BACKGROUND Lacrimal sac rhinosporidiosis,with nil or minor nasal extensions,rarely presents as an acquired cutaneous fistula in the periocular area.The correct diagnosis in such cases can be challenging,leading to rep...BACKGROUND Lacrimal sac rhinosporidiosis,with nil or minor nasal extensions,rarely presents as an acquired cutaneous fistula in the periocular area.The correct diagnosis in such cases can be challenging,leading to repeated failure of conservative or surgical interventions.CASE SUMMARY A 39-year-old female presented with a 6-year history of swelling in the periocular area,specifically in the left lacrimal sac area.Symptoms were limited to epiphora and constant mucoid discharge from the fistula,clinically mimicking chronic lacrimal sac fistula.She had a history of treatment with multiple antibiotic courses and dacryocystectomy in the past,with no or transient symptomatic relief.On surgical exploration of the site,a large pedunculated polypoidal vascular mass,suspicious of rhinosporidiosis,was noted.En bloc resection of the mass with cauterization of the base and fistulectomy was performed.Histopathology confirmed the diagnosis of lacrimal sac rhinosporidiosis.The patient was further evaluated and treated for the nasal extension of rhinosporidiosis.The patient has been frequently followed up for the last 3 years with a good clinical outcome and no recurrence.CONCLUSION Lacrimal sac rhinosporidiosis,in isolated or limited nasal extension cases,can rarely mimic a chronic discharging fistula.Patients with this disease often face distress due to misdiagnosis and repeated failure of conservative or surgical interventions.A high index of suspicion is needed for early diagnosis.Proper surgical intervention at the right time can lead to an excellent prognosis in such patients.展开更多
Basal cell carcinoma(BCC)is the most prevalent form of skin cancer in the world,primarily affecting sun-exposed areas,including the periocular region.When BCC occurs near the eyes,surgical treatment becomes uniquely c...Basal cell carcinoma(BCC)is the most prevalent form of skin cancer in the world,primarily affecting sun-exposed areas,including the periocular region.When BCC occurs near the eyes,surgical treatment becomes uniquely complex.Excess excisions may cause detrimental effects to eyelid function and undesirable aesthetic outcomes.Conversely,adequate resection must occur to prevent further disease progression.Mohs micrographic surgery(MMS),a technique offering high remission rates,is often employed for periocular BCC.This method allows for precise cancer removal while preserving as much healthy tissue as possible,balancing the need for both effective treatment and aesthetic and functional preservation.Following Mohs surgery of periocular BCC,reconstruction methods vary and can be tailored based on the size of the resection and the functional requirements of the affected tissue.Amongst these methods,primary closure with and without secondary intentions,direct margin repair,local flap closure and advance flap,Tenzel flap,tarso-conjunctival flap,periocular skin grafting,and structural grafting are commonly utilized and each has its advantages and limitations.In the future,advancements in synthetic flaps and stabilizing glues in the periocular region may provide additional tools for post-Mohs reconstruction.However,these emerging techniques require further research to establish efficacy and safety,especially in more complex and sensitive regions like the periocular tissues.The primary purpose of this review is to provide a comprehensive analysis of periocular reconstructive techniques following Mohs surgery,comparing their efficacy,functional outcomes,and aesthetic considerations while addressing recent advancements such as synthetic flaps and stabilizing glues to guide clinical decision-making.展开更多
Objective To examine the hyperglycemic effects of periocular dexamethasone injection in type 2 diabetic patients after vitreoretinal surgery （VRS）. Methods This was a retrospective non-randomized controlled trial. T...Objective To examine the hyperglycemic effects of periocular dexamethasone injection in type 2 diabetic patients after vitreoretinal surgery （VRS）. Methods This was a retrospective non-randomized controlled trial. Twenty consecutive hospitalized patients with type 2 diabetes and ocular inflammatory reaction after VRS were enrolled in this study. Ten patients received 2.5 mg dexamethasone and 10 patients received 5 mg dexamethasone. Fourteen consecutive type 2 diabetic patients without ocular inflammatory reaction after VRS were used as control group. We measured fasting blood glucose （FBG） and at 2 h after each meal （post prandial glucose, PBG; 09：00, 13：00, and 19：00 h） after periocular dexamethasone injection. Differences among three groups were determined by q tests. Results The PBG levels in both dexamethasone-treated groups started to increase within 5 h after injection （i.e., PBG at 13：00 h）, and were significantly increased at 29：00 h after injection （P〈0.05）. BG levels were almost 2-fold higher than at baseline and compared with the control group. The BG values declined gradually by 24 h to 48 h after injection. There were no differences in BG levels between the two dexamethasone-treated groups （P〉0.05）, except for PBG at 19：00 h on day 2 after injection （P〈0.05）. Conclusion Periocular dexamethasone injection can cause transient hyperglycemia in diabetic patients after VRS. BG monitoring should be performed following such injection.展开更多
For patients with metastatic or locally advanced eyelid and periocular carcinoma not amenable to surgical excision, targeted therapies have shown efficacy with better tolerability compared to cytotoxic chemotherapy. O...For patients with metastatic or locally advanced eyelid and periocular carcinoma not amenable to surgical excision, targeted therapies have shown efficacy with better tolerability compared to cytotoxic chemotherapy. Overexpression of epithelial growth factor receptor was found in squamous cell carcinomas. Vismodegib targets the mutation in the hedgehog pathway identified in basal cell carcinoma and basal cell nevus syndrome. Targeted therapies provide a novel and potentially effective treatment alternative for patients with eyelid carcinoma not amendable for surgery, including those with metastatic, locally advanced disease, advanced age, and significant comorbidities. High cost, need for long-term treatment, and toxicity are relative limitations.展开更多
Experts lack knowledge of periocular tuberculosis（TB） in China. Nested polymerase chain reaction（PCR） shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory featu...Experts lack knowledge of periocular tuberculosis（TB） in China. Nested polymerase chain reaction（PCR） shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory features of PCR-confirmed periocular TB. We retrospectively reviewed medical records of presumptive periocular TB and performed nested PCR test to confirm diagnosis. Nine cases were recruited. Clinical symptoms were chronic and insidious. Eight cases achieved favorable visual acuity, while one underwent enucleation due to fungalTB panophthalmitis. Sensitivity of caseous necrosis, acidfast bacilli（AFB） staining and interferon γ release assay（T-SPOT） test are 33.3%, 44.4% and 85.7% respectively. Low lymphocyte percentage（P=0.019） and high monocytelymphocyte ratio（P=0.042） positively correlate with AFB staining. Male gender（P=0.048） and Langhans giant cell（P=0.048） positively correlate with caseous necrosis. To conclude, traditional TB ancillary tests are not as sensitive as nested PCR technique. Several factors facilitate diagnosis including male gender, decreased lymphocytes, and typical Langhans giant cells.展开更多
The global pandemic of novel coronavirus that started in 2019 has ser-iously affected daily lives and placed everyone in a panic condition.Widespread coronavirus led to the adoption of social distancing and people avo...The global pandemic of novel coronavirus that started in 2019 has ser-iously affected daily lives and placed everyone in a panic condition.Widespread coronavirus led to the adoption of social distancing and people avoiding unneces-sary physical contact with each other.The present situation advocates the require-ment of a contactless biometric system that could be used in future authentication systems which makesfingerprint-based person identification ineffective.Periocu-lar biometric is the solution because it does not require physical contact and is able to identify people wearing face masks.However,the periocular biometric region is a small area,and extraction of the required feature is the point of con-cern.This paper has proposed adopted multiple features and emphasis on the periocular region.In the proposed approach,combination of local binary pattern(LBP),color histogram and features in frequency domain have been used with deep learning algorithms for classification.Hence,we extract three types of fea-tures for the classification of periocular regions for biometric.The LBP represents the textual features of the iris while the color histogram represents the frequencies of pixel values in the RGB channel.In order to extract the frequency domain fea-tures,the wavelet transformation is obtained.By learning from these features,a convolutional neural network(CNN)becomes able to discriminate the features and can provide better recognition results.The proposed approach achieved the highest accuracy rates with the lowest false person identification.展开更多
Since the outbreak of Coronavirus Disease 2019(COVID-19),people are recommended to wear facial masks to limit the spread of the virus.Under the circumstances,traditional face recognition technologies cannot achieve sa...Since the outbreak of Coronavirus Disease 2019(COVID-19),people are recommended to wear facial masks to limit the spread of the virus.Under the circumstances,traditional face recognition technologies cannot achieve satisfactory results.In this paper,we propose a face recognition algorithm that combines the traditional features and deep features of masked faces.For traditional features,we extract Local Binary Pattern(LBP),Scale-Invariant Feature Transform(SIFT)and Histogram of Oriented Gradient(HOG)features from the periocular region,and use the Support Vector Machines(SVM)classifier to perform personal identification.We also propose an improved Convolutional Neural Network(CNN)model Angular Visual Geometry Group Network(A-VGG)to learn deep features.Then we use the decision-level fusion to combine the four features.Comprehensive experiments were carried out on databases of real masked faces and simulated masked faces,including frontal and side faces taken at different angles.Images with motion blur were also tested to evaluate the robustness of the algorithm.Besides,the experiment of matching a masked face with the corresponding full face is accomplished.The experimental results show that the proposed algorithm has state-of-the-art performance in masked face recognition,and the periocular region has rich biological features and high discrimination.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
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
The gender recognition problem has attracted the attention of the computer vision community due to its importance in many applications(e.g.,sur-veillance and human–computer interaction[HCI]).Images of varying levels ...The gender recognition problem has attracted the attention of the computer vision community due to its importance in many applications(e.g.,sur-veillance and human–computer interaction[HCI]).Images of varying levels of illumination,occlusion,and other factors are captured in uncontrolled environ-ments.Iris and facial recognition technology cannot be used on these images because iris texture is unclear in these instances,and faces may be covered by a scarf,hijab,or mask due to the COVID-19 pandemic.The periocular region is a reliable source of information because it features rich discriminative biometric features.However,most existing gender classification approaches have been designed based on hand-engineered features or validated in controlled environ-ments.Motivated by the superior performance of deep learning,we proposed a new method,PeriGender,inspired by the design principles of the ResNet and DenseNet models,that can classify gender using features from the periocular region.The proposed system utilizes a dense concept in a residual model.Through skip connections,it reuses features on different scales to strengthen dis-criminative features.Evaluations of the proposed system on challenging datasets indicated that it outperformed state-of-the-art methods.It achieved 87.37%,94.90%,94.14%,99.14%,and 95.17%accuracy on the GROUPS,UFPR-Periocular,Ethnic-Ocular,IMP,and UBIPr datasets,respectively,in the open-world(OW)protocol.It further achieved 97.57%and 93.20%accuracy for adult periocular images from the GROUPS dataset in the closed-world(CW)and OW protocols,respectively.The results showed that the middle region between the eyes plays a crucial role in the recognition of masculine features,and feminine features can be identified through the eyebrow,upper eyelids,and corners of the eyes.Furthermore,using a whole region without cropping enhances PeriGender’s learning capability,improving its understanding of both eyes’global structure without discontinuity.展开更多
Approximately 5 to 10 percent of all skin cancers occur in the periocular region. Basal cell carcinoma is the most frequent malignant periocular tumor, followed by squamous cell carcinoma, sebaceous gland carcinoma, a...Approximately 5 to 10 percent of all skin cancers occur in the periocular region. Basal cell carcinoma is the most frequent malignant periocular tumor, followed by squamous cell carcinoma, sebaceous gland carcinoma, and malignant melanoma. Nonmelanoma skin tumors at the periocular area often cause disfigurement with destruction of soft conjunctival tissue. Many therapeutic methods have been recommended to combat the morbidity and mortality associated with these lesions. Excisions with frozen-section control or Mohs micrographic surgery are regarded as the gold-standard treatments for periocular basal cell and squamous cell carcinomas. However, these treatment modalities have various limitations and reconstruction surgery is often associated with these treatment options. The chemotherapeutic agents solasodine rhamnosides in a cream formulation CuradermBEC5 are specific, effective and safe treatments for nonmelanoma skin cancers with excellent cosmesis. The antineoplastic mode of action is by apoptosis. In this review it is shown that CuradermBEC5 also treats periocular basal cell carcinoma and squamous cell carcinoma with impressive cosmetic outcomes and no reconstructive surgery is required.展开更多
Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechan...Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechanisms of pathogenesis of COVID-19 infection and necrotising superinfections.Case Description:A 33-year-old previously healthy female presented with right-sided progressive periocular swelling,erythema,pain and fever,two days after sustaining a laceration to the right superolateral brow from a clenched fist.She had a concurrent COVID-19 infection,detected on nasopharyngeal polymerase chain reaction swab thirteen days prior to presentation and again at presentation.She did not have an oxygen requirement.There was a large bulbous collection of the right upper lid with fluctuance and overlying erythema,and a communicating sinus drained frank pus from the superolateral brow.Pre-operative T2-weighted MRI demonstrated fascial hyperintensity involving the pre-septal tissues and extending to the anterior temporal fossa.She was commenced on intravenous meropenem,clindamycin and vancomycin,and underwent early surgical debridement.Initial debridement demonstrated right upper lid necrosis involving the dermal and pre-septal layers,including the orbicularis,but sparing the tarsus.Streptococcus pyogenes was isolated,and she was continued on a prolonged course of intravenous antibiotic.Periocular defects were repaired with a right-sided brow adipo-fascial flap based on the supratrochlear artery,browpexy and dual full thickness skin grafts on the right upper lid and flap.Conclusions:NF is an acute fulminant infection rarely affecting the periocular tissues.This represents a unique case of periocular NF associated with a concurrent COVID-19 infection.展开更多
Background:Basal cell carcinoma(BCC)accounts for 90%of the eyelid malignancies followed by sebaceous cell carcinoma(SC)and squamous cell carcinoma(SCC).Even though biopsy for histopathological(HP)evaluation remains th...Background:Basal cell carcinoma(BCC)accounts for 90%of the eyelid malignancies followed by sebaceous cell carcinoma(SC)and squamous cell carcinoma(SCC).Even though biopsy for histopathological(HP)evaluation remains the gold standard for confirming the diagnosis of eyelid tumors and the status of surgical margins,noninvasive techniques such as dermoscopy and optical coherence tomography(OCT)may increase diagnostic sensitivity and contribute to more accurate delineation of surgical margins.The purpose of this prospective study was to correlate the HP and OCT findings of eyelid malignancies.Methods:After ethics committee approval(BCC/2017-2608),patients with suspected eyelid carcinomas had photographs taken,tumor characteristics assessed clinically and using dermoscopy and OCT,which were subsequently compared with HP evaluation.We obtained OCT images of periorbital tumors with an anterior segment lens adjusted in an Optovue Avanti.The histopathology was evaluated using a digital pathology system.Patients under 18 years old were excluded from this study.Results:Three female and three male patients(age 69-88 years)with lesions located in the lower periorbital area(n=5)and upper eyelid(n=1)were included in this study.Two participants previously had skin cancer:1 female patient had a lentigo maligna and a BCC,and 1 male patient had multiple BCC and actinic keratosis due to immunosuppression related to a liver transplant.Clinical and dermoscopicc diagnosis were accurate in four cases:3 BCC and 1 SCC.One clinically suspicious BCC was diagnosed as SC and one patient had a previous confirmed diagnosis of SC.All OCT images showed disruption of the dermoepidermal junction and hyporeflective areas in the dermis,which were darker and well-delineated in the three confirmed BCCs.OCT also clearly demarcated the transition between tumor and normal skin in all cases.Conclusions:OCT is a fast and non-invasive exam to acquire high-resolution images of intraocular and ocular surface structures.Preliminary data from our study indicates that real-time OCT images correlate with HP findings and may also help delineate tumor margins.The inclusion of additional participants will provide further evidence of the benefits of using OCT pre-operatively to safely minimize surgical margins during eyelid tumor excision.展开更多
