some of here described diseases.Nevertheless,they all provide essential insights and knowledge that should be of use in the future for better understanding and pursuit of new therapeutic strategies.展开更多
Anthropometry can analyze the size,weight,and proportion of the human body objectively and quantitatively to supplement the visual assessment.Various non-invasive three-dimensional(3D)anthropometric techniques have be...Anthropometry can analyze the size,weight,and proportion of the human body objectively and quantitatively to supplement the visual assessment.Various non-invasive three-dimensional(3D)anthropometric techniques have been applied to assess soft tissues’3D morphology in the clinical practice.Among them,non-invasive stereophotogrammetry and laser scanning techniques are becoming increasingly popular in craniofacial surgery and plastic surgery.They have been applied for craniofacial growth estimation and morphometric investigation,genetic and acquired malformation diagnosis,as well as orthodontic or surgical treatment arrangement and outcome evaluation.However,few studies have been published for assessing the 3D morphology of soft tissues in the periorbital region.This paper reviews the studies involving the application and evaluation of the increasingly popular 3D photogrammetry in the periorbital region.These studies proposed detailed and standardized protocols for three-dimensionally assessing linear,curvilinear,angular,as well as volumetric measurements,and verified its high reliability in the periorbital region(even higher than caliper-derived direct measurements).In the future,reliable and accurate 3D imaging techniques,as well as standardized analyzing protocols,may find applications in following up morphological growth,preoperatively diagnosing and assessing patient periorbital conditions,planning surgical procedures,postoperatively evaluating treatment outcomes of a specific procedure,and comparing the differences in surgical results between various procedures,studies,as well as populations.展开更多
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 rehab...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.展开更多
Eyelid surgery is widely and extensively used in facial plastic and reconstructive surgeries.There are many categories of eyelid surgeries,the most common of which include blepharoplasty,ptosis surgery,and eyelid reco...Eyelid surgery is widely and extensively used in facial plastic and reconstructive surgeries.There are many categories of eyelid surgeries,the most common of which include blepharoplasty,ptosis surgery,and eyelid reconstruction.In many cases,these procedures are combined,and there are many different techniques for each type of operation.Upper eyelid blepharoplasty usually includes the excision of skin,preseptal orbicularis oculi muscle,and orbital fat.Common methods of lower eyelid blepharoplasty are the skin-muscle flap,the skin flap,and the transconjunctival.Ptosis surgery is mainly divided into three types:transcutaneous,transconjunctival,and sling surgery.Surgeons often used the Hughes or Cutler-Beard Bridge Flaps in eyelid reconstruction.Different types and methods of surgery have their own advantages and disadvantages,and postoperative complications may occur.Therefore,postoperative complications of eyelid surgeries,such as dry eye symptoms,should be taken into serious consideration.Relevant literature involving these complaints can be found in PubMed by searching the terms“dry eye”,“eyelid”,“surgery”,and other related keywords.Moreover,various ocular surface and tear film alterations may be detected using the Ocular Surface Disease Index(OSDI),tear film breakup time,Schirmer test,fluorescein staining,and lissamine green staining after various eyelid surgeries.As dry eye disease is prevalent in the general population,it is more urgent to figure out what we can learn from these complaints.Further exploration in this field may help surgeons to choose a better surgical method and give an accurate evaluation of the postoperative effect.展开更多
Introduction The word pterygium comes from two Greek words:(pteryx)meaning wing and(pterygion)fin(1-3).Pterygium,one of the most common benign tumors of the ocular surface,is a focal fibrovascular proliferation of con...Introduction The word pterygium comes from two Greek words:(pteryx)meaning wing and(pterygion)fin(1-3).Pterygium,one of the most common benign tumors of the ocular surface,is a focal fibrovascular proliferation of conjunctival tissue onto the cornea(1-6).The pterygium is usually triangular in shape and localized in the nasal palpebral fissure(1-6).Histopathologically,there is usually a nonkeratinizing epithelium and loss of goblet cells(4).Some cases show also the development of a multilayered keratinizing squamous epithelium.Subepithelial features include thickened collagen fibers,numerous vascular incisions,and pathognomonic elastoid degeneration.Sometimes,chronic inflammation,such as lymphocytic infiltration,can also be seen(2-6).Furthermore,the head of the pterygium,which is firmly fused to the cornea,can also grow into the upper corneal layers and fragment Bowman’s lamella(1-4).展开更多
