Subconjunctival Fat Research Articles

Subconjunctival Fat Prolapse

Subconjunctival fat prolapse is an extremely rare condition. Confirmation of the fatty nature of this lesion and demonstration of the focal tenon capsule defect makes Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) of orbit the investigations of choice. This manuscript report a 69-year-old female who presented with complaints of swelling in lateral aspect of both orbit, since two years. On clinical examination, there was yellowish colored swelling in the superolateral quadrant of bilateral orbit. CT scan show herniation of intraconal fat content through the defect at the tenon capsule, intermuscular septum and thus confirmed the nature of lesion and the diagnosis. The patient was not willing for surgical correction and preferred regular follow-ups.

Subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association.

BackgroundThyroid associated orbitopathy (TAO) comprises a spectrum of well-recognized clinical signs including exophthalmos, eyelid retraction, soft tissue swelling, ocular misalignment, keratopathy as well as a number of less common manifestations. Subconjunctival fat prolapse is a rare clinical condition occurring typically spontaneously in elderly patients with a mean age of 65–72 years. We describe subconjunctival prolapse of orbital fat as an uncommon clinical association of TAO.Materials and methodsObservational study of six patients presenting with a subconjunctival protrusion under the lateral canthus in a series of 198 consecutive cases with TAO examined at a tertiary care referral center.ResultsA superotemporally located yellowish, very soft, freely mobile subconjunctival protrusion developed unilaterally in two and bilaterally in four patients with TAO (incidence 3.03%). It was one of the presenting manifestations of TAO in four of ten eyes studied and incited the diagnostic work-up for TAO in two of six patients in this series. Magnetic resonance imaging of the orbit indicated fat density in continuity with intraorbital fat in the area of protrusion. A male to female preponderance of 4:2 and an advanced mean age at onset of TAO is noteworthy for these six patients compared to the pool of 192 patients (64.8 versus 51.8 years, respectively, P=0.003) not bearing this sign.ConclusionSubconjunctival orbital fat prolapse, a clinically impressive age-related ocular lesion, may occasionally predominate amid other clinical manifestations of TAO. It is a nonspecific sign developing most commonly among patients with a relatively advanced age at presentation. Awareness of this association may alert to the diagnosis of thyroid orbitopathy and reassure the patient and physician as to the benign character of the lesion.

Subconjunctival fat prolapse: a disease little known to radiologists.

Subconjunctival fat prolapse: a disease little known to radiologists.

Subconjunctival Fat Prolapse: What Radiologists Need to Know?

Subconjunctival fat prolapse is a rare benign entity or disease presenting as fat containing epibulbar mass in lateral canthus region. Weakness of Tenon's capsule secondary to age, trauma or any surgery leads to herniation of intraconal fat. Radiologists should be aware of the condition and its imaging features. We report a case of 70-year-old obese man presenting with bilateral soft yellowish lateral canthal mass. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed typical imaging features of epibulbar fatty lesion in continuation with the intraconal fat.

Subconjunctival Orbital Fat Prolapse

Subconjunctival orbital fat prolapse has been rarely described in the literature, often leading to misdiagnosis. In this article, we present the clinical features and treatment of patients with subconjunctival orbital fat prolapse as experienced in our clinic. Cases of subconjunctival orbital fat prolapse were evaluated retrospectively from the records of the Zhongshan Ophthalmic Center at Sun Yat-sen University for the period of January 1, 1991 to December 31, 2010. A total of 46 patients (33 males and 13 females) with subconjunctival orbital fat prolapse were identified. Their ages ranged from 44.0 to 82.0 years (mean age, 65.8 y). The right eye was involved in 16 cases, the left eye was involved in 11 cases, and both eyes were involved in 19 cases. Subconjunctival fat prolapse appeared as a soft, mobile yellowish mass, quite different from conjunctival dermolipoma, which presents as a congenital soft or firm pinkish-white or pinkish-yellow mass with hairs on the surface. The conjunctival fat prolapse was located in the superotemporal quadrant in 45 patients and in the superonasal quadrant in the remaining patient with no history of trauma or previous eye surgery in all the patients. Forty patients underwent surgical excision of the prolapsed fat and fixation of Tenon's capsule to the sclera. There were no recurrences of orbital fat prolapse or surgical complications in these patients with a mean follow-up of 2.4 years. Subconjunctival orbital fat prolapse is a rare benign entity and can be easily diagnosed when this condition is considered. The surgical management usually has an excellent therapeutic outcome.

