Lacrimal Gland Inflammation - The Singapore National Eye Centre Experience

Abstract

Purpose:: To review the clinical profile, spectrum of presentations, histological types and treatment response of patients with lacrimal gland inflammatory disease treated at the Singapore National Eye Centre, between the year 2001 to 2005.

Methods:: A retrospective tissue audit review of patients with biopsy proven lacrimal gland inflammatory disease. Those with thyroid eye disease, infections and lymphoproliferative diseases were excluded.

Results:: A total of 21 patients were reviewed in this study, which accounted for 76.9% of the patients with biopsy proven orbital inflammation. The age of the patients ranged from 12 to 64 years, with a mean of 40.6 years of age. There was no age predeliction among the specific and non-specific inflammation groups of patients. Among the 2 groups, 42.9% of patients (9 patients) were diagnosed to have specific inflammation, whilst the remaining 57.1% (12 patients) were non-specific disease. Within the specific inflammatory group, majority were sclerosing inflammation (4), while the other 4 were related to kimura’s inflammation (2), Wegener’s granulomatosis and Systemic Lupus erythematosus (SLE). The 3 most common presenting symptoms in both groups were: pain, redness and swelling and majority (66%) of the patients presented with chronic onset of symptoms of more than 1 month duration. Systemic associations were only found in the group with specific inflammation. (5 patients - Kimura’s inflammation, SLE, Wegerner’s granulomatosis, Alopecia) The most common therapy instituted was systemic steroids. Those in the specific inflammatory group generally required longer durations of steroid treatment (mean = 16.1 months) as compared to an average of 3.9 months in group with non-specific inflammation.

Conclusions:: Lacrimal inflammation accounts for majority of the orbital inflammatory disease. Histological diagnosis is important in establishing the nature of the inflammation which can then guide the duration and response to treatment.

Keywords: lacrimal gland • inflammation • orbit