Related Experiment Video
Updated: Mar 28, 2026

Induction of Ocular Surface Inflammation and Collection of Involved Tissues
Published on: August 4, 2022
Bilateral IgG4-related ophthalmic disease: a strong indication for systemic imaging
Albert Wu1, Nicholas H Andrew1, Alan A McNab2
1South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, Australia.
Background/Aims:
To investigate whether bilateral or unilateral IgG4-related ophthalmic disease (IgG4-ROD) is associated with extra-ophthalmic IgG4-related disease (IgG4-RD).
Methods:
Twin-centre retrospective observational case series of biopsy-confirmed IgG4-ROD. Clinical and radiology data were reviewed for laterality of IgG4-ROD and presence of extra-ophthalmic disease. The literature was reviewed for case series of IgG4-ROD.
Results:
40 IgG4-ROD cases were identified, with median follow-up of 36 months. At diagnosis of IgG4-ROD, all cases were screened for extra-ophthalmic disease with physical examination and blood testing. Systemic imaging was performed in 20 (50%) cases due to clinical suspicion of extra-ophthalmic disease. Of the 21 unilateral IgG4-ROD cases, 3 (14%) had extra-ophthalmic involvement. Of the 19 bilateral cases, 15 (79%) had extra-ophthalmic involvement. Extra-ophthalmic involvement was strongly associated with bilateral IgG4-ROD (p<0.001). On pooling our data (n=40) with previously published cases (n=142), the association remained strong (p<0.001).
Conclusions:
Bilateral IgG4-ROD is strongly associated with extra-ophthalmic IgG4-RD. We recommend that imaging of the neck, chest, abdomen and pelvis be performed for all bilateral cases. Systemic imaging should also be considered in unilateral cases as a significant proportion of these patients will also have extra-ophthalmic disease.
Related Concept Videos
Glaucoma: Overview
Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
Photoreceptors and Visual Pathways
Angle Closure Glaucoma: Treatment
Ophthalmic Drug Delivery Systems

