Inflammation and Fibrosis in Orbital Inflammatory Disease: A Histopathologic Analysis
Rohan Verma1,2, Allison J Chen3, Dongseok Choi4,5
1Oculofacial Plastic and Reconstructive Surgery, Casey Aesthetic Facial Surgery Center, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, U.S.A.
Ophthalmic Plastic and Reconstructive Surgery
|June 6, 2023
Summary
Orbital inflammatory diseases like GPA, sarcoidosis, and NSOI show increased inflammation and fibrosis in orbital fat compared to controls. Thyroid-associated orbitopathy did not significantly differ from healthy controls.
Area of Science:
- Ophthalmology
- Pathology
- Immunology
Background:
- Orbital inflammatory disease (OID) encompasses a range of conditions affecting the tissues around the eye.
- Histopathologic changes in orbital adipose tissue can provide insights into disease mechanisms and severity.
Purpose of the Study:
- To compare histopathologic inflammation and fibrosis in orbital adipose tissue across different OID subtypes and healthy controls.
- To evaluate the utility of adipose tissue analysis in understanding OID.
Main Methods:
- A retrospective cohort study involving 74 orbital adipose tissue specimens from patients with thyroid-associated orbitopathy (TAO), granulomatosis with polyangiitis (GPA), sarcoidosis, nonspecific orbital inflammation (NSOI), and healthy controls.
- Tissue specimens were scored by two masked ocular pathologists for inflammation and fibrosis on a 0-3 scale.
- Data were collected from eight international centers across four countries.
Main Results:
- Mean inflammation and fibrosis scores for healthy controls were 0.0 and 1.1, respectively.
- GPA, sarcoidosis, and NSOI demonstrated significantly higher inflammation and fibrosis scores compared to controls (p ≤ 0.001).
- Sarcoidosis exhibited the highest mean inflammation score, while GPA showed the highest mean fibrosis score.
Conclusions:
- Orbital adipose tissue in TAO did not show significant differences in inflammation or fibrosis compared to healthy controls.
- More severe inflammatory conditions (GPA, sarcoidosis, NSOI) exhibit increased histopathologic inflammation and fibrosis.
- These findings have implications for OID prognosis, treatment selection, and monitoring disease activity.
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