Background Ocular cancer represents a significant threat to vision and life among various eye diseases.Conjunctival melanoma is regarded as one of the most feared and unpredictable ocular tumors.Considering the global...Background Ocular cancer represents a significant threat to vision and life among various eye diseases.Conjunctival melanoma is regarded as one of the most feared and unpredictable ocular tumors.Considering the global differences in the occurrence of ocular melanoma across different races and regions,this study provides a thorough examination of the current state of research pertaining to the epidemiology of ocular and conjunctival cancers.Methods This bibliometrics analysis used the Web of Science Core Collection(WoSCC)to collect data from publications on the epidemiology of ocular cancer,including relevant literature from 1951 to 2024.We examined indicators including t publication counts,citation rates,and data on contributing countries,institutions,and journals.Use VOSviewer and CiteSpace for network visualization and Microsoft Excel for data management.Our analysis reveals key trends in the epidemiology of ocular cancer across countries and identifies prominent keywords.Results A total of 406 articles on ocular cancer were identified,with significant contributions from the United States,the United Kingdom,and Germany.Denmark also plays a crucial role,particularly in conjunctival cancer research.Carol L.Shields is a leading figure widely recognized for her influential citations in ocular cancer epidemiology.The top publication platforms include the British Journal of Ophthalmology,Ophthalmic Epidemiology,and Ophthalmology.Key terms in ocular cancer research focus on prevalence,survival,and epidemiology,while conjunctival cancer studies emphasize malignant melanoma,conjunctiva,and epidemiology.Through keyword co-occurrence and burst analysis,trending topics include prevalence,risk factors,uveal melanoma,choroidal melanoma,malignant melanoma,squamous cell carcinoma,and conjunctiva.For conjunctival cancer,key research areas expected to remain prominent are cell carcinoma,management,recurrence,ocular surface squamous neoplasia,and pathology.Conclusions This analysis represents the first comprehensive bibliometric review mapping the trends and the knowledge structure in ocular cancer research,specifically from an epidemiological viewpoint.The results meticulously explore and encapsulate the research frontiers for scholars dedicated to the epidemiology of conjunctival cancer.展开更多
Purpose:To explore the role of ultraviolet radiation(UVR)in the occurrence and development of various ocular malignancies.Methods:In this article,we retrieved ocular malignancy data from the Global Cancer Observatory(...Purpose:To explore the role of ultraviolet radiation(UVR)in the occurrence and development of various ocular malignancies.Methods:In this article,we retrieved ocular malignancy data from the Global Cancer Observatory(GCO)and performed correlation analysis with the global UV index and sunshine duration.We searched for associated studies using the following databases:Embase,Pubmed,Cochrane Library,and Google Scholar.We conducted the literature by searching the Mesh terms denoting an exposure of interest("UV radiation","ultraviolet rays",and"ocular malignancies"),All studies included are published until December 30,2023 without language restrictions.Results:The mechanisms and epidemiological statistics of UVR on the onset and progression of eyelid malig-nancies are the most studied and clear.The role of UVR in conjunctival melanoma is similar to that in eyelid melanoma.The relationship between uveal melanoma and UVR is controversial,however,it may have at least a certain impact on its prognosis.UVR causes ocular surface squamous neoplasia by further activating HPV infection.Conclusions:UVR is a decisive risk factor for ocular malignancies,but the incidence of ultraviolet-induced tumors is also affected by many other factors.A correct and comprehensive understanding of the mechanisms of UVR in the pathogenesis of ocular malignant tumors can provide patients with more effective and selective immune regulation strategies.展开更多
Background:The periocular skin is neoplasms-prone to various benign and malignant.Periocular malignancies are more aggressive and challenging to cure and repair than those in other skin areas.In recent decades,immuno-...Background:The periocular skin is neoplasms-prone to various benign and malignant.Periocular malignancies are more aggressive and challenging to cure and repair than those in other skin areas.In recent decades,immuno-therapy has significantly advanced oncology,allowing the autoimmune system to target and destroy malignant cells.Skin malignancies,especially periocular tumors,are particularly sensitive to immunotherapy.This tech-nique has dramatically impacted the successful treatment of challenging tumors.Main text:Extraocular cancers,including eyelid(basal cell carcinoma,squamous cell carcinoma,melanoma,merkel cell carcinoma),conjunctival tumors(conjunctival melanoma,ocular surface squamous neoplasia)and other rare tumors,are unique and challenging clinical situations.Several genetic alterations associated with the pathogenesis of these diseases have been identified,and molecular mechanism are essential for the development of the immunotherapy agents,such as Hedgehog pathway inhibitors(vismodegib and sonidegib)for basal cell carcinoma,BRAF/MEK inhibitors(vemurafenib,dabrafenib,and encorafenib)for melanoma,and immune checkpoint inhibitors(Avelumab,pembrolizumab)for Merkel cell carcinoma.Conclusions:The optimal treatment for periocular skin cancer depends on the type and size of the tumor and whether it involves orbital and adnexal structures.Adjuvant and neoadjuvant therapy with chemotherapy-targeted therapies and immune checkpoint inhibitors should be considered based on tumor type,tumor molec-ular profile,expected response rate,and candidacy for systemic treatment.展开更多
