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Autoimmune markers in screening for orbital inflammatory disease
Terence Ang1, Valerie Juniat2, Dinesh Selva2
1Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, SA, Australia. terencewxang@gmail.com.
Eye (London, England)
|April 20, 2022
Summary
Autoimmune markers like ANA are not reliable for diagnosing orbital inflammation. Serological testing alone is insufficient, and biopsy decisions are independent of these results.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Differentiating immunogenic causes of orbital inflammation can be challenging.
- Orbital inflammatory disease (OID) requires accurate diagnostic work-up.
Purpose of the Study:
- To evaluate the effectiveness of autoimmune markers in screening for OID.
- To assess the utility of markers such as antinuclear antibody (ANA), anti-neutrophilic cytoplasmic autoantibodies (ANCA), and others in diagnosing orbital inflammation.
Main Methods:
- Retrospective analysis of 79 patients with non-infective OID.
- Screening for autoimmune markers (ACE, ANA, ANCA, ENA, Anti-CCP, Anti-dsDNA) at presentation.
- Interpreting serology alongside clinical data, imaging, and histopathology.
Main Results:
- Autoimmune markers showed limited discriminatory value in differentiating specific OID from non-specific orbital inflammation (NSOI).
- Serological results did not correlate with the decision to perform a biopsy.
- Only 41.7% of patients with positive serology and a specific diagnosis had concordant results.
Conclusions:
- Serological testing alone is insufficient for diagnosing OID and guiding further investigations.
- Biopsies are often performed irrespective of serological findings.
- Autoimmune markers may have value in long-term follow-up for patients with indeterminate or initially negative results.
