title: Orbital Inflammation in Pregnant Women.
abstract: OBJECTIVE
  To analyze overlaps between pregnancy and orbital inflammation (OI).
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  Eight new cases from 1997 to 2015 and 2 previously published cases were identified for inclusion in this investigation to provide the fullest clinical picture. Medical records, imaging studies, and the results of biopsies were reviewed.
  
  
  RESULTS
  Three categories of association were discovered: (1) OI arising for the first time during pregnancy (5 cases); (2) OI arising within 3 months of delivery (2 cases); and (3) previously diagnosed OI reactivated or exacerbated by pregnancy (3 cases). One patient had a preexistent systemic autoimmune disease and another's was later diagnosed. One patient had attacks during sequential pregnancies. Findings included eyelid swelling and erythema, conjunctival chemosis, pain on eye movement, minimal diplopia, the usual absence of proptosis, and general preservation of visual acuity. Imaging studies disclosed extraocular muscle swelling (8 cases), most frequently of a single lateral rectus muscle. There were 2 cases of dacryoadenitis; 1 of these and an additional case displayed inflammation of the retrobulbar fat. Corticosteroids effected resolution of most symptoms. Singleton births were normal with the exceptions of an intrauterine fetal demise owing to acrania and a molar pregnancy.
  
  
  CONCLUSIONS
  OI usually affects a single rectus muscle (typically the lateral) and, less often, the lacrimal gland and is often mild when it arises during or after pregnancy. Independent systemic autoimmune disease is an uncommon feature. Corticosteroids were efficacious except in 1 case with severe orbital scarring. No definitive causal relationships between pregnancy and OI could be established based on the clinical data.
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. Electronic address: Fred_Jakobiec@meei.harvard.edu.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Jakobiec
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
authors.forename: Zeba A
authors.initials: ZA
authors.lastname: Syed
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Stagner
authors.affiliation: Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Harris
authors.affiliation: Department of Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, Canada.
authors.forename: Jack
authors.initials: J
authors.lastname: Rootman
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Yoon
authors.affiliation: Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Ilse
authors.initials: I
authors.lastname: Mombaerts
mesh_terms: D000328:Adult; D003607:Dacryocystitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D009801:Oculomotor Muscles / Q000473:pathology*; D055622:Orbital Myositis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D016727:Orbital Pseudotumor / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D005938:Glucocorticoids