Evaluation of the specificity of trigeminal nerve enlargement in the diagnosis of IgG4-related ophthalmic disease.

IF 2.1 3区医学 Q2 OPHTHALMOLOGY Japanese Journal of Ophthalmology Pub Date : 2024-09-23 DOI:10.1007/s10384-024-01116-9

Hiroshi Goto, Kumiko Sone, Masaki Asakage, Kazuhiko Umazume, Yoshihiko Usui, Hideki Mori

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Abstract

Purpose: Enlargement of the trigeminal nerve is observed in 20-53% of patients with IgG4-related ophthalmic disease (IgG4-ROD) and is known to be a useful finding for the diagnosis of IgG4-ROD. On the other hand, enlargement of the trigeminal nerve has also been found at a certain frequency in orbital lymphoproliferative diseases other than IgG4-ROD. Therefore, we here re-evaluated the specificity of trigeminal nerve enlargement in the diagnosis of IgG4-ROD.

Study design: Retrospective, comparative study.

Methods: A total of 149 consecutive cases of IgG4-ROD diagnosed at the Department of Ophthalmology, Tokyo Medical University Hospital were studied. As controls, 218 cases of orbital lymphoma, 13 cases of reactive lymphoid hyperplasia (RLH), and 117 cases of benign orbital tumors other than lymphoproliferative diseases were included. Enlargement of the trigeminal nerve (infraorbital or supraorbital nerve) in IgG4-ROD and all the control cases was evaluated on MRI or CT coronal images.

Results: Enlargement of the trigeminal nerve was observed in 35 of the 149 cases (23.5%) of IgG4-ROD and in 7 of the 218 cases (3.2%) of lymphoma, with a significantly highly frequency in IgG4-ROD (P < .0001). No cases of trigeminal nerve enlargement were observed in the cases of RLH or benign orbital tumors. The sensitivity and the specificity of trigeminal nerve enlargement in the diagnosis of IgG4-ROD were 23.5% and 96.8%, respectively. Additionally, enlargement of the trigeminal nerve was significantly more common in men than in women (P < .028).

Conclusions: The present study indicates that trigeminal nerve enlargement is a characteristic imaging finding and has diagnostic value for IgG4-ROD.

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评估三叉神经肿大在诊断 IgG4 相关眼科疾病中的特异性。

目的：在20%-53%的IgG4相关眼病（IgG4-ROD）患者中可观察到三叉神经肿大，众所周知，三叉神经肿大是诊断IgG4-ROD的一个有用发现。另一方面，在 IgG4-ROD 以外的眼眶淋巴组织增生性疾病中，也有一定频率的三叉神经肿大。因此，我们在此重新评估了三叉神经肿大在 IgG4-ROD 诊断中的特异性：研究设计：回顾性比较研究：研究对象：在东京医科大学附属医院眼科确诊的 IgG4-ROD 连续病例共 149 例。对照组包括 218 例眼眶淋巴瘤、13 例反应性淋巴细胞增生症（RLH）和 117 例淋巴增生性疾病以外的良性眼眶肿瘤。通过核磁共振成像或 CT 冠状图像对 IgG4-ROD 和所有对照病例的三叉神经（眶下或眶上神经）增粗情况进行评估：结果：在149例IgG4-ROD中的35例（23.5%）和218例淋巴瘤中的7例（3.2%）中观察到三叉神经扩张，IgG4-ROD中三叉神经扩张的频率明显较高（P 结论：本研究表明，三叉神经扩张是淋巴瘤的一种常见并发症：本研究表明，三叉神经肿大是一种特征性影像学发现，对IgG4-ROD具有诊断价值。

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

Japanese Journal of Ophthalmology 医学-眼科学

CiteScore

4.80

自引率

8.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.