title: IGG4-RELATED OPHTHALMIC DISEASE PRESENTING AS CHOROIDAL AND ORBITAL LESIONS.
abstract: OBJECTIVE
  To report a case of IgG4-related ophthalmic disease (IgG4-ROD) which presented as choroidal and orbital lesions.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 64-year-old man presented with left eye photopsias and a history of IgG4-related perirenal fibrosis. Fundoscopic examination showed multiple bilateral yellow choroidal lesions, and optical coherence tomography showed multiple choroidal lesions. Magnetic resonance imaging of the orbits showed an enhancing lesion present circumferential to the optic nerve, but greater medially, abutting the posterior surface of the left globe. Workup for infectious, autoimmune, and malignant etiologies was negative, and the patient has responded well to treatment with rituximab.
  
  
  CONCLUSIONS
  IgG4-related disease is a systemic fibroinflammatory disease, which often presents in another location, as in our patient. In cases of uncertain choroidal and orbital lesions, a thorough workup for other etiologies is indicated, and lymphoma must be ruled out. Steroids are the mainstay of treatment for IgG4-ROD, however, small case series and our patient responded well to rituximab. To our knowledge, this is the first reported case of choroidal and orbital lesions secondary to IgG4-ROD.
authors.affiliation: Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois.|Department of Ophthalmology, Loyola University Medical Center, Maywood, Illinois.
authors.forename: William S
authors.initials: WS
authors.lastname: Gange
authors.affiliation: Department of Ophthalmology, Loyola University Medical Center, Maywood, Illinois.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Holland
authors.affiliation: Department of Ophthalmology, Loyola University Medical Center, Maywood, Illinois.
authors.forename: Felipe
authors.initials: F
authors.lastname: De Alba
mesh_terms: D001327:Autoimmune Diseases / Q000150:complications*; D015862:Choroid Diseases / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000276:immunology*
chemical_list: D007074:Immunoglobulin G