Objective To investigate the clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment.Methods The clinical effect of botulinum type A injectio...Objective To investigate the clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment.Methods The clinical effect of botulinum type A injection alone and botulinum type A injection combined with low-energy CO2 fractional laser was compared in 96 patients who needed to receive periocular rejuvenation treatment from April 2018 to April 2019.Results After the combined low-energy CO2 fractional laser treatment was given on the basis of botulinum toxin type A injection,the follow-up global aesthetic improvement scale(GAIS)scores of the observation group were 86.78±4.67,80.31±3.66,76.94±4.03 and 40.59±4.78.The global aesthetic improvement of the dynamic and static wrinkles was obvious.The total effective rate was 93.7%.The total satisfaction rate of the patients was 95.8%,which was higher than that of the control group(P<0.05).The clinical efficacy was significant.Conclusion The application of the combined periocular rejuvenation treatment can improve the dynamic and static wrinkles simultaneously with remarkable rejuvenation effect,increase the effective rate of treatment and enhance the patients'satisfaction.展开更多
文摘BACKGROUND Lacrimal sac rhinosporidiosis,with nil or minor nasal extensions,rarely presents as an acquired cutaneous fistula in the periocular area.The correct diagnosis in such cases can be challenging,leading to repeated failure of conservative or surgical interventions.CASE SUMMARY A 39-year-old female presented with a 6-year history of swelling in the periocular area,specifically in the left lacrimal sac area.Symptoms were limited to epiphora and constant mucoid discharge from the fistula,clinically mimicking chronic lacrimal sac fistula.She had a history of treatment with multiple antibiotic courses and dacryocystectomy in the past,with no or transient symptomatic relief.On surgical exploration of the site,a large pedunculated polypoidal vascular mass,suspicious of rhinosporidiosis,was noted.En bloc resection of the mass with cauterization of the base and fistulectomy was performed.Histopathology confirmed the diagnosis of lacrimal sac rhinosporidiosis.The patient was further evaluated and treated for the nasal extension of rhinosporidiosis.The patient has been frequently followed up for the last 3 years with a good clinical outcome and no recurrence.CONCLUSION Lacrimal sac rhinosporidiosis,in isolated or limited nasal extension cases,can rarely mimic a chronic discharging fistula.Patients with this disease often face distress due to misdiagnosis and repeated failure of conservative or surgical interventions.A high index of suspicion is needed for early diagnosis.Proper surgical intervention at the right time can lead to an excellent prognosis in such patients.
文摘Basal cell carcinoma(BCC)is the most prevalent form of skin cancer in the world,primarily affecting sun-exposed areas,including the periocular region.When BCC occurs near the eyes,surgical treatment becomes uniquely complex.Excess excisions may cause detrimental effects to eyelid function and undesirable aesthetic outcomes.Conversely,adequate resection must occur to prevent further disease progression.Mohs micrographic surgery(MMS),a technique offering high remission rates,is often employed for periocular BCC.This method allows for precise cancer removal while preserving as much healthy tissue as possible,balancing the need for both effective treatment and aesthetic and functional preservation.Following Mohs surgery of periocular BCC,reconstruction methods vary and can be tailored based on the size of the resection and the functional requirements of the affected tissue.Amongst these methods,primary closure with and without secondary intentions,direct margin repair,local flap closure and advance flap,Tenzel flap,tarso-conjunctival flap,periocular skin grafting,and structural grafting are commonly utilized and each has its advantages and limitations.In the future,advancements in synthetic flaps and stabilizing glues in the periocular region may provide additional tools for post-Mohs reconstruction.However,these emerging techniques require further research to establish efficacy and safety,especially in more complex and sensitive regions like the periocular tissues.The primary purpose of this review is to provide a comprehensive analysis of periocular reconstructive techniques following Mohs surgery,comparing their efficacy,functional outcomes,and aesthetic considerations while addressing recent advancements such as synthetic flaps and stabilizing glues to guide clinical decision-making.
