Publications by authors named "Luai Eldweik"

4 Publications

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Orbital infarction syndrome following hyaluronic acid filler rhinoplasty.

Authors:
Luai Eldweik

Am J Ophthalmol Case Rep 2021 Jun 18;22:101063. Epub 2021 Mar 18.

Eye Institute, Cleveland Clinic Abu Dhabi, C7-257 Swing Wing, Al Maryah Island, Abu Dhabi, 112412, United Arab Emirates.

Purpose: Over the last decade, injectable soft tissue fillers have become an essential part of facial plastic surgery practice. We report here a tragic complication of hyaluronic acid filler injection in a young healthy woman, management offered, and the outcome.

Observations: A 32-year-old woman developed unilateral acute blindness, orbital pain, total ophthalmoplegia, and anterior and posterior segment ischemia immediately following hyaluronic acid injection. Urgent measures were taken including hyaluronidase enzyme injection, vigorous messaging, and systemic steroids. Eight weeks later, the extraocular motility has fully recovered; however, the consequences of ischemia on the anterior and posterior ocular segments persisted.

Conclusions And Importance: Describing a major refractory complication following injecting hyaluronic acid dermal filler. Prompt intervention including the use retro or peribulbar injection of hyaluronidase has a little impact when it comes to reversing ocular sequalae. Therefore, injectors should be aware of facial danger zones that could potentially lead to this devastating outcome.
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http://dx.doi.org/10.1016/j.ajoc.2021.101063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020441PMC
June 2021

Retinal Nerve Fibre Layer Thickness Increases with Decreasing Spectralis OCT Signal Strength in Normal Eyes.

Neuroophthalmology 2020 Apr 29;44(2):100-103. Epub 2019 Oct 29.

Department of Ophthalmology & Visual Neurosciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

We sought to determine effect of signal strength on mean retinal nerve fibre layer (RNFL) using Spectralis optical coherence tomography (S-OCT). Thirty normal subjects (18 female, mean 37.9 years, range 24-61) were imaged with S-OCT using variably dense Bangerter foils to alter Q value (1 unit signal strength = 4 units Q). We found a statistically significant (p < 0.01) linear relationship (R = 0.8643) between Q and RNFL (1 unit decrease Q = 0.181 um mean RNFL increase). Unlike previous observations of Cirrus and Stratus OCT, we found RNFL thickness does not decrease with decreasing signal strength in S-OCT.
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http://dx.doi.org/10.1080/01658107.2019.1653934DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202426PMC
April 2020

Association between cycline antibiotic and development of pseudotumor cerebri syndrome.

J Am Acad Dermatol 2019 Aug 21;81(2):456-462. Epub 2019 Mar 21.

Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota. Electronic address:

Background: Cycline antibiotics (CAs) are commonly used to treat acne, blepharitis, and dry eye syndrome. Prescribers or patients may hesitate to use Cas because they may increase the risk of pseudotumor cerebri syndrome (PTCS).

Objective: We sought to assess whether CA use is associated with an increased risk of PTCS or papilledema and whether the risk depends upon dosage or duration of CA intake.

Methods: We studied patients 12 to 65 years of age who were diagnosed with acne, blepharitis, or dry eye syndrome, who were enrolled in a nationwide managed care network between January 1, 2001 and December 31, 2015, and who had no preexisting diagnosis of papilledema or PTCS. Multivariable Cox regression modeling was used to assess the risk of developing papilledema or PTCS from exposure to CAs.

Results: Among the 728,811 eligible enrollees (mean age, 34.7 years; 72% female), 42.0% filled ≥1 CA prescription. Of the 305,823 CA users, 170 (0.06%) were diagnosed with papilledema or PTCS. By comparison, of the 57.0% with no record of CA use, 121 (0.03%) were diagnosed with papilledema or PTCS (P < .0001). In the unadjusted model, every additional year of CA use was associated with a 70% (doxycycline: hazard ratio, 1.70 [95% confidence interval 0.98-2.97]; P = .06) or 91% (minocycline: hazard ratio, 1.91 [95% confidence interval 1.11-3.29]; P = .02) increased hazard of papilledema/PTCS relative to nonusers of CAs. After adjustment for confounders, the increased hazard of PTCS/papilledema with CA use was no longer statistically significant (P = .06, doxycycline; P = .08, minocycline).

Limitations: This study relies on claims data, which lack clinical data.

Conclusion: This study offers some evidence that CAs may increase the risk of PTCS/papilledema. However, after accounting for confounding factors in our multivariable models, we found no statistically significant association between CA use and the development of PTCS. Moreover, there was no dose-response effect whereby greater CA use was associated with a higher PTCS risk.
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http://dx.doi.org/10.1016/j.jaad.2019.03.041DOI Listing
August 2019

Role of VEGF Inhibition in the Treatment of Retinopathy of Prematurity.

Semin Ophthalmol 2016 ;31(1-2):163-8

a Department of Ophthalmology , Boston Children's Hospital, Harvard Medical School , Boston , Massachusetts , USA.

Retinopathy of prematurity (ROP) is a potentially blinding disease characterized by retinal neovascularization, which eventually can lead to tractional retinal detachment. Improvements have been made regarding the management of retinopathy of prematurity (ROP) since it was described in the Cryotherapy for Retinopathy of Prematurity study. A more appropriate time for therapeutic intervention was defined by the Early Treatment for Retinopathy of Prematurity (ETROP) trial. Advances in screening strategies with the use of digital imaging systems are now available. All of this and the use of laser photocoagulation and vitreoretinal surgery have contributed to significant increases in favorable outcomes and decreases in child blindness secondary to ROP. Recently the use of vascular endothelial growth factor (VEGF) inhibitors has been introduced to the armamentarium for the treatment of ROP. The purpose of this review article is to evaluate the role of VEGF inhibition in the treatment of ROP.
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http://dx.doi.org/10.3109/08820538.2015.1114847DOI Listing
October 2016
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