Abstract Listings 2024

Purpose

Accurately diagnosing orbital lesions is critical yet challenging, often necessitating orbital biopsies that pose significant risks. This study aims to assess the accuracy of clinical and radiological evaluations in distinguishing between orbital inflammatory disease (OID) and orbital lymphoma (OL), underscoring the need for enhanced diagnostic methodologies.

Methods

This retrospective study reviewed records of patients diagnosed with either OL (n=48) or OID (n=44) who underwent orbital biopsies preceded by MRI from 2016 to 2023. Patients with incomplete radiological or clinical data were excluded from the analysis. Data were analyzed using IBM SPSS 29.0.1.1 to examine demographics, clinical presentation, and diagnostic concordance.

Results

The OID group had a mean age of 54.32 ± 17.01 years, while the OL group had a mean age of 67.42 ± 12.86 years (p < 0.001). Clinical differences included higher incidences of lacrimal gland involvement (OID 68.2%, OL 35.4%, p=0.002), eyelid swelling (OID 90.9%, OL 66.7%, p=0.005), and ptosis (OL 16.7%, OID 2.3%, p=0.020). Clinically suspected diagnoses matched histology in 36.4% of OID and 31.3% of OL cases. Radiological diagnoses matched histology in 52.3% of OID and 43.8% of OL cases. For clinical diagnosis, sensitivity and specificity were 36.36% and 68.75% for OID, and 31.25% and 63.64% for OL. For radiological diagnosis, sensitivity and specificity were 52.27% and 56.25% for OID (LR+ 1.19, LR- 0.85), and 43.75% and 47.73% for OL (LR+ 0.84, LR- 1.18).

Conclusion

Despite some diagnostic value, the concordance of clinical and radiological exams with histological findings is suboptimal. Histological confirmation remains indispensable in ambiguous cases to ensure appropriate treatment. Enhancing non-invasive diagnostic techniques is crucial to decrease reliance on biopsies and improve patient outcomes.

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