title: Pediatric Idiopathic Orbital Inflammation: Clinical Features of 30 Cases.
abstract: OBJECTIVE
  Pediatric idiopathic orbital inflammation (IOI) is a rare entity with little known about the clinical presentation and natural history. The authors report the demographics, clinical presentations, radiographic and histopathologic characteristics, and treatment outcome of 30 children with IOI.
  
  
  METHODS
  Retrospective chart review of 30 patients 18 years and younger diagnosed with IOI and statistical analysis using analysis of variance and Fisher's exact test. This study was reviewed and approved by the Institutional Review Board of SUNY Downstate Medical Center.
  
  
  RESULTS
  There were 9 males (30%) and 21 females (70%) with pediatric IOI who presented at a median age of 11 years (range 2-18 years). Primary IOI was found in 19 patients (63%) and recurrent IOI in 11 patients (37%). Overall, 26 patients (87%) had unilateral IOI while 4 patients (13%) had bilateral disease at presentation. There were 12 patients (40%) with systemic constitutional signs. The most common ophthalmic findings included periorbital edema (n = 20, 67%) and blepharoptosis (n = 17, 57%). All patients had orbital radiography with common findings of dacryoadenitis (n = 12, 40%), orbital mass (n = 12, 40%), or myositis (n=10, 33%). The presence of a radiographic orbital mass was significantly related to the clinical presence of blepharoptosis (p = 0.03). The most common treatment was oral glucocorticoids in 24 patients (80%). Over mean follow up of 19 months (range 6-64 months), females were more likely to display recurrent disease (p = 0.01).
  
  
  CONCLUSIONS
  Idiopathic orbital inflammation is an uncommon but important cause of acute orbital syndrome in children, manifesting as a bilateral condition in 13% and with constitutional symptoms in 40%. Posttreatment recurrence is found in 37% of cases.
authors.affiliation: *Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York; †Department of Ophthalmology, The University of Colorado, Denver, Colorado; ‡Lions Eye Institute, Albany Medical College, Albany, New York; §A.O. Ospedale Niguarda Ca' Granda, Milan, Italy; ‖Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy; and ¶Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Jordan
authors.initials: J
authors.lastname: Spindle
authors.forename: Sunny X
authors.initials: SX
authors.lastname: Tang
authors.forename: Brett
authors.initials: B
authors.lastname: Davies
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Wladis
authors.forename: Elena
authors.initials: E
authors.lastname: Piozzi
authors.forename: Marco
authors.initials: M
authors.lastname: Pellegrini
authors.forename: Sara E
authors.initials: SE
authors.lastname: Lally
authors.forename: Carol
authors.initials: C
authors.lastname: Shields
authors.forename: Roman
authors.initials: R
authors.lastname: Shinder
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009915:Orbit / Q000000981:diagnostic imaging*; D016727:Orbital Pseudotumor / Q000175:diagnosis* / Q000188:drug therapy; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids