title: [Diagnostic value of multidisciplinary meetings on orbital inflammatory pathologies discussed in Nantes University Medical Center].
abstract: BACKGROUND
  Observational study of the diagnoses and the treatment modalities used for orbital inflammatory pathologies discussed in multidisciplinary meetings (MDM) in Nantes University Medical Center over 4 years.
  
  
  METHODS
  A multidisciplinary meeting to discuss eyelid and orbital pathologies (excluding cancer) has been held in Nantes three times per year since October 2008. This retrospective study focuses on the cases of orbital inflammatory pathologies discussed at this meeting from October 2008 to October 2012 (49 cases included).
  
  
  RESULTS
  Twenty-eight (57%) patients were diagnosed with orbital inflammation, 16 (33%) cases with isolated myositis and 5 (10%) with dacryoadenitis. In the diagnostic work-up, orbital biopsy was performed in 64% of orbital inflammation cases, 38% of myositis cases and 80% of dacryoadenitis cases. These specimens led to the diagnosis of 9 lymphomas, 2 histiocytoses and 1 metastasis. The internal medicine work-up allowed for the diagnosis of 3 granulomatoses with polyangiitis, one patient with sarcoidosis, and one patient with tuberculosis. Despite work-up, there remained 14 (29%) idiopathic orbital inflammatory syndromes (IOIS).
  
  
  CONCLUSIONS
  The MDM of orbital pathology allows for the collective approach to the most difficult cases of management and is not concerned with stable orbitopathies or those presenting no diagnostic dilemma. Despite a multidisciplinary, rational etiologic work-up (frequently involving a biopsy), we find a higher rate of IOIS than reported in the literature.
  
  
  CONCLUSIONS
  A multidisciplinary approach appears to be useful in improving management of orbital disease.
authors.affiliation: Service d'ophtalmologie du CHU de Nantes, 2, place Alexis-Ricordeau, 44000 Nantes, France. Electronic address: pierregrimbert@hotmail.fr.
authors.forename: P
authors.initials: P
authors.lastname: Grimbert
authors.forename: B
authors.initials: B
authors.lastname: Vabres
authors.forename: I
authors.initials: I
authors.lastname: Orignac
authors.forename: P
authors.initials: P
authors.lastname: Lebranchu
authors.forename: R
authors.initials: R
authors.lastname: Clairand
authors.forename: M
authors.initials: M
authors.lastname: Gayet
authors.forename: I
authors.initials: I
authors.lastname: Smolik
authors.forename: C
authors.initials: C
authors.lastname: Ferron
authors.forename: P
authors.initials: P
authors.lastname: Corre
authors.forename: M
authors.initials: M
authors.lastname: Weber
mesh_terms: D000046:Academic Medical Centers; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005602:France; D006126:Group Processes; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D033183:Interdisciplinary Communication; D008297:Male; D009916:Orbital Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D010348:Patient Care Team; D011237:Predictive Value of Tests; D012189:Retrospective Studies
keywords: Dysthyroid orbitopathy; Granulomatoses avec polyangéite; Granulomatosis with polyangiitis; Histiocytose; Histiocytosis; Idiopathic orbital inflammatory syndrome; Lymphoma; Lymphome; Multidisciplinary meeting; Orbitopathie dysthyroïdienne; Réunion de concertation pluridisciplinaire; Syndrome d’inflammation orbitaire idiopathique