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Clinical, demographic, and outcome differences between isolated and non-isolated lacrimal gland involvement in
Elif Akbas Ulman1, Melis Palamar1, Berkay Anil Kupal1
1Department of Ophthalmology, Ege University Medical Faculty Hospital, 35100, Bornova, Izmir, Turkey.
Purpose:
To evaluate the clinical data of idiopathic orbital inflammation with isolated and non-isolated lacrimal gland involvement.
Methods:
The medical records of patients who were diagnosed with idiopathic orbital inflammation between January 2016 and June 2022 were evaluated. The patients were divided into 2 groups: isolated and non-isolated lacrimal gland involvement, and were compared in terms of clinical characteristics, response to treatment and recurrence rates.
Results:
Thirty-three eyes of 32 patients (21 female, 11 male) were included in the study. The mean age of the patients was 47.4 ± 14.8 (range, 11-70). The mean follow-up period was 37.4 ± 21.5 (range, 6-76) months. Isolated lacrimal gland involvement was found in 18 eyes (54.5%), myositis and orbital adipose tissue involvement in addition to lacrimal gland involvement in 13 eyes (39.4%), and diffuse orbital inflammation in two eyes (6.1%). While a total of 24 patients (75.0%) were treated with systemic steroids alone, immunosuppressive drugs were used in addition to steroids in eight patients (25.0%). In patients with isolated lacrimal gland involvement, complete recovery with steroid treatment was significantly higher (p = 0.02), while the need for immunosuppressant medication (p = 0.02) and recurrence rates (p = 0.006) were found to be significantly lower.
Conclusion:
To the best of our knowledge, this is the first study to describe and compare the clinical features and treatment outcomes of lacrimal gland biopsy-proven idiopathic orbital inflammation according to the extent of involvement. Knowing whether lacrimal gland involvement is isolated or not may help predict steroid resistance and recurrence risk in patient management.
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