AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospecti...AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023.Patients were stratified into two subgroups:primary OA-DLBCL(no prior history of lymphoma)and secondary OA-DLBCL(history of DLBCL at non-ocular adnexal sites).OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause.Survival analysis was performed using the Kaplan–Meier method,and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.RESULTS:The cohort included 24 patients with primary OA-DLBCL(13 males,11 females;mean age:61.36±18.29y)and 5 patients with secondary OA-DLBCL(2 males,3 females;mean age:50.94±18.17y).Among the primary OA-DLBCL subgroup,12 patients(50%)presented with advanced disease(Ann Arbor stage IIIE–IV),and 16 patients(66%)were classified as T4 disease according to the tumor-node-metastasis(TNM)staging system.The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group.The 5-year OS rate for the entire cohort was 27.7%.Multivariate analysis identified five factors significantly associated with poor survival outcomes:epiphora[adjusted hazard ratio(aHR),36.95],atherosclerotic cardiovascular disease(aHR,10.08),human immunodeficiency virus(HIV)infection(aHR,12.47),M1 stage(aHR,6.99),and secondary OA-DLBCL(aHR,6.03;all P<0.05).The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.CONCLUSION:A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis.Epiphora,atherosclerotic cardiovascular disease,HIV infection,M1 stage,and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes.These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL,particularly in developing countries.展开更多
AIM:To evaluate the characteristics of exotropia(XT)and motor-sensory outcomes after surgical correction and to determine the factors associated with sensory outcomes of XT surgery.METHODS:The medical records of all p...AIM:To evaluate the characteristics of exotropia(XT)and motor-sensory outcomes after surgical correction and to determine the factors associated with sensory outcomes of XT surgery.METHODS:The medical records of all patients that were diagnosed with XT and underwent strabismus surgery in 13 major government hospitals in Thailand;from January 2012 to December 2019,were retrospectively reviewed.Univariable and multivariable logistic regression were performed to identify factors related to binocular vision.RESULTS:Data of five hundred and thirty-seven patients were analyzed.Two hundred and twenty-six patients were men(42.1%).The median age of onset was 3 years old[Interquartile range(IQR):1,8].The median age at diagnosis was 9.21 years old(IQR;4.64,21.06).intermittent exotropia[X(T)]was the most common type(52.1%);19.5%of the patients had amblyopia.For refractive error,spherical equivalent refraction on right eye(RE)and left eye(LE)were-0.53±2.45 diopters(D)(range-14.88 to+10 D)and-0.48±2.37 D(range-19.50 to+7.75 D),respectively.The mean angle of deviation at distance and near before surgery were 42.06±14.91 prism diopters(PD)and 40.81±16.09 PD,respectively.Follow-up time after first operation was 2.48±2.27y.Four hundred sixtytwo patients(86%)needed only one operation and 299(55.6%)patients had bilateral lateral rectus recession.At final visit,the mean angles of deviation at distance and near decreased to 5.76±8.96 PD and 5.01±8.73 PD,respectively.After surgery,two hundred seventy-three patients(50.8%)were evaluated for binocular function,but the others did not have result.From multivariable logistic regression in 273 patients,the factors related to better binocular function were type of XT which was X(T)[adjusted odds ratio(aOR)10.35;95%CI:4.73,22.66]compared to constant XT,without amblyopia(aOR 3.97;95%CI:1.84,8.53),underwent only single operation compared with more than 1 operation(aOR 3.80,95%CI:1.58,9.16),the angle of deviation at near in last visit less than 10 PD better than 10–30 PD with aOR 0.42(95%CI:0.18,0.96)and type of refraction revealed isometropia better than anisometropia with aOR 4.13(95%CI:1.19,14.32).CONCLUSION:The surgical outcomes of XT within one operation in Thailand is 86%.The factors related to achieve binocular function includes type of XT as X(T),without amblyopia,angle of deviation at final visit less than 10 PD,isometropia type of refraction and underwent only one surgical correction.展开更多