文摘Objective To examine the hyperglycemic effects of periocular dexamethasone injection in type 2 diabetic patients after vitreoretinal surgery （VRS）. Methods This was a retrospective non-randomized controlled trial. Twenty consecutive hospitalized patients with type 2 diabetes and ocular inflammatory reaction after VRS were enrolled in this study. Ten patients received 2.5 mg dexamethasone and 10 patients received 5 mg dexamethasone. Fourteen consecutive type 2 diabetic patients without ocular inflammatory reaction after VRS were used as control group. We measured fasting blood glucose （FBG） and at 2 h after each meal （post prandial glucose, PBG; 09：00, 13：00, and 19：00 h） after periocular dexamethasone injection. Differences among three groups were determined by q tests. Results The PBG levels in both dexamethasone-treated groups started to increase within 5 h after injection （i.e., PBG at 13：00 h）, and were significantly increased at 29：00 h after injection （P〈0.05）. BG levels were almost 2-fold higher than at baseline and compared with the control group. The BG values declined gradually by 24 h to 48 h after injection. There were no differences in BG levels between the two dexamethasone-treated groups （P〉0.05）, except for PBG at 19：00 h on day 2 after injection （P〈0.05）. Conclusion Periocular dexamethasone injection can cause transient hyperglycemia in diabetic patients after VRS. BG monitoring should be performed following such injection.
文摘For patients with metastatic or locally advanced eyelid and periocular carcinoma not amenable to surgical excision, targeted therapies have shown efficacy with better tolerability compared to cytotoxic chemotherapy. Overexpression of epithelial growth factor receptor was found in squamous cell carcinomas. Vismodegib targets the mutation in the hedgehog pathway identified in basal cell carcinoma and basal cell nevus syndrome. Targeted therapies provide a novel and potentially effective treatment alternative for patients with eyelid carcinoma not amendable for surgery, including those with metastatic, locally advanced disease, advanced age, and significant comorbidities. High cost, need for long-term treatment, and toxicity are relative limitations.
基金Supported by National Natural Science Foundation of China (No.81800867)
文摘Experts lack knowledge of periocular tuberculosis（TB） in China. Nested polymerase chain reaction（PCR） shows advantages in diagnosis of extrapulmonary TB. Our study aims to explore the clinical and laboratory features of PCR-confirmed periocular TB. We retrospectively reviewed medical records of presumptive periocular TB and performed nested PCR test to confirm diagnosis. Nine cases were recruited. Clinical symptoms were chronic and insidious. Eight cases achieved favorable visual acuity, while one underwent enucleation due to fungalTB panophthalmitis. Sensitivity of caseous necrosis, acidfast bacilli（AFB） staining and interferon γ release assay（T-SPOT） test are 33.3%, 44.4% and 85.7% respectively. Low lymphocyte percentage（P=0.019） and high monocytelymphocyte ratio（P=0.042） positively correlate with AFB staining. Male gender（P=0.048） and Langhans giant cell（P=0.048） positively correlate with caseous necrosis. To conclude, traditional TB ancillary tests are not as sensitive as nested PCR technique. Several factors facilitate diagnosis including male gender, decreased lymphocytes, and typical Langhans giant cells.
文摘The global pandemic of novel coronavirus that started in 2019 has ser-iously affected daily lives and placed everyone in a panic condition.Widespread coronavirus led to the adoption of social distancing and people avoiding unneces-sary physical contact with each other.The present situation advocates the require-ment of a contactless biometric system that could be used in future authentication systems which makesfingerprint-based person identification ineffective.Periocu-lar biometric is the solution because it does not require physical contact and is able to identify people wearing face masks.However,the periocular biometric region is a small area,and extraction of the required feature is the point of con-cern.This paper has proposed adopted multiple features and emphasis on the periocular region.In the proposed approach,combination of local binary pattern(LBP),color histogram and features in frequency domain have been used with deep learning algorithms for classification.Hence,we extract three types of fea-tures for the classification of periocular regions for biometric.The LBP represents the textual features of the iris while the color histogram represents the frequencies of pixel values in the RGB channel.In order to extract the frequency domain fea-tures,the wavelet transformation is obtained.By learning from these features,a convolutional neural network(CNN)becomes able to discriminate the features and can provide better recognition results.The proposed approach achieved the highest accuracy rates with the lowest false person identification.
