- •Contents
- •Introduction
- •Contributors
- •ROLE OF BIOPSY
- •DIRECTED TREATMENTS OF DISTINCT ORBITAL INFLAMMATIONS
- •ABSTRACT
- •ACKNOWLEDGEMENTS
- •5 Future and Emerging Treatments for Microbial Infections
- •MICROBIOLOGIC DIAGNOSIS
- •EMERGING ANTIBIOTIC RESISTANCE
- •HISTORICAL PERSPECTIVE
- •CURRENT APPROACH
- •FUTURE DIRECTIONS
- •7 Non-Hodgkin’s Lymphoma
- •INCIDENCE AND EPIDEMIOLOGY
- •ETIOLOGY AND RISK FACTORS
- •DIAGNOSIS, CLASSIFICATION, AND STAGING
- •TREATMENT
- •ABSTRACT
- •INTRODUCTION
- •STEPS TOWARD TUMOR SPECIFIC THERAPY
- •CANCER SPECIFIC MOLECULAR TARGETS
- •DNA ARRAY ANALYSIS
- •WHICH MOLECULAR TARGETS?
- •CONCLUSIONS
- •10 Malignant Lacrimal Gland Tumors
- •THERAPEUTIC RECOMMENDATIONS
- •SPHENOID WING MENINGIOMAS
- •Location
- •PRESENTING SIGNS AND SYMPTOMS
- •RADIOGRAPHIC IMAGING
- •ULTRASOUND
- •HISTOPATHOLOGY
- •TREATMENT AND PROGNOSIS
- •13 Stereotactic Radiotherapy for Optic Nerve and Meningeal Lesions
- •BACKGROUND
- •DEFINITIONS
- •Precise Immobilization
- •Precise Tumor Localization
- •Conformal Treatment Planning and Delivery
- •FUTURE DEVELOPMENTS
- •SUMMARY
- •ABSTRACT
- •INTRODUCTION
- •ABSTRACT
- •INTRODUCTION
- •Enzyme-Linked Immunosorbent Assay (ELISA)
- •Prospective Study of Graves’ Disease Patients
- •DISCUSSION
- •ACKNOWLEDGEMENTS
- •ORBITAL FIBROBLASTS DISPLAY CELL-SURFACE CD40 AND RESPOND TO CD154
- •CONCLUSIONS
- •ACKNOWLEDGEMENTS
- •INTRODUCTION
- •Retina, RPE, and Choroid
- •Optic Nerve
- •ACKNOWLEDGMENT
- •INTRODUCTION
- •METHODS
- •Historical Features
- •Tempo of Disease Onset
- •Clinical Features
- •DISCUSSION
- •19 Prognostic Factors
- •PREVENTION OF GRAVES’ OPHTHALMOPATHY BY EARLIER DIAGNOSIS AND TREATMENT OF GRAVES’ HYPERTHYROIDISM?
- •CLINICAL ACTIVITY SCORE
- •ORBITAL ECHOGRAPHY
- •ORBITAL OCTREOSCAN
- •ORBITAL MAGNETIC RESONANCE IMAGING
- •URINARY GLYCOSAMINOGLYCANS
- •SERUM CYTOKINES
- •CONCLUSION
- •BACKGROUND
- •VISA CLASSIFICATION
- •Strabismus
- •Appearance=Exposure
- •DISCUSSION
- •INTRODUCTION
- •NONSEVERE GRAVES’ OPHTHALMOPATHY
- •SEVERE GRAVES’ OPHTHALMOPATHY
- •Glucocorticoids
- •Orbital Radiotherapy
- •Immunosuppressive Drugs
- •Plasmapheresis
- •Somatostatin Analogues
- •Intravenous Immunoglobulins
- •Antioxidants
- •Cytokine Antagonists
- •Colchicine
- •INTRODUCTION
- •STABLE ORBITOPATHY
- •Preferred Decompression Techniques
- •EYE MUSCLE SURGERY
- •LID PROCEDURES
- •PATHOPHYSIOLOGY OF THE DISEASE
- •MEDICAL THERAPY
- •IMPROVEMENTS IN ORBITAL DECOMPRESSION
- •IMPROVEMENTS IN EYELID SURGERY
- •STRABISMUS SURGERY
- •Michael Kazim
- •John Kennerdell
- •Daphne Khoo
- •Claudio Marcocci
- •Jack Rootman
- •Wilmar Wiersinga
- •Answer
- •Question 1 (continued)
- •Answer
- •Question 2 (from M. Potts)
- •Answer
- •Question 2 (continued)
- •Question 3
- •Answer
- •Question 3 (continued)
- •Answer
- •Question 3 (continued)
- •Answer
- •Question 3 (continued)
- •Answer
- •Question 4 (from M. Mourits)
- •Answer
- •Question 5 (from F. Buffam)
- •Answer
- •Question 6 (from F. Buffam)
- •Answer
- •Question 7 (from P. Dolman)
- •Answer
- •INTRODUCTION
- •CLINICAL MANIFESTATIONS OF DVVMs
- •INVESTIGATION OF DVVMs
- •FUTURE CONSIDERATIONS
- •CONCLUSION
- •INTRODUCTION
- •CAROTID-CAVERNOUS SINUS FISTULAS
- •ARTERIOVENOUS MALFORMATIONS
- •DISTENSIBLE VENOUS ANOMALIES
- •PREOPERATIVE EMBOLIZATION OF TUMORS
- •ANEURYSMS
- •FUTURE DIRECTIONS
- •ABSTRACT
- •INTRODUCTION
- •TECHNOLOGICAL ADVANCEMENTS
- •Advances in Medical Imaging
- •Virtual Reality Surgical Simulation
- •Surgical Robotics
- •HUMAN BODY MODELS
- •FUTURE COMPUTER-AIDED ORBITAL SURGERY
- •SUMMARY
- •ACKNOWLEDGMENTS
- •30 The Future of Orbital Surgery
- •Index
Vascular Intervention: Current and Future Opportunities |
349 |
artery. By careful case selection, judicious use of embolic agents, and the use of provocative testing, embolization of the ophthalmic artery can be safely accomplished without visual loss in a significant number of cases (16). These authors used direct injection of lignocaine and amytal as the provocative agents to assess the dependence of the retina and optic nerve on the ophthalmic artery circulation.
ANEURYSMS
Aneurysms have largely neuro-ophthalmic manifestations and are therefore outside the confines of this presentation. However, the techniques used in the management of aneurysms may have spin-offs for cases with orbital vascular lesions and a large impetus to the development of newer techniques has been the possibility of treating aneurysms using minimally invasive or interventional radiological techniques.
FUTURE DIRECTIONS
It is certain there will be continued development in the basic materials used by interventional radiologists with smaller and more maneuverable catheters and guide wires, and novel embolic agents. Additionally, the combined use of techniques to allow embolization of lesions whilst protecting the normal circulation continues to expand. Examples include temporary balloon occlusion above broad-necked aneurysms to allow safer embolization of the aneurysm, and the placement of stents with the mesh of the stent acting as a barrier to the passage of detachable balloons back into the ICA during occlusion of broad-necked aneurysms.
Advances in imaging technology will allow three-dimen- sional imaging and virtual trips down blood vessels and into vascular lesions. This will allow better definition of complex vascular anomalies and safer treatments. Guidance systems for catheters are also likely to be improved, with less reliance
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McNab |
on the manipulative skills of the radiologist. Such systems may ultimately lead to ‘‘hands-free’’ interventional techniques.
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