Notes

Evaluation of skeletal readiness using maxillary doggy, mandibular next and also next molar calcification phases.
Lupus mastitis (LM) is a rare presentation of lupus panniculitis (LP) that usually affects women of childbearing age and may mimic malignancy. The condition is recurrent and progresses along with the underlying disease. Breast pathology that may be associated with LM includes fat necrosis, calcification, fibrosis, scarring, and breast atrophy. Therefore, LM should be considered in the differential diagnosis of a suspicious breast mass on mammography or ultrasound, particularly if the patient has a background of systemic lupus erythematosus (SLE) or discoid lupus erythematosus (DLE). Traumatic procedures such as surgery or biopsy may worsen the condition and it is advisable to avoid biopsy if the diagnosis can be established through accurate patient history, with identification of typical clinical and radiological features. Thus, awareness of the radiologic and clinical features of LM is essential to avoid unnecessary interventional procedures that carry the potential for disease exacerbation. The authors present here the imaging findings of LM in a 37-year old female with SLE, which presented as bilateral palpable breast lumps.Breast cancer treatment has seen many advances in recent decades, lessening the morbidity to patients, while improving outcomes. Central to these gains has been the introduction of breast conserving surgery and neoadjuvant systemic therapy (NST). There is a considerable interest in further de-escalation of the treatment of breast cancer, which is being studied in several ongoing randomised trials. We aimed to appraise the current literature regarding the various aspects of de-escalation of surgical treatment of breast cancer after NST, and attempt to prognosticate the future course of breast oncotherapy.Accessory breast tissue is a rare aberration of normal breast development, that presents most commonly in the axilla. Similar to normal breast tissue, it can undergo physiologic and pathologic changes, including malignant transformation. We report a rare case of accessory breast cancer, treated with surgical resection and axillary reverse mapping (ARM), and review current literature focusing on management. We report a 68-year-old female with a history of left breast cancer treated with lumpectomy and axillary dissection, who later developed in-breast recurrence treated with re-lumpectomy and sentinel node biopsy which mapped at the contralateral (right) axilla, but was negative. Two years later screening imaging revealed right axillary tail focal asymmetry with two spiculated masses. Core biopsy showed invasive ductal carcinoma (IDC), and histologic examination of the biopsy could not determine whether this represents a new primary breast cancer or axillary metastasis from the contralateral site. She underwent lumpectomy of the two masses and sentinel node biopsy. During surgery, the masses were identified in the axilla itself, rather than the axillary tail. Final pathology revealed IDC, pT1N0(sn), and extensive ductal carcinoma in situ (DCIS). Due to positive margins, she underwent re-lumpectomy with ARM. Final pathology revealed residual DCIS with negative new margins. The patient was referred for adjuvant radiotherapy. Accessory axillary breast tissue can be confused with axillary tail tissue. It is necessary for the surgeon to distinguish between them by meticulous physical examination and radiologic evaluation, as resection of axillary breast tissue may warrant reverse lymphatic mapping for lymphedema prevention.Presented are 2 cases of acute corneal hydrops in keratoconus with Graves' orbitopathy (GO). Two patients (Case 1 female, 54 years old; Case 2 male, 33 years old) with coexisting keratoconus and GO demonstrated typical findings of acute corneal hydrops (ACH) in 1 eye during the active stage of orbitopathy. There was no history of trauma. The ACH healed with scarring after management with a therapeutic contact lens and medical treatment in each patient within 3 months and 5 months, respectively. The development of ACH in keratoconus patients has previously been reported to be associated with male gender, ethnicity, age, eye rubbing, trauma, rapidly progressive disease, atopy, and vernal conjunctivitis. GO involves ocular surface inflammation and fluctuation of intraocular pressure. Active GO can be a risk factor for ACH in keratoconus patients.This case report illustrates the successful use of the double-layer amniotic membrane technique in a child with glaucoma and aniridia. A 3.5-year-old girl with bilateral congenital glaucoma as well as aniridia, lens coloboma, nystagmus, and strabismus had been followed up since birth. Medical treatment did not result in the desired intraocular pressure improvement. An Ahmed glaucoma valve was implanted bilaterally. In a follow-up visit at 2 years of age, there were complaints of redness with watery discharge in the right eye. A biomicroscopic evaluation revealed tube erosion of the conjunctiva. The eroded area was dissected from the surrounding tissue and the area was closed using the new double-layer amnion membrane technique. After the surgery, the intraocular pressure was normal. Subsequent follow-up indicated that the erosion defect was closed and stabilized. The double-layer amniotic membrane technique can be used successfully in cases of conjunctival tube erosion. To the authors' knowledge, this is the first published pediatric case report of using the novel technique of amniotic membrane transplantation for tube erosion.
This study was performed to assess and analyze the retinal and choroidal thickness in amblyopic eyes using spectral-domain optical coherence tomography and enhanced depth imaging optical coherence tomography.

A total of 67 children with amblyopia and 31 age- and gender-matched healthy non-amblyopic control subjects were enrolled in the study. RGDyK in vitro The 67 amblyopic children were divided into 3 groups hypermetropic amblyopia (Group 1). microesotropia (Group 2). and myopic anisometropia (Group 3). All of the participants underwent a detailed ophthalmologic examination and orthoptic assessment. The subfoveal choroidal thickness was measured at 500-. 750-. 1000-. and 15000-micron intervals nasally and temporally. Central macular thickness was also measured in the subfoveal. parafoveal inferior. parafoveal superior. parafoveal nasal. and parafoveal temporal superior. inferior. nasal. and temporal quadrants. All of the parameters of the amblyopic eyes. fellow eyes. and control eyes were compared.

In all. 34 female and 33 male patients were studied. The mean age was 8.6±2.8 years (range 5-12 years). Comparison of the choroidal thickness and macular thickness measurements between the amblyopic and non-amblyopic eye of the same patient within each group revealed no statistically significant differences. Comparison of the findings in the amblyopic eyes of Group 1 and Group 3 with the control group revealed that the choroidal thickness measurements were smaller in the amblyopic eyes in all quadrants. however. only the nasal quadrant measurements demonstrated a statistical significance. The subfoveal macular thickness value was also smaller in both groups when compared with the control eyes.

Our results indicated that amblyopia. whether anisometropic or microtropic. did not seem to significantly affect choroidal thickness.
Our results indicated that amblyopia. whether anisometropic or microtropic. did not seem to significantly affect choroidal thickness.
This study was a comparison of the outcomes of transcanalicular multidiode laser dacryocystorhinostomy (TCLDCR) and external dacryocystorhinostomy (EXDCR) treatment for patients with acquired nasolacrimal duct obstruction.

Thirty-one consecutive patients who underwent TCLDCR (TCLDCR group) and 68 consecutive patients who underwent EXDCR (EXDCR group) due to acquired nasolacrimal duct obstruction were enrolled in the study. Follow-up visits were performed on the first day, and at the first week, first month, third month, sixth month, and every six months thereafter. Surgical success was defined as achievement of a patent osteotomy and a successful bicanalicular silicone intubation during the procedure. Anatomical success was defined by observation of a patent osteotomy on lacrimal irrigation, regardless of epiphora. The surgery time and intra- and postoperative complications were noted for each patient.

The TCLDCR group had a significantly shorter mean surgery time (27.9±5.5 minutes) compared with the EXy should be made based on the cosmetic and success expectations of the patients and the presence of systemic problems.
This was an assessment of one-snip punctoplasty outcomes in patients for whom adjunctive punctal re-dilatation was performed in-office for early postoperative cicatricial changes.

A retrospective analysis was conducted of patients who underwent one-snip punctoplasty between March 2019 and February 2020 due to acquired punctal stenosis. Patients were followed up on the first, third, and seventh postoperative day, then weekly for the remainder of the first month, every 2 weeks over the next month, and then monthly. Punctal re-dilatation was performed if patients showed early clinical signs of re-stenosis. Demographic details, the number and timing of re-dilatation procedures, the timing of re-stenosis, and anatomical and functional success rates were analyzed.

The medical records of 148 eyes of 86 patients were evaluated. A re-dilation procedure was performed in a total of 57 (38.5%) puncta showing signs of early cicatrization. The first punctal re-dilatation was performed at a mean of 17.2±11.3 days (range 3-57 days). Re-stenosis was observed in 25 puncta (16.9%) at a mean of 5.6±3.1 weeks (range 2-16 weeks). The anatomical success rate was 83.1% and the functional success rate was 79.1%. There were no significant differences in the anatomical and functional success rates between the patients who did and did not need adjunctive re-dilatation.

In-office punctal re-dilatation may improve functional and anatomical success rates after one-snip punctoplasty by preventing recurrent punctal cicatrization.
In-office punctal re-dilatation may improve functional and anatomical success rates after one-snip punctoplasty by preventing recurrent punctal cicatrization.
The aim of this study was to examine and provide real-life data of patients with exudative-type age-related macular degeneration (AMD).

A total of 189 eyes of 160 patients with exudative AMD treated with intravitreal anti-vascular endothelial growth factor therapy (anti-VEGF) injections (ranibizumab 0.3 mg/0.05 mL, aflibercept 2 mg/0.05 mL, bevacizumab 1.25 mg/0.05 mL) were included in the study. Patient demographic characteristics, and details of the clinical examinations, number of injections, best-corrected visual acuity (BCVA) measured with the Snellen chart, optical coherence tomography, and fundus fluorescein angiography images were evaluated at the first visit and during the follow-up period.

In the study group, 78 of the patients were female (48.8%) and 82 were male. The mean age was 72.20±8.97 years. While no treatment had been applied to 151 eyes before the first examination, 38 had previously received an intravitreal injection at another center. The mean number of patient visits was 5.83 in the first year, 4.
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