Purpose:Aims to provide an overview of the contemporary epidemiology of malignant orbital tumors by analyzing population-based incidence patterns across various regions worldwide.Methods:In this article,we retrieved o...Purpose:Aims to provide an overview of the contemporary epidemiology of malignant orbital tumors by analyzing population-based incidence patterns across various regions worldwide.Methods:In this article,we retrieved orbital malignancy data from the MEDLINE database and analyzed the incidence and prevalence of orbital malignancies worldwide.We performed the literature search by searching on the Mesh terms for malignant orbital tumors("orbital","tumor","lymphoma","malignant","cancer","incidence",and"epidemiology").All included studies were published between 1993 and 2023 and were written in English.Results:Ocular or ophthalmic lymphoma most frequently occurred in the orbit,with a prevalence ranging from 47%to 54%.The incidence of malignant orbital tumors was increasing in the USA 2.0 per million(1981–1993),Netherlands(0.86(1981–1985)to 2.49(2001–2005)per million)and South Korea(0.3–0.8 per million(1999–2016)),respectively.Ophthalmic lymphoma which includes orbit lymphoma was increasing in Canada(0.17–1.47 per million(1992–2010)),Denmark(0.86 per million(1981–1985)to 2.49 per million(2001–2005)),respectively.Conclusions:The predominant primary malignant orbital tumor in adults was lymphoma.Ocular or ophthalmic lymphoma most frequently occured in the orbit.The limited data available suggested an increasing trend in the incidence of malignant orbital tumors in each country included,which were mainly attributed to the increase in lymphoma.Generally,incidence rates were found to increase with advancing age,with no difference between males and females.展开更多
Background:Intraocular malignant tumors represent a severe disease that threatens vision as well as life.To better extend the life of the patient,preserve visual function,and maintain ocular aesthetics,selecting the a...Background:Intraocular malignant tumors represent a severe disease that threatens vision as well as life.To better extend the life of the patient,preserve visual function,and maintain ocular aesthetics,selecting the appropriate timing and methods of treatment becomes crucial.Main text:With the continuous advancement of medical technology,the techniques and methods for treating intraocular malignant tumors are constantly evolving.While surgery was once considered the optimal method to prolong patient survival and prevent local recurrence,the discovery and application of various treatments such as radiotherapy,laser therapy,chemotherapy,cryotherapy,and monoclonal antibodies have led to a greater di-versity of treatment options.This diversity offers more possibilities to develop personalized treatment plans,and thereby maximize patient benefit.This article reviews the various treatment methods for intraocular malignant tumors,including indications for treatment,outcomes,and potential complications.Conclusions:Differentiating small intraocular malignant tumors from pigmented lesions is challenging,and ongoing monitoring with regular follow-up is required.Small to medium-sized tumors can be treated with radiotherapy combined with transpupillary thermotherapy.Depending on the tumor's distance from the optic disc,surgery with partial resection may be considered for distant tumors,while proximal tumors may require complete enucleation.Systemic chemotherapy has been widely applied to patients with retinal tumors,lym-phomas,and intraocular metastatic cancers,but has limited efficacy in patients with choroidal melanoma.An-tagonists of Vascular Endothelial Growth Factor(Anti-VEGF)drugs can improve patient vision and quality of life,while the efficacy of immunotherapy and molecular targeted therapy is still under research.展开更多
Objective:This study aims to identify research trends and hot spots in the treatment of Squamous Cell Carcinoma(SCC)over the past decade using bibliometric analysis.Methods:Data were extracted from the Web of Science ...Objective:This study aims to identify research trends and hot spots in the treatment of Squamous Cell Carcinoma(SCC)over the past decade using bibliometric analysis.Methods:Data were extracted from the Web of Science Core Collection,including Science Citation Index Expanded(SCI-Expanded),Social Sciences Citation Index(SSCI),and Emerging Sources Citation Index(ESCI).The data underwent manual cleaning to remove inaccuracies and irrelevancies,followed by transformation into an analyzable format via the VOSviewer software.This tool facilitated the visualization of co-occurrence networks and keyword maps,highlighting the relationships and the prominence of research themes.Results:A total of 46448 authors from 7374 institutions across 108 countries contributed to the literature,reflecting a broad international effort.The study documented a consistent increase in SCC-related publications up to 2020,with some variability in subsequent years.Notably,the United States,Germany,China,the United Kingdom,and France were predominant in this research area.The University of Texas MD Anderson Cancer Center and the University of Pittsburgh were leading contributors in terms of publication volume and citation impact.Key journals included‘Oral Oncology’and‘Clinical Cancer Research’,which were central to the dissemination of high-impact research.Our keyword analysis identified three major research clusters focused on molecular mechanisms,clinical treatment strategies,and emerging interests in immunotherapeutic approaches.Conclusions:The extensive collaboration and the increasing publication trend underscore the growing global commitment to advancing SCC treatment.The high level of engagement from top institutions and the concentration of research in influential journals reflect the field's dynamic evolution towards innovative and effective treatment modalities.This study provides a valuable overview for researchers,guiding future studies towards areas of high impact and emerging trends in SCC treatment.The findings advocate for enhanced focus on personalized medicine and combination therapies,which are poised to improve outcomes for SCC patients.展开更多