基金Supported by the Postgraduate Research and Practice Innovation Program of Nanjing University of Aeronautics and Astronautics(XCXJH20220318)。
文摘Since the outbreak of Coronavirus Disease 2019(COVID-19),people are recommended to wear facial masks to limit the spread of the virus.Under the circumstances,traditional face recognition technologies cannot achieve satisfactory results.In this paper,we propose a face recognition algorithm that combines the traditional features and deep features of masked faces.For traditional features,we extract Local Binary Pattern(LBP),Scale-Invariant Feature Transform(SIFT)and Histogram of Oriented Gradient(HOG)features from the periocular region,and use the Support Vector Machines(SVM)classifier to perform personal identification.We also propose an improved Convolutional Neural Network(CNN)model Angular Visual Geometry Group Network(A-VGG)to learn deep features.Then we use the decision-level fusion to combine the four features.Comprehensive experiments were carried out on databases of real masked faces and simulated masked faces,including frontal and side faces taken at different angles.Images with motion blur were also tested to evaluate the robustness of the algorithm.Besides,the experiment of matching a masked face with the corresponding full face is accomplished.The experimental results show that the proposed algorithm has state-of-the-art performance in masked face recognition,and the periocular region has rich biological features and high discrimination.
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.
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.
基金The authors are thankful to the Deanship of Scientific Research,King Saud University,Riyadh,Saudi Arabia for funding this work through the Research Group No.RGP-1439-067.
文摘The gender recognition problem has attracted the attention of the computer vision community due to its importance in many applications(e.g.,sur-veillance and human–computer interaction[HCI]).Images of varying levels of illumination,occlusion,and other factors are captured in uncontrolled environ-ments.Iris and facial recognition technology cannot be used on these images because iris texture is unclear in these instances,and faces may be covered by a scarf,hijab,or mask due to the COVID-19 pandemic.The periocular region is a reliable source of information because it features rich discriminative biometric features.However,most existing gender classification approaches have been designed based on hand-engineered features or validated in controlled environ-ments.Motivated by the superior performance of deep learning,we proposed a new method,PeriGender,inspired by the design principles of the ResNet and DenseNet models,that can classify gender using features from the periocular region.The proposed system utilizes a dense concept in a residual model.Through skip connections,it reuses features on different scales to strengthen dis-criminative features.Evaluations of the proposed system on challenging datasets indicated that it outperformed state-of-the-art methods.It achieved 87.37%,94.90%,94.14%,99.14%,and 95.17%accuracy on the GROUPS,UFPR-Periocular,Ethnic-Ocular,IMP,and UBIPr datasets,respectively,in the open-world(OW)protocol.It further achieved 97.57%and 93.20%accuracy for adult periocular images from the GROUPS dataset in the closed-world(CW)and OW protocols,respectively.The results showed that the middle region between the eyes plays a crucial role in the recognition of masculine features,and feminine features can be identified through the eyebrow,upper eyelids,and corners of the eyes.Furthermore,using a whole region without cropping enhances PeriGender’s learning capability,improving its understanding of both eyes’global structure without discontinuity.
文摘Approximately 5 to 10 percent of all skin cancers occur in the periocular region. Basal cell carcinoma is the most frequent malignant periocular tumor, followed by squamous cell carcinoma, sebaceous gland carcinoma, and malignant melanoma. Nonmelanoma skin tumors at the periocular area often cause disfigurement with destruction of soft conjunctival tissue. Many therapeutic methods have been recommended to combat the morbidity and mortality associated with these lesions. Excisions with frozen-section control or Mohs micrographic surgery are regarded as the gold-standard treatments for periocular basal cell and squamous cell carcinomas. However, these treatment modalities have various limitations and reconstruction surgery is often associated with these treatment options. The chemotherapeutic agents solasodine rhamnosides in a cream formulation CuradermBEC5 are specific, effective and safe treatments for nonmelanoma skin cancers with excellent cosmesis. The antineoplastic mode of action is by apoptosis. In this review it is shown that CuradermBEC5 also treats periocular basal cell carcinoma and squamous cell carcinoma with impressive cosmetic outcomes and no reconstructive surgery is required.
