J Neurol Surg B Skull Base 2021; 82(01): 096-099
DOI: 10.1055/s-0040-1722636
Typical Orbital Pathologies
Review Article

Not a Tumor-Nonspecific Orbital Inflammation

James A. Garrity
1   Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
› Author Affiliations

Abstract

Objective This study was aimed to illustrate the features and complexities of nonspecific orbital inflammation via discussion of two representative cases.

Design Present study is a retrospective case review.

Setting The study was conducted at a tertiary care medical center.

Participants Two patients with nonspecific orbital inflammation were participants of this retrospective study.

Main Outcome Measures Outcome of the study was disease-free patients and off all medications.

Results At follow-up, both patients are disease free and off all medications.

Conclusion Surgery plays a diagnostic and therapeutic role. While the clinical subtype is important for differential diagnosis and symptomatic treatment, the histologic subtype is similarly important. For inflammatory dacryoadenitis, surgery can be therapeutic. For extensive granulomatosis with polyangiitis, debulking surgery may allow better penetration of medications, especially rituximab.



Publication History

Article published online:
02 February 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Birch-Hirschfeld A. Handbuch der Gesamten Augenheilkunden: Die Krankheiten der Orbita. 2nd ed.. Berlin, Germany: Springer-Verlag; 1930
  • 2 Jakobiec FA, Font RL. Orbit. In: Spencer WH. ed. Ophthalmic Pathology an Atlas and Textbook. Philadelphia, PA: W.B. Saunders; 1986: 2777-2795
  • 3 Nugent RA, Rootman J, Robertson WD, Lapointe JS, Harrison PB. Acute orbital pseudotumors: classification and CT features. AJR Am J Roentgenol 1981; 137 (05) 957-962
  • 4 Kennerdell JS, Dresner SC. The nonspecific orbital inflammatory syndromes. Surv Ophthalmol 1984; 29 (02) 93-103
  • 5 Mahr MA, Salomao DR, Garrity JA. Inflammatory orbital pseudotumor with extension beyond the orbit. Am J Ophthalmol 2004; 138 (03) 396-400
  • 6 McCarthy JM, White VA, Harris G, Simons KB, Kennerdell J, Rootman J. Idiopathic sclerosing inflammation of the orbit: immunohistologic analysis and comparison with retroperitoneal fibrosis. Mod Pathol 1993; 6 (05) 581-587
  • 7 Rootman J, McCarthy M, White V, Harris G, Kennerdell J. Idiopathic sclerosing inflammation of the orbit. A distinct clinicopathologic entity. Ophthalmology 1994; 101 (03) 570-584
  • 8 Plaza JA, Garrity JA, Dogan A, Ananthamurthy A, Witzig TE, Salomão DR. Orbital inflammation with IgG4-positive plasma cells: manifestation of IgG4 systemic disease. Arch Ophthalmol 2011; 129 (04) 421-428
  • 9 Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med 2012; 366 (06) 539-551
  • 10 Mombaerts I, Rose GE, Garrity JA. Orbital inflammation: Biopsy first. Surv Ophthalmol 2016; 61 (05) 664-669
  • 11 Carruth BP, Wladis EJ. Inflammatory modulators and biologic agents in the treatment of idiopathic orbital inflammation. Curr Opin Ophthalmol 2012; 23 (05) 420-426
  • 12 Suhler EB, Lim LL, Beardsley RM. et al. Rituximab therapy for refractory orbital inflammation: results of a phase 1/2, dose-ranging, randomized clinical trial. JAMA Ophthalmol 2014; 132 (05) 572-578
  • 13 Garrity JA, Coleman AW, Matteson EL, Eggenberger ER, Waitzman DM. Treatment of recalcitrant idiopathic orbital inflammation (chronic orbital myositis) with infliximab. Am J Ophthalmol 2004; 138 (06) 925-930
  • 14 Garrity JA, Matteson EL. Biologic response modifiers for ophthalmologists. Ophthal Plast Reconstr Surg 2008; 24 (05) 345-347
  • 15 Mombaerts I, Cameron JD, Chanlalit W, Garrity JA. Surgical debulking for idiopathic dacryoadenitis: a diagnosis and a cure. Ophthalmology 2014; 121 (02) 603-609
  • 16 Mombaerts I, Schlingemann RO, Goldschmeding R, Noorduyn LA, Koornneef L. The surgical management of lacrimal gland pseudotumors. Ophthalmology 1996; 103 (10) 1619-1627