Purpose:The most common intraocular cancer in adults is uveal melanoma(UM).This study aimed to investigate and report the incidence and prognosis of UM in different regions of the world.Methods:We retrieved relevant d...Purpose:The most common intraocular cancer in adults is uveal melanoma(UM).This study aimed to investigate and report the incidence and prognosis of UM in different regions of the world.Methods:We retrieved relevant data on UM from the PubMed database and analyzed its global incidence and prognosis.All data was obtained from a national population-based registry,with publication dates ranging from 2013 to 2023.Results:The incidence rates of UM vary across different regions:in the United States,rates were 5.1 per million(1993–2008)and 5.2 per million(1973–2013);in Canada,rates ranged from 3.34 per million(1992–2010)to 5.09 per million(2011–2017);in Republic of Korea,the rate was 0.42 per million(1999–2011);in New Zealand,it was 5.56 per million(2000–2020);in Australia,it was 7.6 per million(1982–2014);and in Europe,rates ranged from 3.1 to 5.8 per million(1995–2002).Among European countries,Sweden(5.6 per million(1960–2009)),Germany(6.41 per million(2009–2015)),Poland(6.67 per million(2010–2017)),and the United Kingdom(10 per million(1999–2010)).Conclusions:The most common site of occurrence for UM is in the choroid.Limited data suggest a stable trend in UM incidence rates across the included countries,but significant differences in incidence rates exist among different countries and regions,with notably lower rates in Asian countries compared to Europe,North America,and Oceania.In general,the incidence rate in males is slightly higher compared to that in females.展开更多
文摘Bioengineered materials are used as a substitute in many fields of medicine,especially in plastic surgery and in burns.In ophthalmic plastic surgery they can be used for covering large tissue defects or as a tarsal plate substitute,in cases when it is not possible to use conventional surgical techniques.We have searched PubMed and Web of Science scientific databases.We can generally categorize skin substitutes by the type of tissue used-we distinguish autografts,allografts,and xenografts.There are also completely synthetic substitutes.The aim of our article was to summarize the current state of knowledge and to sum up all the clinical applications of bioengineered materials in the periocular region.There are only a few scientific articles about this topic and lack of prospective randomized studies aimed on use of bioengineered materials in periocular region.Nevertheless,there are many articles describing successful case reports or case reports series.According to literature,bioengineered materials are the most commonly used in big traumas or large surgical defects,especially in oculoplastic tumour surgery.Bioengineered dermal substitutes are not frequently used in the periocular region.Dermal substitutes are useful,when it is not possible to close the defect with any other conventional surgical technique.
文摘In a comprehensive literature review,PubMed,Embasem and Web of Science were searched for studies examining targeted therapy of ocular malignant melanomas to present and discuss targeted therapy treatment options of ocular tumors,mainly conjunctival and uveal melanoma(UM).Conjunctival malignant melanomas showed similarities in clinical and genetic aspects with cutaneous melanomas.Many therapies with checkpoint inhibitors already established for cutaneous melanomas may be a treatment option for conjunctival malignant melanomas with shared traits.Existing targeted therapies are for example checkpoint inhibitors like pembrolizumab or nivolumab.As a corollary,due to marked differences in clinics and genetics between UMs and conjunctival melanomas(CMs)or cutaneous melanomas,it has remained elusive whether the available possibilities of molecular targeted therapy will be an option for the therapy of metastasizing UMs.Possible novel ways of treating UM are being explored.Fotemustine or the inoculation of dendritic cells with tumorous RNA or sunitinib in combination with cisplatin and or tamoxifen may be used in future to treat UM.While CM are treatable using targeted therapies,UM have not been researched enough to find working targeted therapy options.Further research has to be done in order to find acceptable treatment options.
基金This study was supported by the Koeln Fortune Program/Faculty of Medicine,University of Cologne,Germany(No.2680148101)the State Scholarship Fund from China Scholarship Council,China(No.201708080141).
文摘Basal cell carcinoma(BCC)is by far the most common human skin cancer.In Caucasians,BCCs account for around 90%of periocular malignancies.However,periocular BCCs are usually neglected due to their slow and painless growth,unless presenting complaints,e.g.,large size,bleeding,recurrent infections of the tumor,or secondary symptoms resulting from adjacent structures involvement as epiphora,limited eye globe motility as well as globe displacement.Moreover,although the tumor can usually be cured with local excision,local recurrence can occur in up to 20%of eyelid BCC cases.Recurrent BCCs of the eyelid show a poorer overall prognosis than the primary ones.In addition,the management of advanced diseases,such as orbital or intracranial invasion as well as metastatic lesions,is challenging and often involves a multidisciplinary approach.In this paper,we reviewed the recent research progress of pathogenesis,clinical presentation,and therapeutics of periocular BCCs.We introduced the molecular pathogenesis of BCCs[multi-step ultraviolet(UV)-induced carcinogenesis model,genetic predisposition,and epigenetic changes],clinical classification,and tumor-node-metastasis(TNM)clinically stage of eyelid skin BCCs.We also emphasized the treatment of BCCs,i.e.,surgical resection,oculoplastic reconstruction,and alternative therapies(radiation therapy,systemic therapy,topical therapy,and prophylactic therapy).In the end,we proposed that considering the possible iatrogenic damage to the surface of the eye by surgical excision,the treatment of periocular BCCs is recommended to be performed by or in the presence of an oculoplastic surgeon.
