Idiopathic granulomatous orbital inflammation: A case series and literature review.

IF 3.3 4区 医学 Q1 OPHTHALMOLOGY
Sonia Huang, Valerie Juniat, Jessica Y Tong, Craig James, Nigel Morlet, Saul Rajak, Roy Tan Da Duan, Peerooz Saeed, Ilse Mombaerts, Dinesh Selva
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引用次数: 0

Abstract

Purpose: Idiopathic granulomatous orbital inflammation is an uncommon histological finding that remains poorly defined due to its overlap with specific causes of granulomatous orbital inflammation, such as orbital sarcoidosis. We aim to identify clinico-radiological features that may differentiate it from other aetiologies of granulomatous inflammation.

Methods: Retrospective case series involving 12 patients and review of the literature.

Results: Eight patients (66.7%) were female. The mean age at presentation was 57.8 ± 9.1 years of age. Eleven cases were unilateral (91.7%). The most common presenting symptoms and signs were palpable mass (n = 10; 83.3%), lid swelling (n = 9; 75%) decreased extraocular movements (n = 4; 33.3%), and proptosis (n = 4; 33.3%). One patient (8.3%) had signs consistent with optic neuropathy on presentation. The lacrimal glands were involved in 6 (50%) cases. For initial management, 2 patients (16.7%) underwent observation only, 8 patients (66.7%) were managed with immunosuppressive drugs, and 2 patients (16.7%) were managed with surgical excision or debulking. Four patients (33.3%) required additional management with either methotrexate or intralesional triamcinolone. Patients were followed up for a mean of 68.4 months. At last follow-up, 7 patients (63.6%) had complete resolution, and 5 (41.7%) had stable disease without further progression.

Conclusion: We present a case series of idiopathic granulomatous orbital inflammation. We found that those with idiopathic disease often had unilateral presentations and appeared to present at a later age than those with orbital sarcoidosis in the literature. Although the differentiation between orbital sarcoidosis and idiopathic disease remains difficult, the features described in this series contribute to a greater understanding of the latter condition.

特发性眼眶肉芽肿性炎症:一个病例系列和文献复习。
目的:特发性眼眶肉芽肿性炎症是一种罕见的组织学发现,由于其与眼眶肉芽肿性炎症的特定病因(如眼眶结节病)重叠,目前仍未明确定义。我们的目的是确定临床放射学特征,可能区分它与其他原因的肉芽肿性炎症。方法:回顾性分析12例患者的病例,并复习文献。结果:女性8例,占66.7%。平均发病年龄57.8±9.1岁。单侧11例(91.7%)。最常见的症状和体征是可触及的肿块(n = 10;83.3%),眼睑肿胀(n = 9;75%)眼外运动减少(n = 4;33.3%),前列腺增生(n = 4;33.3%)。1例患者(8.3%)在就诊时有视神经病变的体征。累及泪腺6例(50%)。在初始治疗中,仅观察2例(16.7%),使用免疫抑制药物8例(66.7%),手术切除或减体积2例(16.7%)。4名患者(33.3%)需要甲氨蝶呤或局部曲安奈德治疗。患者平均随访68.4个月。最后随访,7例患者(63.6%)完全缓解,5例患者(41.7%)病情稳定,无进一步进展。结论:我们报告一个特发性眼眶肉芽肿性炎症系列病例。我们发现,那些特发性疾病往往有单侧表现,出现在较晚的年龄比那些眼眶结节病在文献中。虽然眼眶结节病和特发性疾病之间的区分仍然很困难,但本系列所描述的特征有助于更好地了解后者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
4.80%
发文量
223
审稿时长
38 days
期刊介绍: Official journal of the Canadian Ophthalmological Society. The Canadian Journal of Ophthalmology (CJO) is the official journal of the Canadian Ophthalmological Society and is committed to timely publication of original, peer-reviewed ophthalmology and vision science articles.
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