J Korean Ophthalmol Soc.  2017 Jul;58(7):776-781. 10.3341/jkos.2017.58.7.776.

Clinical Characteristics of Idiopathic Orbital Inflammation Accompanied with Paranasal Sinusitis

• Lee KH
• Yoon JS

• KMID: 2387150
• DOI: http://doi.org/10.3341/jkos.2017.58.7.776

Abstract

PURPOSE
To investigate the clinical characteristics of idiopathic orbital inflammatory disease (IOI) with paranasal sinusitis.
METHODS
This study is a retrospective, comparative case series of patients who were diagnosed with IOI between January 2009 and December 2016. This study included patients with available medical and radiologic data at diagnosis and who participated in follow-up for more than 12 months after treatment. The patients were divided into two groups according to accompaniment of paranasal sinusitis and were compared.
RESULTS
Among 101 patients with IOI, 13 (12.9%) were identified to have paranasal sinusitis. The incidence of pain was higher in patients with sinusitis (69.2%) than in patients without sinusitis (25.0%, p = 0.003). More patients with paranasal sinusitis experienced recurrence after systemic steroid therapy (69.2%) than in the other group (34.1%, p = 0.033). Additional immunosuppressants and/or radiation therapy were needed only in 9.1% patients without sinusitis but in 38.5% patients with sinusitis (p = 0.039).
CONCLUSIONS
IOI patients with sinusitis showed a significantly higher recurrence rate. More careful follow-up of patients during steroid tapering and treatment of sinusitis might be helpful to prevent recurrence of IOI.

Keyword

Idiopathic orbital inflammation; Sinusitis

MeSH Terms

Diagnosis
Follow-Up Studies
Humans
Immunosuppressive Agents
Incidence
Inflammation*
Orbit*
Recurrence
Retrospective Studies
Sinusitis*
Immunosuppressive Agents

Figure

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  Figure 1. Treatment and outcome for patients with orbital inflammatory disease. More patients with paranasal sinusitis experienced re-currence after systemic steroid therapy (69.2%) than in the other group (34.1%, p = 0.033). Additional immunosuppressants and/or radiation therapy were needed only in 9.1% patients without sinusitis but in 38.5% patients with sinusitis (p = 0.039). IOI = idiopathic orbital inflammation.

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  Figure 2 . Facial photograph and orbital computed tomography (CT) in a patient who visited our clinic with a 1-month history of pain and proptosis in the right eye, and diplopia (case 2). (A, B) Facial photograph at initial visit shows proptosis in the right eye. (C) Initial CT results revealed infiltration of the right inferior orbital area with ipsilateral maxillary sinusitis. She experienced repetitive inflammation despite of systemic steroid therapy and additional immunosuppressants. (D) The follow-up CT taken after functional endoscopic sinus surgery for maxillary sinusitis. She stopped systemic steroid and additional immunosuppressant, and maintained without recurrence.

Reference

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