Bilateral idiopathic sclerosing inflammation of the orbit: report of three cases

We report 3 cases of bilateral orbital sclerosing inflammation and review the literatures concerning bilateral idiopathic orbital inflammation. We found that when idiopathic orbital inflammation presents as a bilaterally diffuse retrobulbar apical mass, the sclerosing subtype must be considered first, and an orbital biopsy should be performed. The present cases were characterized by chronic-onset, cicatricial inflammation with a mass effect. The most common ocular findings in our study were vision decrease, proptosis, and restriction of extraocular muscle movement. We found that current treatment, using systemic corticosteroids and radiotherapy, was nonspecific, incomplete, or frequently resulted in relapse. For cases refractory to corticosteroids and radiotherapy, early and aggressive multiagent immunosuppressive therapy should be used to minimize visual and ocular disabilities.