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Orbital and adnexal sarcoidosis
Venkatesh C Prabhakaran1, Perooz Saeed, Bita Esmaeli
1South Australian Institute of Ophthalmology and Department of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia. eye@health.sa.gov.au
Archives of Ophthalmology (Chicago, Ill. : 1960)
|December 12, 2007
Summary
Orbital sarcoidosis, affecting women and those over 50, often presents as a periocular mass. While steroids offer good initial response, long-term monitoring is crucial for potential systemic disease recurrence.
Area of Science:
- Ophthalmology
- Rheumatology
- Pathology
Background:
- Sarcoidosis is a multisystem inflammatory disease characterized by noncaseating granulomas.
- Orbital and adnexal involvement can significantly impact vision and ocular function.
Purpose of the Study:
- To delineate the clinical presentation and management strategies for orbital and adnexal sarcoidosis.
- To identify demographic and clinical factors associated with this condition.
Main Methods:
- A multicenter retrospective study analyzed 26 patients with biopsy-proven orbital/adnexal sarcoidosis and systemic disease.
- Data collected included initial findings, imaging, treatments, and patient outcomes.
Main Results:
- The most frequent initial symptom was a palpable periocular mass, followed by discomfort, proptosis, and ptosis.
- The lacrimal gland (42.3%) and orbit (38.5%) were most commonly affected, with a predilection for the antero-inferior quadrant.
- Eighty-four percent of patients responded well to treatments like steroids and methotrexate, but 19.2% experienced disease recurrence.
Conclusions:
- Orbital sarcoidosis predominantly affects women over 50, often involving the lacrimal gland and anterior orbit.
- Oral steroids provide effective initial treatment, but long-term surveillance is essential due to the risk of late systemic disease reactivation.
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