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2,445 results on '"Selva, Dinesh"'

10. Predictive Modeling of New-Onset Postoperative Diplopia Following Orbital Decompression for Thyroid Eye Disease

Author

Nair, Archana A, Ediriwickrema, Lilangi S, Dolman, Peter J, Law, Geoffrey, Harrison, Andrew R, Mokhtarzadeh, Ali, Stewart, Krista, Men, Clara, Lucarelli, Mark J, van Landingham, Suzanne, Wingelaar, Maxwell, Verma, Rohan, Chen, Allison, Selva, Dinesh, Garrity, James, Eckel, Laurence, Kazim, Michael, Godfrey, Kyle, Baxter, Sally L, Korn, Bobby S, and Kikkawa, Don O

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Ophthalmology and Optometry, Clinical Research, Eye Disease and Disorders of Vision, Patient Safety, Prevention, Brain Disorders, Humans, Graves Ophthalmopathy, Retrospective Studies, Decompression, Surgical, Diplopia, Orbit, Treatment Outcome, Opthalmology and Optometry, Ophthalmology & Optometry, Ophthalmology and optometry
Abstract

PurposeTo identify risk factors for the development of new-onset, postoperative diplopia following orbital decompression surgery based on patient demographics, clinical exam characteristics, radiographic parameters, and surgical techniques.MethodsWe conducted a multi-center retrospective chart review of patients who underwent orbital decompression for thyroid eye disease (TED). Patient demographics, including age, gender, smoking history, preoperative exophthalmometry, clinical activity score (CAS), use of peribulbar and/or systemic steroids, and type of orbital decompression were reviewed. Postoperative diplopia was determined at a minimum of 3 months postoperatively and before any further surgeries. Cross-sectional area ratios of each extraocular muscle to orbit and total fat to orbit were calculated from coronal imaging in a standard fashion. All measurements were carried out using PACS imaging software. Multivariable logistic regression modeling was performed using Stata 14.2 (StataCorp, College Station, TX).ResultsA total of 331 patients without preoperative diplopia were identified. At 3 months postoperatively, 249 patients had no diplopia whereas 82 patients developed diplopia. The average postoperative follow-up was 22 months (range 3-156) months. Significant preoperative clinical risk factors for postoperative diplopia included older age at surgery, proptosis, use of peribulbar or systemic steroids, elevated clinical activity score, and presence of preoperative compressive optic neuropathy. Imaging findings of enlarged cross-sectional areas of each rectus muscle to the overall orbital area also conferred a significant risk of postoperative diplopia. Regarding surgical factors, postoperative diplopia was more common among those undergoing medial wall decompression, bilateral orbital surgery, and balanced decompression, whereas endoscopic medial wall decompression was found to be relatively protective.ConclusionsThis study identifies risk factors associated with the development of diplopia following orbital decompression using multivariable data. This study demonstrates that several characteristics including age, clinical activity score, the cross-sectional muscle to orbit ratios, in addition to the type of orbital decompression surgery, are predictive factors for the development of new-onset postoperative diplopia.

Published
2022

34. Orbital Multiple Myeloma

Author

Aujla, Jaskirat, Juniat, Valerie, Patel, Sandy, Selva, Dinesh, Ben Simon, Guy, editor, Greenberg, Gahl, editor, and Landau Prat, Daphna, editor

Published
2022
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35. Orbital Lymphoma

Author

Aujla, Jaskirat, Juniat, Valerie, Patel, Sandy, Selva, Dinesh, Ben Simon, Guy, editor, Greenberg, Gahl, editor, and Landau Prat, Daphna, editor

Published
2022
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45. Disseminated thrombosis of the internal jugular vein, superior ophthalmic vein and cavernous sinus as the primary manifestation of occult malignancy: a case report.

Author

Cameron, Cassie, Tong, Jessica Y., Patel, Sandy, Foreman, Andrew, and Selva, Dinesh

Subjects
COMPARTMENT syndrome, JUGULAR vein, CAVERNOUS sinus, SINUS thrombosis, MEDICAL drainage
Abstract

Internal jugular vein (IJV) thrombosis is a life-threatening condition most often associated with local risk factors such as head or neck infection or central venous catheterisation. Underlying malignancy is a rare but important aetiology to consider in patients presenting with spontaneous IJV thrombosis. We describe a case of necrotic cervical lymphadenopathy with thrombosis of the IJVs, cavernous sinuses and superior ophthalmic veins in a patient with metastatic squamous cell carcinoma, which was further complicated by an orbital compartment syndrome. The differential diagnosis of IJV thrombosis includes a range of infective, metastatic and thrombophilic pathologies. This case illustrates that, in the absence of an underlying precipitating factor, spontaneous IJV thrombosis should prompt further systemic investigations. Furthermore, patients with thrombotic events affecting the orbital venous drainage system should be monitored closely for signs of an acute orbital compartment syndrome. [ABSTRACT FROM AUTHOR]

Published
2024
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