Clinical, demographic, and outcome differences between isolated and non-isolated lacrimal gland involvement in idiopathic orbital inflammation.

IF 1.4 4区 医学 Q3 OPHTHALMOLOGY
Elif Akbas Ulman, Melis Palamar, Berkay Anil Kupal, Banu Yaman, Taner Akalın, Naim Ceylan, Ozlem Barut Selver
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Abstract

Purpose: To evaluate the clinical data of idiopathic orbital inflammation with isolated and non-isolated lacrimal gland involvement.

Methods: The medical records of patients who were diagnosed with idiopathic orbital inflammation between January 2016 and June 2022 were evaluated. The patients were divided into 2 groups: isolated and non-isolated lacrimal gland involvement, and were compared in terms of clinical characteristics, response to treatment and recurrence rates.

Results: Thirty-three eyes of 32 patients (21 female, 11 male) were included in the study. The mean age of the patients was 47.4 ± 14.8 (range, 11-70). The mean follow-up period was 37.4 ± 21.5 (range, 6-76) months. Isolated lacrimal gland involvement was found in 18 eyes (54.5%), myositis and orbital adipose tissue involvement in addition to lacrimal gland involvement in 13 eyes (39.4%), and diffuse orbital inflammation in two eyes (6.1%). While a total of 24 patients (75.0%) were treated with systemic steroids alone, immunosuppressive drugs were used in addition to steroids in eight patients (25.0%). In patients with isolated lacrimal gland involvement, complete recovery with steroid treatment was significantly higher (p = 0.02), while the need for immunosuppressant medication (p = 0.02) and recurrence rates (p = 0.006) were found to be significantly lower.

Conclusion: To the best of our knowledge, this is the first study to describe and compare the clinical features and treatment outcomes of lacrimal gland biopsy-proven idiopathic orbital inflammation according to the extent of involvement. Knowing whether lacrimal gland involvement is isolated or not may help predict steroid resistance and recurrence risk in patient management.

特发性眼眶炎症累及孤立性和非孤立性泪腺的临床、人口学和结局差异。
目的:评价特发性眼眶炎伴孤立性和非孤立性泪腺累及的临床资料。方法:对2016年1月至2022年6月诊断为特发性眼眶炎的患者病历进行分析。将患者分为孤立性和非孤立性受累泪腺两组,比较两组患者的临床特点、治疗效果及复发率。结果:32例患者33只眼纳入研究,其中女性21例,男性11例。患者平均年龄47.4±14.8岁(范围11 ~ 70岁)。平均随访时间37.4±21.5(范围6 ~ 76)个月。孤立性泪腺受累18眼(54.5%),除泪腺受累外,肌炎和眶脂肪组织受累13眼(39.4%),弥漫性眶炎2眼(6.1%)。共有24例患者(75.0%)单独使用全身类固醇治疗,8例患者(25.0%)在类固醇治疗的同时使用免疫抑制药物。在孤立性泪腺受累的患者中,类固醇治疗的完全康复率明显更高(p = 0.02),而免疫抑制药物的需求(p = 0.02)和复发率(p = 0.006)明显较低。结论:据我们所知,这是第一个根据累及程度描述和比较泪腺活检证实的特发性眼眶炎症的临床特征和治疗结果的研究。了解是否孤立的泪腺受损伤可能有助于预测患者治疗中的类固醇抵抗和复发风险。
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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
451
期刊介绍: International Ophthalmology provides the clinician with articles on all the relevant subspecialties of ophthalmology, with a broad international scope. The emphasis is on presentation of the latest clinical research in the field. In addition, the journal includes regular sections devoted to new developments in technologies, products, and techniques.
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