Orbital Inflammation in Pregnant Women. Am J Ophthalmol 2016 Jun;166:91-102
Date
04/04/2016Pubmed ID
27038895DOI
10.1016/j.ajo.2016.03.029Scopus ID
2-s2.0-84964913519 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
OBJECTIVE: To analyze overlaps between pregnancy and orbital inflammation (OI).
DESIGN: Retrospective observational case series.
METHODS: Eight new cases from 1997 to 2015 and 2 previously published cases were identified for inclusion in this investigation to provide the fullest clinical picture. Medical records, imaging studies, and the results of biopsies were reviewed.
RESULTS: Three categories of association were discovered: (1) OI arising for the first time during pregnancy (5 cases); (2) OI arising within 3 months of delivery (2 cases); and (3) previously diagnosed OI reactivated or exacerbated by pregnancy (3 cases). One patient had a preexistent systemic autoimmune disease and another's was later diagnosed. One patient had attacks during sequential pregnancies. Findings included eyelid swelling and erythema, conjunctival chemosis, pain on eye movement, minimal diplopia, the usual absence of proptosis, and general preservation of visual acuity. Imaging studies disclosed extraocular muscle swelling (8 cases), most frequently of a single lateral rectus muscle. There were 2 cases of dacryoadenitis; 1 of these and an additional case displayed inflammation of the retrobulbar fat. Corticosteroids effected resolution of most symptoms. Singleton births were normal with the exceptions of an intrauterine fetal demise owing to acrania and a molar pregnancy.
CONCLUSION: OI usually affects a single rectus muscle (typically the lateral) and, less often, the lacrimal gland and is often mild when it arises during or after pregnancy. Independent systemic autoimmune disease is an uncommon feature. Corticosteroids were efficacious except in 1 case with severe orbital scarring. No definitive causal relationships between pregnancy and OI could be established based on the clinical data.
Author List
Jakobiec FA, Syed ZA, Stagner AM, Harris GJ, Rootman J, Yoon MK, Mombaerts IAuthor
Gerald J. Harris MD Professor in the Ophthalmology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultDacryocystitis
Female
Glucocorticoids
Humans
Magnetic Resonance Imaging
Oculomotor Muscles
Orbital Myositis
Orbital Pseudotumor
Pregnancy
Pregnancy Complications
Retrospective Studies
Young Adult
