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X. Mira, H. López, B. Dominguez, B. Najera, M. Tejeda, A. Almanza; Clinical - Tomographic- Pathological Correlation in Idiopathic Orbital Inflammation. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3586. doi: https://doi.org/.
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To correlate clinical, tomographical and histopathological findings of the orbital pseudotumor (OP).
Retrospective, observational, transversal and descriptive study which included the charts of patients with diagnosis of orbital pseudotumor at the orbit department of the Fundacion Hospital Nuestra Señora de la Luz from 2001 to 2006. We divided the patients in the following varieties:A). Anterior OP : When clinically it was reported blepharoedema, conjunctival hyperemia , pain , limitation of extraocular movements, some of them presented vertical dyplopia and ptosis ; at the computed tomography scan (CT scan) the findings : anterior lesion with well defined borders that affected the lacrimal gland at most. The histopathological findings were chronic inflammatory infiltration with hyalinization, and eosynophilic infiltrate in children which is termed childhood orbital pseudotumor . This was the only variety that had an autoimmune disease relatedB) Posterior OP in which their clinical symptoms were proptosis, mild pain, decreased visual acuity and ipsilteral elevated intraocular pressure. The CT scan showed a retrobulbar localization that affected the optic nerve. The histopathological findings were a lymphocitic infiltrate with abundant lymphoid follicules.C)Sclerosing OP in which their clinical symptoms were: severe pain , proptosis , conjuctival hyperemia and intraocular pressure elevated (IOP). At the CT scan both orbits were affected including sclera, extraocular muscles and also the optic nerve. Histopathology revealed large amount of fibrous tissue.
A total of 21 charts were reviewed. Three were excluded because they were incomplete. Of the 17 remaining, 12 were women and 5 men. Mean age 39.8 years (4- 76 years). According to the classification above mentioned the distribution is as follows: 11 cases with anterior OP from 4 years old to 76 years old with a mean of 39.6 years old, 4 of them had arthritis rheumatoid and 3 with Diabetes , 4 cases posterior OP from 15 years old to 67 years old mean age 39.5 years old had important visual loss and elevated IOP and 2 cases were sclerosing OP, they were women at the fourth decade , mean age 44 years both with a past history of scleritis, and one of them had Crohn disease which was simultaneously active with the OP.
This is a rare orbital disease which predominates in women with a relation 2:1 with men. It is more frequent around the fourth decade of life. Also, we found that the anterior orbital pseudotumor is associated with an autoimmune disease simultaneously.
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