基金Supported by the Project of National Key Research and Development (No.2018YFC1106103)Chongqing Science and Health Joint Medical Research Project-Youth Project (No.2022QNXM016)The Fundamental Research Funds for the Central Universities (No.2021FZZX005-15)。
文摘AIM: To investigate the reliability of a modified threedimensional distraction test(3D-DT) and three-dimensional pinch test(3D-PT) for assessing lower eyelid tension(LET).METHODS: A cross-sectional study was conducted among 97 volunteer s including 97 eyelids with no history of trauma, tumor, or reconstructive surgeries. Six three-dimensional photographs were acquired for each par ticipant, including two photographs obtained in a neutral position(NP), two using a modified 3D-DT with a 15.9-grammes stainless steel eyelid hook performed, and two using 3D-PT.RESULTS: The mean absolute differences between NP, 3D-DT, and 3D-PT measurements varied between 0.07 and 7.42, 0.10 and 13.10, and 0.07 and 15.97, respectively;technical error of measurement varied between 0.05 and 7.81, 0.09 and 10.19, and 0.07 and 12.47, respectively;and relative error measurements varied between 0.10% and 11.50%, 0.16% and 30.51%, and 0.11% and 38.75%, respectively. For intra-rater reliability, the intraclass correlation coefficients(ICCs) were more than 0.80 in seven out of eight measurements obtained in the NP and 3D-DT, whereas those obtained in the 3D-PT were as low as less than 0.30 by rater 1;the ICCs of all the measurements obtained in all the positions(NP, 3D-DT, and 3D-PT) were more than 0.80 by rater 2. For inter-rater reliability six out of eight NP and 3D-DT measurements had an ICC greater than 0.80, whereas those of 3D-PT measurements were less than 0.30. For intra-method reliability, the ICCs of all the NP measurements were more than 0.87, whereas those of the six 3D-DT measurements and four 3D-PT measurements were more than 0.80.CONCLUSION: Our study results prove that the modified 3D-DT, which involves the use of an eyelid hook, can be a highly reliable method for evaluating LET. Furthermore, this novel and simple method may be utilized as the basis for further investigation and routine pre-and postoperative clinical evaluation.
文摘Objective:This review serves as a comprehensive description and summary of currently available preclinical models of three tumors in ophthalmic oncology:conjunctival melanoma(CM),uveal melanoma(UM),and retinoblastoma.Background:Malignant melanomas are the most common tumors of the eye in adults,most often localized in the uvea and conjunctiva.Although the primary tumor can be successfully eliminated in many cases,nearly one in two UMs-and one in three CMs-are fatal to the patient due to metastasis.Effective therapies for metastatic uveal and CMs are unfortunately still not available,so there is an urgent need for new therapeutic strategies to improve prognosis quoad vitam and prolong the survival of melanoma patients.Another widely known tumor of the eye is retinoblastoma,which is the most common pediatric ocular malignancy,occurring in approximately 1 in 15,000-18,000 live births.Overall,it is considered well treatable,with a survival rate of approximately 90%at 3 years,although fatal if untreated.For a long time,enucleation was also considered the treatment of choice,with bilateral cases having one eye irradiated and the eye with the more advanced tumor removed.Since the 1990s,however,systemic chemotherapy has been predominantly used to preserve the quality of life and vision of young patients,although the cellular activity of the retinoblastoma often remains after treatment with chemotherapeutic agents.Prognosis of the disease is immensely depending on the stage and time of diagnosis and is varying between countries due to different developmental status of health care systems.Methods:We review recent advances in the available literature on established preclinical models in CM,UM,and retinoblastoma.In addition,we discuss the advantages and limitations of these models and provide an overview of current alternatives to animal testing in preclinical studies.Conclusions:In the case of all three diseases,further research is needed for improved therapeutic options.Animal models in particular are indispensable for cancer research in order to mimic the extremely complex processes of human carcinogenesis,physiology and progression.Certainly,animal studies do not easily translate to human diseases due to biological differences and limitations.However,they continue to serve as the primary source and link between in vitro testing and clinical studies in patients.In order to minimize animal experiments and possibly even replace them in the future,alternatives such as 3D cell cultures and in silico predictions are useful and insightful additions and require further development.Still,no currently available preclinical model can be fully translated to some of here described diseases.Nevertheless,they all provide essential insights and knowledge that should be of use in the future for better understanding and pursuit of new therapeutic strategies.
