Orbital inflammatory disease: a joint clinical experience in rheumatology and ophthalmology.

Abstract

Purpose: This retrospective study aimed to characterize the clinical features, histopathological findings, and treatment outcomes of patients diagnosed with orbital inflammatory disease (OID) co-managed by the rheumatology and ophthalmology departments in a tertiary hospital.

Methods: Medical records of 14 patients with OID were analyzed. Data on demographics, clinical presentation, laboratory investigations, radiological imaging, histopathological results, treatment regimens, and disease outcomes were collected and reviewed.

Results: The mean age of the patients was 34.5 years, with a female (71.4%) predominance. Periorbital pain (62.5%), periorbital edema (50%) and diplopia (50%) were the most common presenting symptoms. Histopathological evaluation revealed diverse subtypes, including non-specific orbital inflammation (NSOI) (42.8%), orbital myositis (28.5%) and IgG4-related disease (14.3%). Initial treatment with systemic corticosteroids achieved remission in 14.3% of patients, while 85.7% required additional immunosuppressive therapy. Radiotherapy was effective in one patient unresponsive to steroid and azathioprine treatment.

Conclusion: OID presents with diverse clinical manifestations and histopathological subtypes, often requiring multidisciplinary management. While corticosteroids remain the first-line therapy, adjunctive immunosuppressive agents or radiotherapy may be necessary in refractory cases.