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Exp Ther Med 2021 Jun 19;21(6):650. Epub 2021 Apr 19.

Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion 71003, Greece.

Pseudoexfoliation syndrome (PEX) is characterized by the deposition of proteinaceous material in the anterior ocular segment (resulting in ophthalmic pathologies such as glaucoma and increased risk of complications in cataract surgery), but also by several systemic manifestations. The involvement of peri-ocular tissues in PEX, including the eyelid skin, lacrimal gland, conjunctiva, orbital fat and vessels, as well as the optic nerve, has been reported by several previous studies. The peri-ocular effects of PEX include the development of eyelid laxity, conjunctival chalasis, tear film abnormalities, pronounced orbital fat atrophy in response to the administration of prostaglandin analogues in pseudoexfoliative glaucoma, deficient orbital vascular supply and biomechanical changes in both the eyeball and the optic nerve. Read More

Ocul Immunol Inflamm 2021 May 4:1-8. Epub 2021 May 4.

Institute of Anatomy, Department of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.

: The meibomian glands are located in the tarsal plate of the upper and lower eyelid and are responsible for the production of a lipid-rich secretion, the meibum, which forms the outer component of the tear film. Meibomian gland dysfunction results in excessive evaporation of the tear film and is the leading cause of dry eye disease (DED). Despite the high prevalence of DED, the etiology of meibomian gland dysfunction is only basically understood. Read More

Med Clin North Am 2021 May 2;105(3):551-562. Epub 2021 Apr 2.

Department of Ophthalmology, University of Washington School of Medicine, Box 359608, 325 9th Avenue, Seattle, WA 98104, USA.

The eyelids and orbit encompass intricate bony and soft tissue structures that work harmoniously in concert to protect, support, and nourish the eye in order to facilitate and maintain its function. Insult to periorbital and orbital anatomy can compromise orbital and ocular homeostasis. This article provides a foundational overview of eyelid and orbital anatomy, as well as common and key disorders that may confront internists and medical subspecialists. Read More

Indian J Ophthalmol 2021 May;69(5):1150-1154

Department of Anatomy, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province; Dalian Hoffen Preservation Technique Institution, No. 36, Guangyuan Street, Lushunkou Economic Development Zone, Dalian, China.

Purpose: Ocular suspensory ligament is an important part of the lower eyelid retractors. However, there is a scarcity of studies examining detailed en-block histologies of ocular suspensory ligaments.

Methods: In this study, we included the cadavers of Chinese adults as subjects. Read More

Ann Dermatol 2021 Feb 30;33(1):52-60. Epub 2020 Dec 30.

Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Background: Understanding the age-related morphological changes of facial soft tissue is fundamental in achieving improved outcomes of rejuvenating procedures. Three-dimensional (3D) photogrammetry is a reliable and convenient anthropometric tool to assess facial soft tissue.

Objective: The aim of this study was to establish age-related facial soft tissue morphology in Korean adult females using non-invasive 3D photogrammetry. Read More

Facial Plast Surg Clin North Am 2021 May 24;29(2):335-348. Epub 2021 Apr 24.

University of Puerto Rico School of Medicine, Medical Sciences Campus, PO BOX 365067, San Juan, PR 00936, USA.

A retrospective observational case study and a literature review were conducted to evaluate how anatomic findings, especially those related to the periorbital zone, serve as a guiding compass for injectable implants. Treatment techniques and product selection will be discussed for patients with negative vector, shallow orbit, and deep set eyes. Versatility of injectables will be demonstrated on patients with peanut face, iatrogenically altered anatomy (after surgery), and trauma. Read More

Facial Plast Surg Clin North Am 2021 May 24;29(2):311-321. Epub 2021 Apr 24.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Electronic address:

Globe prominence (proptosis) may be caused by a variety of congenital or acquired conditions and poses unique challenges to aesthetic and reconstructive surgery. Once the underlying cause of proptosis is determined, a treatment plan consisting of surgical and medical procedures can be formed. Thyroid eye disease is the most common cause of proptosis and helps guide treatment options for proptosis. Read More

Facial Plast Surg Clin North Am 2021 May 24;29(2):301-309. Epub 2021 Apr 24.

Oculofacial Plastic Surgery, Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Electronic address:

Festoons represent a combination of fluid accumulation and soft tissue laxity in the superolateral cheek. They remain a difficult entity to treat. The ideal treatment for festoons would possess minimal invasiveness and recovery time, and predictably improve the condition. Read More

Facial Plast Surg Clin North Am 2021 May 24;29(2):275-289. Epub 2021 Apr 24.