基金This study was supported by the Koeln Fortune Program/Faculty of Medicine,University of Cologne,Germany(No.2680148101)the State Scholarship Fund from China Scholarship Council,China(No.201708080141).
文摘Anthropometry can analyze the size,weight,and proportion of the human body objectively and quantitatively to supplement the visual assessment.Various non-invasive three-dimensional(3D)anthropometric techniques have been applied to assess soft tissues’3D morphology in the clinical practice.Among them,non-invasive stereophotogrammetry and laser scanning techniques are becoming increasingly popular in craniofacial surgery and plastic surgery.They have been applied for craniofacial growth estimation and morphometric investigation,genetic and acquired malformation diagnosis,as well as orthodontic or surgical treatment arrangement and outcome evaluation.However,few studies have been published for assessing the 3D morphology of soft tissues in the periorbital region.This paper reviews the studies involving the application and evaluation of the increasingly popular 3D photogrammetry in the periorbital region.These studies proposed detailed and standardized protocols for three-dimensionally assessing linear,curvilinear,angular,as well as volumetric measurements,and verified its high reliability in the periorbital region(even higher than caliper-derived direct measurements).In the future,reliable and accurate 3D imaging techniques,as well as standardized analyzing protocols,may find applications in following up morphological growth,preoperatively diagnosing and assessing patient periorbital conditions,planning surgical procedures,postoperatively evaluating treatment outcomes of a specific procedure,and comparing the differences in surgical results between various procedures,studies,as well as populations.
文摘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.
基金This study was supported by the State Scholarship Fund from China Scholarship Council,China(No.202008080258).
文摘Eyelid surgery is widely and extensively used in facial plastic and reconstructive surgeries.There are many categories of eyelid surgeries,the most common of which include blepharoplasty,ptosis surgery,and eyelid reconstruction.In many cases,these procedures are combined,and there are many different techniques for each type of operation.Upper eyelid blepharoplasty usually includes the excision of skin,preseptal orbicularis oculi muscle,and orbital fat.Common methods of lower eyelid blepharoplasty are the skin-muscle flap,the skin flap,and the transconjunctival.Ptosis surgery is mainly divided into three types:transcutaneous,transconjunctival,and sling surgery.Surgeons often used the Hughes or Cutler-Beard Bridge Flaps in eyelid reconstruction.Different types and methods of surgery have their own advantages and disadvantages,and postoperative complications may occur.Therefore,postoperative complications of eyelid surgeries,such as dry eye symptoms,should be taken into serious consideration.Relevant literature involving these complaints can be found in PubMed by searching the terms“dry eye”,“eyelid”,“surgery”,and other related keywords.Moreover,various ocular surface and tear film alterations may be detected using the Ocular Surface Disease Index(OSDI),tear film breakup time,Schirmer test,fluorescein staining,and lissamine green staining after various eyelid surgeries.As dry eye disease is prevalent in the general population,it is more urgent to figure out what we can learn from these complaints.Further exploration in this field may help surgeons to choose a better surgical method and give an accurate evaluation of the postoperative effect.
文摘Introduction The word pterygium comes from two Greek words:(pteryx)meaning wing and(pterygion)fin(1-3).Pterygium,one of the most common benign tumors of the ocular surface,is a focal fibrovascular proliferation of conjunctival tissue onto the cornea(1-6).The pterygium is usually triangular in shape and localized in the nasal palpebral fissure(1-6).Histopathologically,there is usually a nonkeratinizing epithelium and loss of goblet cells(4).Some cases show also the development of a multilayered keratinizing squamous epithelium.Subepithelial features include thickened collagen fibers,numerous vascular incisions,and pathognomonic elastoid degeneration.Sometimes,chronic inflammation,such as lymphocytic infiltration,can also be seen(2-6).Furthermore,the head of the pterygium,which is firmly fused to the cornea,can also grow into the upper corneal layers and fragment Bowman’s lamella(1-4).
基金supported by China Scholarship Council(item CSC No.202208330084).
文摘Background Ocular cancer represents a significant threat to vision and life among various eye diseases.Conjunctival melanoma is regarded as one of the most feared and unpredictable ocular tumors.Considering the global differences in the occurrence of ocular melanoma across different races and regions,this study provides a thorough examination of the current state of research pertaining to the epidemiology of ocular and conjunctival cancers.Methods This bibliometrics analysis used the Web of Science Core Collection(WoSCC)to collect data from publications on the epidemiology of ocular cancer,including relevant literature from 1951 to 2024.We examined indicators including t publication counts,citation rates,and data on contributing countries,institutions,and journals.Use VOSviewer and CiteSpace for network visualization and Microsoft Excel for data management.Our analysis reveals key trends in the epidemiology of ocular cancer across countries and identifies prominent keywords.Results A total of 406 articles on ocular cancer were identified,with significant contributions from the United States,the United Kingdom,and Germany.Denmark also plays a crucial role,particularly in conjunctival cancer research.Carol L.Shields is a leading figure widely recognized for her influential citations in ocular cancer epidemiology.The top publication platforms include the British Journal of Ophthalmology,Ophthalmic Epidemiology,and Ophthalmology.Key terms in ocular cancer research focus on prevalence,survival,and epidemiology,while conjunctival cancer studies emphasize malignant melanoma,conjunctiva,and epidemiology.Through keyword co-occurrence and burst analysis,trending topics include prevalence,risk factors,uveal melanoma,choroidal melanoma,malignant melanoma,squamous cell carcinoma,and conjunctiva.For conjunctival cancer,key research areas expected to remain prominent are cell carcinoma,management,recurrence,ocular surface squamous neoplasia,and pathology.Conclusions This analysis represents the first comprehensive bibliometric review mapping the trends and the knowledge structure in ocular cancer research,specifically from an epidemiological viewpoint.The results meticulously explore and encapsulate the research frontiers for scholars dedicated to the epidemiology of conjunctival cancer.