AIM:To compare the exposure rate,infection rate,percentage of enhancement,and success rate between Medpor and the three-dimensional printed polyethylene(3DP-PE)orbital implant in a preliminary report.METHODS:This pros...AIM:To compare the exposure rate,infection rate,percentage of enhancement,and success rate between Medpor and the three-dimensional printed polyethylene(3DP-PE)orbital implant in a preliminary report.METHODS:This prospective,randomized,equivalence,controlled trial was conducted at two institutes.The equivalent margin was±10%.The sample size for the equivalence trial was 174 participants per group.Patients who were eligible for enucleations received either Medpor or 3DP-PE implants based on a randomized block of six.The surgeries were performed by five oculoplastic surgeons.The assessor and patients were masked.The magnetic resonance imaging(MRI)of the orbit was performed at least 6mo after operation and the fibrovascular ingrowth was analyzed using the Image J software.Follow-up continued at least 1y after surgery.The intention to treat and per protocol approaches were used.RESULTS:Totally 128 patients met the criteria in the report.Fifty Medpor and 553DP-PE cases completed the trial.The most common cause of blindness was trauma.The mean follow-up times of Medpor and 3DP-PE were 33 and 40mo respectively.The exposure rate was not statistically significant between two groups(6.0%and 7.3%),P<0.05,95%CI(-9.8%,+12.0%).The success rates were 94%(Medpor)and 92.7%(3DP-PE).No postoperative infection was reported.Nine patients had MRI tests and two had implant exposures with 66.3% enhancement at 75mo(Medpor)and 58% enhancement at 57mo(3DP-PE)postoperatively.CONCLUSION:There is no statistically significant difference in exposure rate and success rate between Medpor and 3DP-PE in enucleation in the report.However,we cannot conclude that they are equivalent in terms of the exposure rate and success rate because the 95%CI is wider than±10%.The infection rate is equivalent in both groups.展开更多
基金Supported by the Faculty of Medicine,Prince of Songkla University.Wainipitapong S has received grants from the Faculty of Medicine,Prince of Songkla University。
文摘AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023.Patients were stratified into two subgroups:primary OA-DLBCL(no prior history of lymphoma)and secondary OA-DLBCL(history of DLBCL at non-ocular adnexal sites).OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause.Survival analysis was performed using the Kaplan–Meier method,and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.RESULTS:The cohort included 24 patients with primary OA-DLBCL(13 males,11 females;mean age:61.36±18.29y)and 5 patients with secondary OA-DLBCL(2 males,3 females;mean age:50.94±18.17y).Among the primary OA-DLBCL subgroup,12 patients(50%)presented with advanced disease(Ann Arbor stage IIIE–IV),and 16 patients(66%)were classified as T4 disease according to the tumor-node-metastasis(TNM)staging system.The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group.The 5-year OS rate for the entire cohort was 27.7%.Multivariate analysis identified five factors significantly associated with poor survival outcomes:epiphora[adjusted hazard ratio(aHR),36.95],atherosclerotic cardiovascular disease(aHR,10.08),human immunodeficiency virus(HIV)infection(aHR,12.47),M1 stage(aHR,6.99),and secondary OA-DLBCL(aHR,6.03;all P<0.05).The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.CONCLUSION:A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis.Epiphora,atherosclerotic cardiovascular disease,HIV infection,M1 stage,and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes.These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL,particularly in developing countries.