Beverly Hills Ophthalmic Plastic and Reconstructive Surgery, 150 North Robertson Boulevard #314, Beverly Hills, CA 90211, USA; Department of Plastic Surgery, Division of Oculoplastic Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA; Department of Ophthalmology, Division of Oculoplastic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address:

Aesthetic canthal suspension can be an effective adjunct to lower eyelid blepharoplasty. Understanding the anatomy and function of the lateral canthal tendon is critical for preoperative evaluation and surgical decision making. In this article, the authors discuss the lateral canthal terminology, anatomy, and aging changes. Read More

Facial Plast Surg Clin North Am 2021 May 24;29(2):209-228. Epub 2021 Apr 24.

Department of Otolaryngology-Head & Neck Surgery, Division of Facial Plastic Surgery, Albert Einstein College of Medicine, New York, NY, USA; Department of Facial Plastic and Reconstructive Surgery, Northwell Health (North Shore LIJ), Manhasset, NY, USA. Electronic address:

The aging appearance of the lower eyelids is multifactorial, involving changes in the skin, orbital fat, orbicularis muscle, soft tissue of the midface, and tear trough. The extent of these changes differs in each case and happens in a background of volume loss that occurs with facial aging. We present the indications, advantages, and technique for volumizing transcutaneous lower blepharoplasty with fat transposition. Read More

Facial Plast Surg Clin North Am 2021 May 24;29(2):155-162. Epub 2021 Apr 24.

Roxbury Institute, Beverly Hills, CA, USA; Roseville Facial Plastic Surgery, Roseville, CA, USA.

The anatomy of the eyelids and periorbital region is delicate. The individual anatomic variations determine each person's eyelid appearance and function. It is essential that every surgeon that evaluates and treats the aesthetic conditions of patients desiring periorbital enhancement understands the association of anatomy and diagnosis. Read More

World Neurosurg 2021 Apr 17;151. Epub 2021 Apr 17.

Department of Otorhinolaryngology-Head and Neck Surgery, ASST Sette Laghi, Varese, Italy.

In recent decades, the ever-expanding use of endoscopes and development of dedicated instrumentation have reshaped the panorama of surgical approaches to the frontal sinus. Nonetheless, the far lateral portion of the sinus might still represent a concern, especially in cases with unfavorable or distorted anatomy. We report the case of a 52-year-old man, referred to our department for recurrent episodes of left orbital swelling and supraorbital headache, 3 months after Draf III frontal sinusotomy for marsupialization of multiple frontal mucoceles. Read More

PLoS One 2021 19;16(4):e0249368. Epub 2021 Apr 19.

Department of Biostructure and Animal Physiology, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Wroclaw, Poland.

In this study, we present the first data concerning the anatomical, morphometrical, histological and histochemical study of the orbit, eye tunics, eyelids and orbital glands in South African Painted Dogs (Lycaon pictus pictus). The study was performed using eyeball morphometry, analysis of the bony orbit including its morphometry, macroscopic study, morphometry, histological examination of the eye tunics and chosen accessory organs of the eye and histochemical analysis. The orbit was funnel shaped and was open-type. Read More

J Med Case Rep 2021 Apr 19;15(1):179. Epub 2021 Apr 19.

Department of Dermatology, The Affiliated Hospital, Guizhou Medical University, Beijing Road 4, Yunyan District, Guiyang, China.

Background: Classic Kaposi sarcoma (CKS) is a vascular sarcoma associated with human herpesvirus 8 (HHV-8), which is known to be more common in Mediterranean elderly men and is characterized by indolent clinical behavior. Xinjiang province in China is considered an endemic region for Kaposi's sarcoma-associated herpesvirus (KSHV), with higher incidence among adults of Kazak and Uyghur ethnicities. Cases of CKS are rarely reported in inland China. Read More

Medicine (Baltimore) 2021 Apr;100(14):e25062

Department of Ophthalmology, Osaka Medical College, Osaka, Japan.

Rationale: Enlargemento of the medial rectus is the most predominant factor of compressive optic neuropathy (CON) in Graves' disease. This case report indicates that CON could develop only from the hypertrophic superior levator and superior rectus (SL/SR) muscle in a patient with poorly controlled Graves' disease, and described the possible risk of FT3-thyrotoxicosis with a prominent goiter to develop the current rare case with a review of the literature.