文摘Purpose:To explore the role of ultraviolet radiation(UVR)in the occurrence and development of various ocular malignancies.Methods:In this article,we retrieved ocular malignancy data from the Global Cancer Observatory(GCO)and performed correlation analysis with the global UV index and sunshine duration.We searched for associated studies using the following databases:Embase,Pubmed,Cochrane Library,and Google Scholar.We conducted the literature by searching the Mesh terms denoting an exposure of interest("UV radiation","ultraviolet rays",and"ocular malignancies"),All studies included are published until December 30,2023 without language restrictions.Results:The mechanisms and epidemiological statistics of UVR on the onset and progression of eyelid malig-nancies are the most studied and clear.The role of UVR in conjunctival melanoma is similar to that in eyelid melanoma.The relationship between uveal melanoma and UVR is controversial,however,it may have at least a certain impact on its prognosis.UVR causes ocular surface squamous neoplasia by further activating HPV infection.Conclusions:UVR is a decisive risk factor for ocular malignancies,but the incidence of ultraviolet-induced tumors is also affected by many other factors.A correct and comprehensive understanding of the mechanisms of UVR in the pathogenesis of ocular malignant tumors can provide patients with more effective and selective immune regulation strategies.
基金supported by the State Scholarship Fund from China Scholarship Council(No.202108080189).
文摘Background:The periocular skin is neoplasms-prone to various benign and malignant.Periocular malignancies are more aggressive and challenging to cure and repair than those in other skin areas.In recent decades,immuno-therapy has significantly advanced oncology,allowing the autoimmune system to target and destroy malignant cells.Skin malignancies,especially periocular tumors,are particularly sensitive to immunotherapy.This tech-nique has dramatically impacted the successful treatment of challenging tumors.Main text:Extraocular cancers,including eyelid(basal cell carcinoma,squamous cell carcinoma,melanoma,merkel cell carcinoma),conjunctival tumors(conjunctival melanoma,ocular surface squamous neoplasia)and other rare tumors,are unique and challenging clinical situations.Several genetic alterations associated with the pathogenesis of these diseases have been identified,and molecular mechanism are essential for the development of the immunotherapy agents,such as Hedgehog pathway inhibitors(vismodegib and sonidegib)for basal cell carcinoma,BRAF/MEK inhibitors(vemurafenib,dabrafenib,and encorafenib)for melanoma,and immune checkpoint inhibitors(Avelumab,pembrolizumab)for Merkel cell carcinoma.Conclusions:The optimal treatment for periocular skin cancer depends on the type and size of the tumor and whether it involves orbital and adnexal structures.Adjuvant and neoadjuvant therapy with chemotherapy-targeted therapies and immune checkpoint inhibitors should be considered based on tumor type,tumor molec-ular profile,expected response rate,and candidacy for systemic treatment.
文摘Purpose:Aims to provide an overview of the contemporary epidemiology of malignant orbital tumors by analyzing population-based incidence patterns across various regions worldwide.Methods:In this article,we retrieved orbital malignancy data from the MEDLINE database and analyzed the incidence and prevalence of orbital malignancies worldwide.We performed the literature search by searching on the Mesh terms for malignant orbital tumors("orbital","tumor","lymphoma","malignant","cancer","incidence",and"epidemiology").All included studies were published between 1993 and 2023 and were written in English.Results:Ocular or ophthalmic lymphoma most frequently occurred in the orbit,with a prevalence ranging from 47%to 54%.The incidence of malignant orbital tumors was increasing in the USA 2.0 per million(1981–1993),Netherlands(0.86(1981–1985)to 2.49(2001–2005)per million)and South Korea(0.3–0.8 per million(1999–2016)),respectively.Ophthalmic lymphoma which includes orbit lymphoma was increasing in Canada(0.17–1.47 per million(1992–2010)),Denmark(0.86 per million(1981–1985)to 2.49 per million(2001–2005)),respectively.Conclusions:The predominant primary malignant orbital tumor in adults was lymphoma.Ocular or ophthalmic lymphoma most frequently occured in the orbit.The limited data available suggested an increasing trend in the incidence of malignant orbital tumors in each country included,which were mainly attributed to the increase in lymphoma.Generally,incidence rates were found to increase with advancing age,with no difference between males and females.
