title: Location and frequency of lesions in patients with IgG4-related ophthalmic diseases.
abstract: BACKGROUND
  It is well-known that the lacrimal gland (LG) may be affected in IgG4-related ophthalmic disease (IgG4ROD). Recently, IgG4-related ophthalmic lesions other than those of the lacrimal gland have been reported. However, no study to date has revealed the details of these lesions. This study was conducted to evaluate the location and frequency of lesions found in conjunction with IgG4ROD using radiological imaging.
  
  
  METHODS
  Radiological images and clinical records of 65 patients collected from seven institutions in Japan were reviewed retrospectively. All patients had been pathologically diagnosed with IgG4ROD. Patients of mucosa-associated lymphoid tissue lymphoma associated with IgG4-related lesions were excluded. Orbital magnetic resonance imaging or computed tomography findings were evaluated.
  
  
  RESULTS
  Of the 65 patients, 31 (47.7 %) had lesions involving the LG alone, whereas 34 (52.3 %) had lesions involving the areas other than LG, including eight patients who had lesions without any LG involvement. IgG4-related ophthalmic lesions included LG enlargement in 57 patients (87.7 %), trigeminal nerve branch enlargement in 25 (38.5 %), extraocular muscle enlargement in 16 (24.6 %), diffuse orbital fat lesions in 15 (23.1 %), orbital mass lesions in 11 (16.9 %), eyelid lesions in eight (12.3 %), and nasolacrimal duct lesion in one (1.5 %). Six patients (9.2 %) presented with visual disturbance due to optic nerve disturbance, eight (12.3 %) with a restriction of ocular movement, and 19 (29.2 %) with exophthalmos.
  
  
  CONCLUSIONS
  Thirty-four (52.3 %) of the 65 IgG4ROD patients had lesions in areas other than LG. Lesions were found in the trigeminal nerve branch including pterygopalatine fossa, extraocular muscles, orbital fat, eyelid, and nasolacrimal duct.
authors.affiliation: Department of Ophthalmology, Mitoyo General Hospital, 708, Himehama, Toyohama-cho, Kanonji, Kagawa, 7691695, Japan, rivon-sogabe@k9.dion.ne.jp.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sogabe
authors.forename: Koh-ichi
authors.initials: K
authors.lastname: Ohshima
authors.forename: Atsushi
authors.initials: A
authors.lastname: Azumi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Takahira
authors.forename: Satoru
authors.initials: S
authors.lastname: Kase
authors.forename: Hideki
authors.initials: H
authors.lastname: Tsuji
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005141:Eyelid Diseases / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D006801:Humans; D006984:Hypertrophy; D007074:Immunoglobulin G / Q000097:blood*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000175:diagnosis*; D009801:Oculomotor Muscles / Q000473:pathology*; D016727:Orbital Pseudotumor / Q000175:diagnosis* / Q000276:immunology; D010265:Paraproteinemias / Q000175:diagnosis* / Q000276:immunology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D020433:Trigeminal Nerve Diseases / Q000175:diagnosis* / Q000276:immunology
chemical_list: D007074:Immunoglobulin G