Patient Concerns: A 66-year-old woman undergoing endocrine management of hyperthyroidism with prominent goiter visited the Department of Ophthalmology due to right-eye upper-eyelid retraction. Read More

J Cosmet Dermatol 2021 Apr 4. Epub 2021 Apr 4.

Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University Munich, Munich, Germany.

Background: Current injection algorithms for treating the glabella rely on a five- or seven-point injection technique with possible medial eyebrow ptosis and lateral eyebrow elevation as undesirable outcomes.

Objective: The objective of this study was to investigate the efficacy and safety profile of a refined 3-point injection technique targeting horizontal and vertical glabellar lines.

Methods: A total of n=105 patients (27 males and 78 females) with a mean age of 40. Read More

Cont Lens Anterior Eye 2021 Apr 25;44(2):192-219. Epub 2021 Mar 25.

School of Optometry and Vision Science, UNSW Sydney, Australia.

This paper outlines changes to the ocular surface caused by contact lenses and their degree of clinical significance. Substantial research and development to improve oxygen permeability of rigid and soft contact lenses has meant that in many countries the issues caused by hypoxia to the ocular surface have largely been negated. The ability of contact lenses to change the axial growth characteristics of the globe is being utilised to help reduce the myopia pandemic and several studies and meta-analyses have shown that wearing orthokeratology lenses or soft multifocal contact lenses can reduce axial length growth (and hence myopia). Read More

Cont Lens Anterior Eye 2021 Apr 25;44(2):132-156. Epub 2021 Mar 25.

School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand.

A key element of contact lens practice involves clinical evaluation of anterior eye health, including the cornea and limbus, conjunctiva and sclera, eyelids and eyelashes, lacrimal system and tear film. This report reviews the fundamental anatomy and physiology of these structures, including the vascular supply, venous drainage, lymphatic drainage, sensory innervation, physiology and function. This is the foundation for considering the potential interactions with, and effects of, contact lens wear on the anterior eye. Read More

Plast Reconstr Surg Glob Open 2021 Feb 18;9(2):e3437. Epub 2021 Feb 18.

Department of Plastic and Cosmetic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

The purpose of this article is to clarify the character of Müller's muscle in Chinese specimens.

Methods: Ten upper eyelids of 10 formalin-fixed Chinese cadavers (9 elderly people, from 68 to 86 years of age; 1 male child, 10 years old) were examined. Full-thickness sagittal sections of the central part of the upper eyelids were microscopically examined using hematoxylin-eosin, Masson trichrome, and anti-smooth muscle actin antibodies staining. Read More

Exp Eye Res 2021 04 2;205:108527. Epub 2021 Mar 2.

Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy. Electronic address:

The purpose of this study was to evaluate the expression of the SARS-CoV-2 receptors ACE2 and TMPRSS2 in an immortalized human conjunctival epithelial cell line and in healthy human conjunctiva excised during ocular surgery, using Western blot, confocal microscopy and immunohistochemistry. The Western blot showed that ACE2 and TMPRSS2 proteins were expressed in human immortalized conjunctival cells, and this was confirmed by confocal microscopy images, that demonstrated a marked cellular expression of the viral receptors and their co-localization on the cell membranes. Healthy conjunctival samples from 11 adult patients were excised during retinal detachment surgery. Read More

Facial Plast Surg 2021 Mar 3. Epub 2021 Mar 3.

Department of Ophthalmology and Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York.

Eyelid trauma occurs across a broad spectrum of pathology, ranging from simple periorbital lacerations to severe, vision-threatening injuries requiring expert oculoplastic consultation. Any injury, no matter how benign, is also inherently cosmetically sensitive, further adding to the reconstructive challenge. In this review, we discuss the anatomy of the eyelid and develop an understanding of evaluating for signs of more serious, potentially occult, trauma. Read More

Aesthet Surg J 2021 Feb 28. Epub 2021 Feb 28.

The Centre for Facial Plastic Surgery, Toorak, Victoria, Australia.

Background: The unique anatomy of the Asian upper eyelid requires specific adaptation to the levator advancement technique for ptosis correction to achieve predictable and reproducible outcomes.

Objectives: The levator musculo-aponeurotic junction was used as our key landmark. With a formula that we developed, the location of fixation relative to this landmark can be predicted preoperatively. Read More

Laryngorhinootologie 2021 03 26;100(3):211-216. Epub 2021 Feb 26.

Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale).

