Non-specific orbital inflammation: Current understanding and unmet needs

Prog Retin Eye Res. 2021 Mar:81:100885. doi: 10.1016/j.preteyeres.2020.100885. Epub 2020 Jul 24.

Abstract

Non-specific orbital inflammation (NSOI) is a noninfectious inflammatory condition of the orbit. Although it is generally considered the most common diagnosis derived from an orbital biopsy, it is a diagnosis of exclusion, meaning that the diagnosis requires exclusion of a systemic process or another identifiable etiology of orbital inflammation. The clinical diagnosis of NSOI is ill-defined, but it is typically characterized by acute orbital signs and symptoms, including pain, proptosis, periorbital edema, chemosis, diplopia, and less commonly visual disturbance. NSOI poses a diagnostic and therapeutic challenge: The clinical presentations and histological findings are heterogeneous, and there are no specific diagnostic criteria or treatment guidelines. The etiology and pathogenesis of NSOI are poorly understood. Here we recapitulate our current clinical understanding of NSOI, with an emphasis on the most recent findings on clinical characteristics, imaging findings, and treatment outcomes. Furthermore, gene expression profiling of NSOI and its implications are presented and discussed.

Keywords: Gene-expression profiling; Granulomatosis with polyangiitis; IgG4-related ophthalmic diseases; Nonspecific orbital inflammation; Orbital sarcoidosis; Thyroid eye disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Gene Expression Profiling
  • Granulomatosis with Polyangiitis / diagnosis
  • Granulomatosis with Polyangiitis / etiology
  • Humans
  • Immunoglobulin G4-Related Disease / diagnosis
  • Immunoglobulin G4-Related Disease / etiology
  • Inflammation / diagnosis*
  • Inflammation / etiology
  • Inflammation / genetics
  • Orbital Diseases / diagnosis*
  • Orbital Diseases / etiology
  • Orbital Diseases / genetics