文摘AIM:To evaluate the characteristics of exotropia(XT)and motor-sensory outcomes after surgical correction and to determine the factors associated with sensory outcomes of XT surgery.METHODS:The medical records of all patients that were diagnosed with XT and underwent strabismus surgery in 13 major government hospitals in Thailand;from January 2012 to December 2019,were retrospectively reviewed.Univariable and multivariable logistic regression were performed to identify factors related to binocular vision.RESULTS:Data of five hundred and thirty-seven patients were analyzed.Two hundred and twenty-six patients were men(42.1%).The median age of onset was 3 years old[Interquartile range(IQR):1,8].The median age at diagnosis was 9.21 years old(IQR;4.64,21.06).intermittent exotropia[X(T)]was the most common type(52.1%);19.5%of the patients had amblyopia.For refractive error,spherical equivalent refraction on right eye(RE)and left eye(LE)were-0.53±2.45 diopters(D)(range-14.88 to+10 D)and-0.48±2.37 D(range-19.50 to+7.75 D),respectively.The mean angle of deviation at distance and near before surgery were 42.06±14.91 prism diopters(PD)and 40.81±16.09 PD,respectively.Follow-up time after first operation was 2.48±2.27y.Four hundred sixtytwo patients(86%)needed only one operation and 299(55.6%)patients had bilateral lateral rectus recession.At final visit,the mean angles of deviation at distance and near decreased to 5.76±8.96 PD and 5.01±8.73 PD,respectively.After surgery,two hundred seventy-three patients(50.8%)were evaluated for binocular function,but the others did not have result.From multivariable logistic regression in 273 patients,the factors related to better binocular function were type of XT which was X(T)[adjusted odds ratio(aOR)10.35;95%CI:4.73,22.66]compared to constant XT,without amblyopia(aOR 3.97;95%CI:1.84,8.53),underwent only single operation compared with more than 1 operation(aOR 3.80,95%CI:1.58,9.16),the angle of deviation at near in last visit less than 10 PD better than 10–30 PD with aOR 0.42(95%CI:0.18,0.96)and type of refraction revealed isometropia better than anisometropia with aOR 4.13(95%CI:1.19,14.32).CONCLUSION:The surgical outcomes of XT within one operation in Thailand is 86%.The factors related to achieve binocular function includes type of XT as X(T),without amblyopia,angle of deviation at final visit less than 10 PD,isometropia type of refraction and underwent only one surgical correction.
基金Supported by the Mettapracharak grantThai Government Budget grant+1 种基金Health Systems Research Institute grantNational Science and Technology Development Agency grant.
文摘AIM:To compare the exposure rate,infection rate,percentage of enhancement,and success rate between Medpor and the three-dimensional printed polyethylene(3DP-PE)orbital implant in a preliminary report.METHODS:This prospective,randomized,equivalence,controlled trial was conducted at two institutes.The equivalent margin was±10%.The sample size for the equivalence trial was 174 participants per group.Patients who were eligible for enucleations received either Medpor or 3DP-PE implants based on a randomized block of six.The surgeries were performed by five oculoplastic surgeons.The assessor and patients were masked.The magnetic resonance imaging(MRI)of the orbit was performed at least 6mo after operation and the fibrovascular ingrowth was analyzed using the Image J software.Follow-up continued at least 1y after surgery.The intention to treat and per protocol approaches were used.RESULTS:Totally 128 patients met the criteria in the report.Fifty Medpor and 553DP-PE cases completed the trial.The most common cause of blindness was trauma.The mean follow-up times of Medpor and 3DP-PE were 33 and 40mo respectively.The exposure rate was not statistically significant between two groups(6.0%and 7.3%),P<0.05,95%CI(-9.8%,+12.0%).The success rates were 94%(Medpor)and 92.7%(3DP-PE).No postoperative infection was reported.Nine patients had MRI tests and two had implant exposures with 66.3% enhancement at 75mo(Medpor)and 58% enhancement at 57mo(3DP-PE)postoperatively.CONCLUSION:There is no statistically significant difference in exposure rate and success rate between Medpor and 3DP-PE in enucleation in the report.However,we cannot conclude that they are equivalent in terms of the exposure rate and success rate because the 95%CI is wider than±10%.The infection rate is equivalent in both groups.