文摘Background:Intraocular malignant tumors represent a severe disease that threatens vision as well as life.To better extend the life of the patient,preserve visual function,and maintain ocular aesthetics,selecting the appropriate timing and methods of treatment becomes crucial.Main text:With the continuous advancement of medical technology,the techniques and methods for treating intraocular malignant tumors are constantly evolving.While surgery was once considered the optimal method to prolong patient survival and prevent local recurrence,the discovery and application of various treatments such as radiotherapy,laser therapy,chemotherapy,cryotherapy,and monoclonal antibodies have led to a greater di-versity of treatment options.This diversity offers more possibilities to develop personalized treatment plans,and thereby maximize patient benefit.This article reviews the various treatment methods for intraocular malignant tumors,including indications for treatment,outcomes,and potential complications.Conclusions:Differentiating small intraocular malignant tumors from pigmented lesions is challenging,and ongoing monitoring with regular follow-up is required.Small to medium-sized tumors can be treated with radiotherapy combined with transpupillary thermotherapy.Depending on the tumor's distance from the optic disc,surgery with partial resection may be considered for distant tumors,while proximal tumors may require complete enucleation.Systemic chemotherapy has been widely applied to patients with retinal tumors,lym-phomas,and intraocular metastatic cancers,but has limited efficacy in patients with choroidal melanoma.An-tagonists of Vascular Endothelial Growth Factor(Anti-VEGF)drugs can improve patient vision and quality of life,while the efficacy of immunotherapy and molecular targeted therapy is still under research.
文摘Objective:This study aims to identify research trends and hot spots in the treatment of Squamous Cell Carcinoma(SCC)over the past decade using bibliometric analysis.Methods:Data were extracted from the Web of Science Core Collection,including Science Citation Index Expanded(SCI-Expanded),Social Sciences Citation Index(SSCI),and Emerging Sources Citation Index(ESCI).The data underwent manual cleaning to remove inaccuracies and irrelevancies,followed by transformation into an analyzable format via the VOSviewer software.This tool facilitated the visualization of co-occurrence networks and keyword maps,highlighting the relationships and the prominence of research themes.Results:A total of 46448 authors from 7374 institutions across 108 countries contributed to the literature,reflecting a broad international effort.The study documented a consistent increase in SCC-related publications up to 2020,with some variability in subsequent years.Notably,the United States,Germany,China,the United Kingdom,and France were predominant in this research area.The University of Texas MD Anderson Cancer Center and the University of Pittsburgh were leading contributors in terms of publication volume and citation impact.Key journals included‘Oral Oncology’and‘Clinical Cancer Research’,which were central to the dissemination of high-impact research.Our keyword analysis identified three major research clusters focused on molecular mechanisms,clinical treatment strategies,and emerging interests in immunotherapeutic approaches.Conclusions:The extensive collaboration and the increasing publication trend underscore the growing global commitment to advancing SCC treatment.The high level of engagement from top institutions and the concentration of research in influential journals reflect the field's dynamic evolution towards innovative and effective treatment modalities.This study provides a valuable overview for researchers,guiding future studies towards areas of high impact and emerging trends in SCC treatment.The findings advocate for enhanced focus on personalized medicine and combination therapies,which are poised to improve outcomes for SCC patients.
基金supported by the State Scholarship Fund from China Scholarship Council(Nr.202108370094 to X.H.).
文摘Purpose:The most common intraocular cancer in adults is uveal melanoma(UM).This study aimed to investigate and report the incidence and prognosis of UM in different regions of the world.Methods:We retrieved relevant data on UM from the PubMed database and analyzed its global incidence and prognosis.All data was obtained from a national population-based registry,with publication dates ranging from 2013 to 2023.Results:The incidence rates of UM vary across different regions:in the United States,rates were 5.1 per million(1993–2008)and 5.2 per million(1973–2013);in Canada,rates ranged from 3.34 per million(1992–2010)to 5.09 per million(2011–2017);in Republic of Korea,the rate was 0.42 per million(1999–2011);in New Zealand,it was 5.56 per million(2000–2020);in Australia,it was 7.6 per million(1982–2014);and in Europe,rates ranged from 3.1 to 5.8 per million(1995–2002).Among European countries,Sweden(5.6 per million(1960–2009)),Germany(6.41 per million(2009–2015)),Poland(6.67 per million(2010–2017)),and the United Kingdom(10 per million(1999–2010)).Conclusions:The most common site of occurrence for UM is in the choroid.Limited data suggest a stable trend in UM incidence rates across the included countries,but significant differences in incidence rates exist among different countries and regions,with notably lower rates in Asian countries compared to Europe,North America,and Oceania.In general,the incidence rate in males is slightly higher compared to that in females.