Efficacy of transconjunctival excision of orbital fat prolapse: a long‐term follow‐up study

To describe the long-term efficacy of transconjunctival excision of subconjunctival orbital fat prolapse. Retrospective study of consecutive cases of orbital fat prolapse treated with transconjunctival resection between December 2002 and December 2011. Thirty-two eyes of 23 patients (19 males and four females) were included. The lesion was unilateral in 14 and bilateral in nine cases. It was located superotemporally in a majority of cases. Excision was performed by opening the conjunctiva and excising the prolapsing orbital fat. The conjunctival wound was closed with 1-2 interrupted sutures. With an average follow-up of 29 months (range 4-108), a recurrence was seen in three cases. The average time to recurrence was 46 months (range 40-52 months). Transconjunctival excision is a simple, safe and effective primary surgical procedure to treat subconjunctival fat prolapse. In our series, the recurrence rate was 9%, but no additional surgery was required. As the average time to recurrence was longer than our average follow-up, more patients may develop a recurrence in future.

Small-Incision, Sutureless Repair of Subconjunctival Fat Prolapse

To present a new, small-incision, sutureless surgical technique for the repair of subconjunctival fat prolapse. This is a retrospective interventional case series. Four eyes of 3 patients who presented with prolapsed subconjunctival fat were surgically repaired using a small-incision, sutureless technique with fibrin glue. No prolapsed subconjunctival fat was excised. The surgical treatment of prolapsed subconjunctival fat using a small-incision, sutureless technique with fibrin glue was successful in all 4 eyes. There have been no cases of recurrence of the prolapsed subconjunctival fat with a mean follow up of 31 months. Small-incision, sutureless repositioning of subconjunctival fat using fibrin glue is an effective new surgical technique for the management of prolapsed subconjunctival fat.

Kim E, Kim H-J, Kim Y-D et al. Subconjunctival fat prolapse and dermolipoma of the orbit: differentiation on CT and MR imaging. AJNR Am J Neuroradiol 2011; 32: 465 – 467

Kim E, Kim H-J, Kim Y-D et al. Subconjunctival fat prolapse and dermolipoma of the orbit: differentiation on CT and MR imaging. AJNR Am J Neuroradiol 2011; 32: 465 – 467

Subconjunctival Fat Prolapse and Dermolipoma of the Orbit: Differentiation on CT and MR Imaging

Subconjunctival fat prolapse and dermolipoma of the orbit are unfamiliar to radiologists and yet should be differentiated because their treatments are different. The purpose of this study was to investigate the CT and MR imaging findings that distinguish these 2 conditions. Between 1995 and 2009, we found 33 patients (27 men, 6 women; mean age, 63 years) with surgically proved subconjunctival fat prolapse and 27 patients (3 males, 24 females; mean age, 17 years) with dermolipoma in our hospital. Among them, 8 patients with subconjunctival fat prolapse and 6 patients with dermolipoma underwent CT and/or MR imaging examinations. We retrospectively reviewed CT scans and MR images in these patients. In all of the 8 patients with subconjunctival fat prolapse, CT and MR images demonstrated the herniated fat at the superotemporal epibulbar area, continuous with the intraconal fat, extending forward between the lateral wall of the globe medially and the lateral rectus muscle and the lacrimal gland laterally, either bilaterally (n = 7) or unilaterally (n = 1). In contrast, all 6 patients with dermolipoma had a unilateral, crescent- (n = 5), or triangle-shaped (n = 1) fatty mass at the temporal or superotemporal epibulbar area, which lay on the lateral wall of the globe, anterior to the insertion of the lateral rectus muscle and medial to the lacrimal gland, without connection to the intraconal fat. The characteristic CT and MR imaging findings may help easily differentiate subconjunctival fat prolapse and dermolipoma, both of which usually present as an epibulbar fatty mass in the lateral canthal area.

Orbital Dermoid Cysts Presenting as Subconjunctival Fat Droplets

The authors report 3 cases of orbital dermoid cysts presenting with subconjunctival fat droplets. Three female patients were evaluated for conjunctival injection and yellowish granular material lying under the bulbar conjunctiva in the left eye. Slit-lamp examination showed a number of subconjunctival fat droplets in the involved eyes. Orbital CT and MRI in each case revealed a cystic mass located in the superotemporal aspect of the left orbit. The masses were excised via lateral orbitotomy in 2 patients, and a conjunctival biopsy of the granular material was performed in 1 patient. The cystic masses were histopathologically diagnosed as dermoid cysts with findings of lipogranuloma that suggested a previous rupture of the cyst itself. Examination of the conjunctival specimen also suggested lipogranuloma. Orbital dermoid cysts should be considered in patients presenting with subconjunctival fat droplets.