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Novel severe oculocutaneous manifestations of human monkeypox virus infection and their historical analogues

Carrubba, Steven; Geevarghese, Alexi; Solli, Elena; Guttha, Samyuktha; Sims, Jeffrey; Sperber, Laurence; Meehan, Shane; Ostrovsky, Ann
WHO has declared human mpox (formerly known as monkeypox) a global public health emergency since July, 2022. When case numbers were increasing, so did clinicians' exposures to new elements of the disease. Additionally, the burden of mpox is particularly apparent in immunocompromised patients, who can have more variable and severe manifestations of disease across organ systems. In this Grand Round, we report novel and severe oculocutaneous manifestations of mpox in this population, which are both sight and life threatening. Specifically, we highlight two patients with mpox and AIDS who had refractory skin necrosis that progressed to either ocular compromise or panfacial gangrene, or both. Both patients ultimately died due to systemic complications of their infections. Through clinical analogies, we show how past experiences with related orthopoxviruses, such as variola virus (smallpox) and vaccinia virus, can add useful context for understanding and treating these new disease states. We suspect that in patients who are immunocompromised, monkeypox virus can clinically evolve not only via viraemia but also through direct intradermal spread. We propose that intradermal spread occurs by a process clinically and immunologically analogous to progressive vaccinia, a complication previously seen after conventional smallpox vaccination. We share evidence in support of this theory and implications regarding early management and post-exposure prophylaxis for at-risk populations. Content note: this Grand Round contains graphic images of mpox lesions of the eyes and face.
PMID: 36702137
ISSN: 1474-4457
CID: 5419692

Modified technique for sutureless amniotic membrane transplantation in acute Stevens-Johnson syndrome using fibrin sealant [Letter]

Sims, Jeffrey R; Kozlova, Anna; Ostrovsky, Ann
PMID: 35644447
ISSN: 1937-5913
CID: 5236012

Impact of the Affordable Health Care Act on No-Show Rates and Demographics of Patients Presenting for Eye Care in an Underserved Inner City Population - a 2-year Update [Meeting Abstract]

Khandji, Joyce; Ostrovsky, Ann
ISSN: 0146-0404
CID: 3979172

Impact of the Affordable Health Care Act on No-Show Rates and Demographics of Patients Presenting for Eye Care in an Underserved Inner City Population [Meeting Abstract]

Richardson, Zachary Ryan; Oliver, Gary; Ostrovsky, Ann
ISSN: 0146-0404
CID: 2690032

Impact of the Affordable Health Care Act on Demographics and Visual Acuities of Patients Presenting For Cataract Extraction in an Underserved Urban Population [Meeting Abstract]

Seidman, Carly; Sleem, Abraham; Ostrovsky, Ann
ISSN: 0146-0404
CID: 1830502

Accuracy of Prediction of Steep Axis and Cylinder Power Using IOL Master versus Pentacam in Patients Undergoing Toric IOL Implantation [Meeting Abstract]

Brown, Sarah Elise; Miller, Darby; Ostrovsky, Ann; Wallenstein, Sylvan; Speaker, Mark
ISSN: 0146-0404
CID: 2502902

Impact of Ultrasound Biomicroscopy (UBM) versus White-to-White (WTW) measurement on sizing of Visian Implantable Collamer Lens (ICL) and Residual Postoperative Refraction [Meeting Abstract]

Panda, Puneet; Ostrovsky, Ann; Brodie, Scott; Speaker, Mark
ISSN: 0146-0404
CID: 2502872

Rectus muscle flap tear as an independent cause of restricted motility [Case Report]

Raab, Edward L; Ackert, Jessica M; Ostrovsky, Ann
Most published cases of rectus muscle flap tear have been associated with orbital trauma of various degrees of severity. When they accompany an orbital fracture, however, it is difficult to determine whether the flap tear is merely an incidental additional finding or a major contributing cause of the resulting restriction. How to treat the flap itself remains an open question. We report a 24-year-old man with an inferior rectus muscle flap tear caused by direct laceration of the muscle. The major finding was a "reverse leash" vertical restriction. Discarding the flap instead of reattaching it did not prevent a successful result. Our case supports the proposition that rectus muscle flap tear can be a restriction-producing entity.
PMID: 22824495
ISSN: 1091-8531
CID: 1323422

Ophthalmic plastic surgery : a history in the making

Chapter by: Meltzer, Murray A; Ostrovsky, Ann
in: Smith and Nesi's ophthalmic plastic and reconstructive surgery by Black, Evan; Smith, Byron C [Eds]
New York : Springer, 2012
pp. 81-96
ISBN: 1461409713
CID: 2502452

Effect of Repeat Selective Laser Trabeculoplasty After Prior Argon Laser Trabeculoplasty in Glaucoma Patients [Meeting Abstract]

Cheung, Natalie C; Ostrovsky, Ann; Franco, Tatiana; Barash, Alexander; Marcus, Craig H; Prywes, Arnold S; Rothman, Robert F; Danias, John; Serle, Janet B
ISSN: 0146-0404
CID: 2502882