Orbital inflammatory disease: a joint clinical experience in rheumatology and ophthalmology

Purpose This retrospective study aimed to characterize the clinical features, histopathological findings, and treatment outcomes of patients diagnosed with orbital inflammatory disease (OID) co-managed by the rheumatology and ophthalmology departments in a tertiary hospital. Methods Medical records of 14 patients with OID were analyzed. Data on demographics, clinical presentation, laboratory investigations, radiological imaging, histopathological results, treatment regimens, and disease outcomes were collected and reviewed. Results The mean age of the patients was 34.5 years, with a female (71.4%) predominance. Periorbital pain (62.5%), periorbital edema (50%) and diplopia (50%) were the most common presenting symptoms. Histopathological evaluation revealed diverse subtypes, including non-specific orbital inflammation (NSOI) (42.8%), orbital myositis (28.5%) and IgG4-related disease (14.3%). Initial treatment with systemic corticosteroids achieved remission in 14.3% of patients, while 85.7% required additional immunosuppressive therapy. Radiotherapy was effective in one patient unresponsive to steroid and azathioprine treatment. Conclusion OID presents with diverse clinical manifestations and histopathological subtypes, often requiring multidisciplinary management. While corticosteroids remain the first-line therapy, adjunctive immunosuppressive agents or radiotherapy may be necessary in refractory cases.