Comparative Analysis of IgG4-Related Orbital Disease and Idiopathic Orbital Inflammatory Syndrome: Clinical Characteristics, Therapy, and Prognosis
Author: Alexander Rattunde
Base Hospital / Institution: Universitätsmedizin Berlin Charité
ePoster presentation
Abstract ID: 24-429
Purpose
IgG4-related orbital disease (IgG4-ROD) is a distinct yet poorly understood differential diagnosis of idiopathic orbital inflammatory syndrome (IOIS). Differentiating these conditions is critical for treatment and prognosis. This retrospective study aimed to compare clinical features, treatment responses, and prognoses of these conditions.
Methods
We reviewed medical records of 54 patients diagnosed with IgG4-ROD or IOIS via orbital biopsy from January 2016 to December 2023. Follow-up was 21.72 ± 26.16 months for IgG4-ROD and 7.5 ± 10.33 months for IOIS. Demographic and clinical parameters were collected and compared between the two groups, and analyzed using IBM SPSS 29.0.1.1.
Results
The study included 18 IgG4-ROD and 36 IOIS patients. IgG4-ROD patients were older (61.78 ± 15.85 years) than IOIS patients (49.94 ± 15.03 years). Both groups commonly had lacrimal gland and extraocular muscle involvement, but paranasal sinus involvement was higher in IgG4-ROD (p = 0.003). IgG4-ROD patients more frequently had a relative afferent pupillary defect (p = 0.042) and systemic diseases (p = 0.005). Visual acuity improved post-therapy in IOIS (p = 0.038) but not in IgG4-ROD (p = 0.25). Systemic involvement did not affect visual acuity in either group. Recurrences were more frequent in IgG4-ROD patients (38.9% vs. 11.4%, p = 0.02), who also required additional therapies beyond steroids more often (p = 0.002).
Conclusion
Although IgG4-ROD and IOIS share some clinical features, they differ significantly in age, associated diseases, recurrence rates, and treatment needs. Recognizing these differences is essential for accurate diagnosis and tailored therapy, highlighting the necessity for further investigations.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Vitus | Knecht | Universitätsmedizin Berlin Charité |
| Eckart | Bertelmann | Universitätsmedizin Berlin Charité |
