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Adult Versus Pediatric Relapse and Recurrence in Orbital Inflammatory Syndrome
Jamie A Keen1, Brandon J Kennedy2, Aleksey Mishulin3
1Kresge Eye Institute, Detroit, Michigan, U.S.A.
Ophthalmic Plastic and Reconstructive Surgery
|May 20, 2020
Summary
Orbital inflammatory syndrome (OIS) frequently recurs, especially in children where relapse predicts recurrence. Underlying causes are more common in recurrent OIS cases, often leading to multiple episodes.
Area of Science:
- Ophthalmology
- Immunology
- Pediatric Medicine
Background:
- Orbital inflammatory syndrome (OIS) is a challenging diagnosis of exclusion.
- OIS often presents variably and unpredictably, with high rates of recurrence and relapse.
- Limited research exists on the characteristics of OIS recurrence and relapse.
Purpose of the Study:
- To investigate the characteristics of recurrence and relapse in orbital inflammatory syndrome.
- To compare OIS recurrence and relapse patterns in pediatric versus adult patients.
Main Methods:
- Retrospective chart review of 56 OIS patients (2004-2018).
- Categorization into adult (>18 years) and pediatric (<18 years) groups.
- Analysis of recurrence and relapse rates and associated factors.
Main Results:
- 18 cases (32.1%) experienced recurrence, and 15 (26.8%) had relapses.
- Pediatric patients with recurrence predominantly experienced initial relapses (100%), unlike adults (8.3%).
- Half of recurrent OIS cases had multiple recurrences; underlying etiologies were more frequent in recurrent cases.
Conclusions:
- Relapse is a significant predictor of recurrence in pediatric OIS.
- Recurrence is common in OIS, with frequent multiple episodes.
- Identifiable underlying etiologies are more prevalent in recurrent OIS and associated with multiple recurrences.