Trauma of the medial canthal region can affect all parts of the lacrimal ducts. Depending on the patient's age, there may be different mechanisms of injury. Surgical reconstruction using two autostable ("self-retaining") monocanaliculonasal lacrimal tubes is demonstrated by two case reports. Read More

Medicine (Baltimore) 2021 Feb;100(7):e24693

Department of Neurosurgery, The Maternal and Child Health Hospital of Hainan Province, Haikou, Hainan, China.

Rationale: Crouzon syndrome is a craniofacial malformation caused by premature fusion of fibrous sutures in infants. It is one of the most common craniosynostosis syndromes, and surgery is the only effective treatment for correcting it. Postoperative complications such as encephalocele, infections, hematoma have been reported. Read More

Exp Eye Res 2021 04 15;205:108501. Epub 2021 Feb 15.

Department of Ophthalmology, Fudan Eye & ENT Hospital, Shanghai, China; Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China. Electronic address:

The angiotensin-converting enzyme 2 (ACE2) receptor has been proved for SARS-CoV-2 cell entry after auxiliary cellular protease priming by transmembrane protease serine 2 (TMPRSS2), but the co-effect of this molecular mechanism was unknown. Here, single-cell sequencing was performed with human conjunctiva and the results have shown that ACE2 and TMPRSS2 were highly co-expressed in the goblet cells with genes involved in immunity process. This identification of conjunctival cell types which are permissive to virus entry would help to understand the process by which SARS-CoV-2 infection was established. Read More

J Med Virol 2021 May 16;93(5):3122-3132. Epub 2021 Feb 16.

Maternal and Child Health Department, Santa Maria Goretti Hospital, Sapienza-University of Rome, Latina, Italy.

Objectives: To perform a comprehensive clinic, laboratory, and instrumental evaluation of children affected by coronavirus disease (COVID-19).

Methods: Children with a positive result of nasopharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) underwent laboratory tests, anal and conjunctival swab, electrocardiography, lung, abdomen, and cardiac ultrasound. Twenty-four-hour ambulatory blood pressure monitoring was performed if abnormal basal blood pressure. Read More

Aesthet Surg J 2021 Feb 9. Epub 2021 Feb 9.

Plastic Surgery, Division of Plastic Surgery, University of California Davis Medical Center, Sacramento, CA.

Background: Asian upper blepharoplasty is the most popular cosmetic procedure for Asian women. However, there is lack of standardized approach to this procedure and less than optimal results are still common.

Objectives: In this article, we introduce our comprehensive approach to Asian upper blepharoplasty in women and report our clinical outcomes with this approach. Read More

Anat Histol Embryol 2021 Feb 9. Epub 2021 Feb 9.

Department of Animal Anatomy and Histology, Faculty of Veterinary Medicine, University of Life Sciences, Lublin, Poland.

The superficial gland of the third eyelid (SGTE) and deep gland of the third eyelid (DGTE) are classified as accessory lacrimal glands. The aim of the present study was to immunohistochemically investigate the expression of vasoactive intestinal peptide (VIP), dopamine beta-hydroxylase (DβH), substance P (SP), galanin, neuropeptide Y (NPY), pituitary adenylate cyclase-activating peptide (PACAP), somatostatin and calcitonin gene-related peptide (CGRP) in the porcine SGTE and DGTE. We demonstrated the distribution patterns of VIP, DβH, SP, NPY and galanin in the nerve fibres in the SGTE and DGTE. Read More

Int J Mol Sci 2021 Feb 4;22(4). Epub 2021 Feb 4.

Department of Stem Cell Biology and Regenerative Biology, Konkuk University, Hwayang-dong, Seoul 05029, Korea.

Antimicrobial peptides (AMPs) are of interest as alternatives to antibiotics or immunomodulators. We generated and characterized the phenotypes of transgenic mice overexpressing protegrin 1 (PG1), a potent porcine cathelicidin. No obvious differences were observed between PG1 transgenic and wild-type mice in terms of growth, development, general behaviour, and the major immune cell population. Read More

Int J Mol Sci 2021 Feb 4;22(4). Epub 2021 Feb 4.

Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9057, USA.

Previous studies on ablation of several key genes of meibogenesis related to fatty acid elongation, omega oxidation, and esterification into wax esters have demonstrated that inactivation of any of them led to predicted changes in the meibum lipid profiles and caused severe abnormalities in the ocular surface and Meibomian gland (MG) physiology and morphology. In this study, we evaluated the effects of ablation that were expected to cause depletion of the second largest class of Meibomian lipids (ML)-cholesteryl esters (CE)-in a mouse model. ML of the null mice were examined using liquid chromatography high-resolution mass spectrometry and compared with those of and wild-type mice. Read More