Clinical Features and Treatment Outcomes of Orbital Inflammatory Disease in Singapore: A 10-Year Clinicopathologic Review.
OBJECTIVE
1) To assess the clinical profile and treatment outcomes of orbital inflammatory disease in the local population, and 2) classify patients using current histopathological criteria.


METHODS
Ten-year retrospective clinicopathologic review of patients diagnosed with orbital inflammatory disease who underwent tissue biopsy from January 2001 to December 2011 at a tertiary referral centre in Singapore. Data collection included patient demographics, clinical presentation, investigations, systemic disease, histopathology review, clinical classification, medical and surgical management, response to treatment and recurrence rates.


RESULTS
The study comprised 70 patients. Thirty-seven (52.9%) had nonspecific inflammation distributed as follows: lacrimal (n = 23), diffuse (n = 5), anterior (n = 5), myositic (n = 4). Thirty-three (47.1%) had specific inflammation of the following subtypes: idiopathic sclerosing inflammation (n = 9), granulomatous disorders (n = 8), transitional lesions (n = 5), vasculitis (n = 4), and others (n = 7). A total of 76.8% of patients received oral prednisolone, with a median duration of three months. Response to treatment was good in 71.9% of patients. Recurrence occurred in 22 (32.8%) patients at a mean interval of 20 months after completion of treatment, and was higher in myositic and vasculitic subtypes. There was no significant correlation between duration of treatment and recurrence.


CONCLUSIONS
This study has re-emphasized the importance and utility of orbital biopsy and histopathologic typing for optimal management of orbital inflammatory disease. It has also improved the knowledge of the rate and response to treatment of its various subtypes.
*National University Health System, †Singapore National Eye Centre, ‡Singapore General Hospital, §Duke-Graduate School of Medicine, and ‖Singapore Eye Research Institute, Singapore, Singapore.
Stephanie M
SM
Young
Anita S Y
ASY
Chan
Issam Al
IA
Jajeh
Sunny
S
Shen
Lay-Leng
LL
Seah
Chai-Teck
CT
Choo
Stephanie S
SS
Lang
Audrey L G
ALG
Looi
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016727:Orbital Pseudotumor / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D011239:Prednisolone / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011239:Prednisolone