Inflammatory modulators and biologic agents in the treatment of idiopathic orbital inflammation

To review the diagnosis and treatment of idiopathic orbital inflammation (IOI), with an emphasis on the development and use of inflammatory mediators and biologic agents.

Use of targeted biologic immunomodulatory therapy is becoming widespread and proving effective against many inflammatory and autoimmune conditions. Although corticosteroids remain the mainstay of care for IOI, their use is fraught with complications and side-effects, suggesting the need for novel therapies. Evidence for the successful implementation of nonsteroidal inflammatory mediators in IOI is accumulating.

The treatment of IOI with traditional methods, particularly corticosteroids, is often inadequate and accompanied by recurrences, medication dependence, and intolerability. Many of these issues may be avoided with the use of existing and novel pharmaceutical agents targeting specific inflammatory mediators. The literature on these agents and their use in IOI is in its infancy but shows tremendous promise in the treatment of this often-recalcitrant illness.