Idiopathic orbital inflammation in pediatric patients: clinical features and treatment
Author: Svitlana Tronina
Base Hospital / Institution: SI “The Filatov Institute of Eye Diseases and Tissue Therapy of AMSU”
ePoster presentation
Abstract ID: 24-435
Purpose
Space-occupying orbital lesions can be caused not only by neoplastic pathology, but also by inflammatory processes, in particular idiopathic orbital inflammation (IOI).
Methods
42 children and adolescents aged from 4 to 17 years (mean age 11.7 ± 3.2 years) with different forms of IOI were treated at the Department of Pediatric Ophthalmopathology, SI “The Filatov Institute of Eye Diseases and Tissue Therapy of AMSU”.
Results
Acute IOI was observed in 28.5% and chronic in 71.5% of cases. Acute IOI proceeded in the form of myositis in 11.9%, dacryoadenitis in 9.5% and diffuse cellulitis in 7.2%. Chronic IOI manifested as focal lesions in 61.9% and dacryoadenitis in 9.5% of children. Treatment of acute IOI was conservative with the use of local and systemic steroid and non-steroid drugs. All patients with acute IOI were free of recurrence after 1 course. Chronic IOI required more prolonged treatment – up to 4 courses of therapy (mean 1.6 ± 0.8 courses). Repeated courses were given to 11 children (36.7%). Of these, 5 children received them because of an exacerbation of the chronic process, and in 6 children they were planned to achieve complete resorption of the residual lesion. Surgical treatment – external orbitotomy with complete removal of the lesion – was performed in 8 children (19.1%) with chronic focal IOI in cases of ineffective conservative therapy and in the presence of compressive optic neuropathy.
Conclusion
The verification of IOI is a difficult diagnostic problem. In fact, it represents a diagnosis of exclusion. The variety of clinical manifestations makes it necessary to differentiate IOI with tumors, post-traumatic, granulomatous processes. In children the most common form is chronic focal IOI, probably due to the peculiarities of their immune reactivity and susceptibility to proliferative processes. The main method of treatment of IOI in pediatric patients is complex anti-inflammatory therapy with the use of local and systemic corticosteroids. Surgical treatment is indicated in the absence of clinical response to conservative treatment and when there is a threat to visual function.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Nadiia | Bobrova | SI “The Filatov Institute of Eye Diseases and Tissue Therapy of AMSU” |