文摘Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechanisms of pathogenesis of COVID-19 infection and necrotising superinfections.Case Description:A 33-year-old previously healthy female presented with right-sided progressive periocular swelling,erythema,pain and fever,two days after sustaining a laceration to the right superolateral brow from a clenched fist.She had a concurrent COVID-19 infection,detected on nasopharyngeal polymerase chain reaction swab thirteen days prior to presentation and again at presentation.She did not have an oxygen requirement.There was a large bulbous collection of the right upper lid with fluctuance and overlying erythema,and a communicating sinus drained frank pus from the superolateral brow.Pre-operative T2-weighted MRI demonstrated fascial hyperintensity involving the pre-septal tissues and extending to the anterior temporal fossa.She was commenced on intravenous meropenem,clindamycin and vancomycin,and underwent early surgical debridement.Initial debridement demonstrated right upper lid necrosis involving the dermal and pre-septal layers,including the orbicularis,but sparing the tarsus.Streptococcus pyogenes was isolated,and she was continued on a prolonged course of intravenous antibiotic.Periocular defects were repaired with a right-sided brow adipo-fascial flap based on the supratrochlear artery,browpexy and dual full thickness skin grafts on the right upper lid and flap.Conclusions:NF is an acute fulminant infection rarely affecting the periocular tissues.This represents a unique case of periocular NF associated with a concurrent COVID-19 infection.
文摘Background:Basal cell carcinoma(BCC)accounts for 90%of the eyelid malignancies followed by sebaceous cell carcinoma(SC)and squamous cell carcinoma(SCC).Even though biopsy for histopathological(HP)evaluation remains the gold standard for confirming the diagnosis of eyelid tumors and the status of surgical margins,noninvasive techniques such as dermoscopy and optical coherence tomography(OCT)may increase diagnostic sensitivity and contribute to more accurate delineation of surgical margins.The purpose of this prospective study was to correlate the HP and OCT findings of eyelid malignancies.Methods:After ethics committee approval(BCC/2017-2608),patients with suspected eyelid carcinomas had photographs taken,tumor characteristics assessed clinically and using dermoscopy and OCT,which were subsequently compared with HP evaluation.We obtained OCT images of periorbital tumors with an anterior segment lens adjusted in an Optovue Avanti.The histopathology was evaluated using a digital pathology system.Patients under 18 years old were excluded from this study.Results:Three female and three male patients(age 69-88 years)with lesions located in the lower periorbital area(n=5)and upper eyelid(n=1)were included in this study.Two participants previously had skin cancer:1 female patient had a lentigo maligna and a BCC,and 1 male patient had multiple BCC and actinic keratosis due to immunosuppression related to a liver transplant.Clinical and dermoscopicc diagnosis were accurate in four cases:3 BCC and 1 SCC.One clinically suspicious BCC was diagnosed as SC and one patient had a previous confirmed diagnosis of SC.All OCT images showed disruption of the dermoepidermal junction and hyporeflective areas in the dermis,which were darker and well-delineated in the three confirmed BCCs.OCT also clearly demarcated the transition between tumor and normal skin in all cases.Conclusions:OCT is a fast and non-invasive exam to acquire high-resolution images of intraocular and ocular surface structures.Preliminary data from our study indicates that real-time OCT images correlate with HP findings and may also help delineate tumor margins.The inclusion of additional participants will provide further evidence of the benefits of using OCT pre-operatively to safely minimize surgical margins during eyelid tumor excision.
文摘Objective To investigate the clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment.Methods The clinical effect of botulinum type A injection alone and botulinum type A injection combined with low-energy CO2 fractional laser was compared in 96 patients who needed to receive periocular rejuvenation treatment from April 2018 to April 2019.Results After the combined low-energy CO2 fractional laser treatment was given on the basis of botulinum toxin type A injection,the follow-up global aesthetic improvement scale(GAIS)scores of the observation group were 86.78±4.67,80.31±3.66,76.94±4.03 and 40.59±4.78.The global aesthetic improvement of the dynamic and static wrinkles was obvious.The total effective rate was 93.7%.The total satisfaction rate of the patients was 95.8%,which was higher than that of the control group(P<0.05).The clinical efficacy was significant.Conclusion The application of the combined periocular rejuvenation treatment can improve the dynamic and static wrinkles simultaneously with remarkable rejuvenation effect,increase the effective rate of treatment and enhance the patients'satisfaction.
