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Factors associated with multiple recurrences of nonspecific orbital inflammation aka orbital pseudotumor

International Ophthalmology volume 38, pages 1485–1495 (2018)Cite this article

Abstract

Objective

To assess clinical characteristics of patients at risk for recurrent nonspecific orbital inflammation (NSOI).

Methods

This was a retrospective comparison study with a 24-month follow-up, in a clinic-based population in rural India. The medical records at two eye care centers were searched from March 2001–2014. A total of 153 patients with recurrent NSOI, 107 of whom had a single recurrence (Group 1) and 46 of whom had multiple recurrences (Group 2). Clinical and demographic data were compared between both groups. Comparisons of mean values were done with multiple 2-tailed independent T tests, and differences in proportions were compared using Chi-squared tests. A multivariate logistic regression model was used to determine which factors were predictive of patients having multiple recurrences.

Results

Several factors were independently related to multiple recurrences (P < 0.05 for all): age ≤16 years (2.5 OR, 95% CI 1.3–3.6), bilateral disease (3.2 OR 95% CI 1.4–5.1), presence of optic disc edema or T-sign on B-scan ultrasonography (3.9 OR 95% CI 1.8–6.2), sclerosing variant (8.5 OR 95% CI 5.4–11.3), corticosteroid taper <4 weeks long (2.8 OR 95% CI 1.1–4.2), autoimmune disease among 1st degree relatives (2.2 OR 95% CI 1.2–3.3). In patients with recurrent disease, the interval between the initial episode and the first recurrence was predictive of further recurrences: ≤3 months (3.2 OR, 95% CI 2.0–4.5) and ≥12 months (0.21 OR, 95% CI 0.01–0.39).

Conclusion

Younger patients and those with bilateral disease are more apt to have recurrences of NSOI. Other factors that increase the risk of multiple recurrences include a T-sign, optic disc edema, poor initial response to steroids, a sclerosing variant, a recurrence within 3 months, and those who underwent a rapid steroid taper.

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Acknowledgements

We would like to express our gratitude to the clinical staff at the KD Dalmia Eye Hospital and the Balwant Singh Charitable hospital for their efforts in translating the medical record, data acquisition, and acting as a liaison for outside health centers.

Author information

Affiliations

  1. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL, 33136, USA

    Puneet S. Braich

  2. Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA, USA

    Robin K. Kuriakose, Naveen S. Khokhar & Jared C. Donaldson

  3. The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Timothy J. McCulley

Authors
  1. Puneet S. Braich
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  2. Robin K. Kuriakose
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Correspondence to Puneet S. Braich.

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Braich, P.S., Kuriakose, R.K., Khokhar, N.S. et al. Factors associated with multiple recurrences of nonspecific orbital inflammation aka orbital pseudotumor. Int Ophthalmol 38, 1485–1495 (2018). https://doi.org/10.1007/s10792-017-0610-7

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  • DOI: https://doi.org/10.1007/s10792-017-0610-7

Keywords

  • Orbital pseudotumor
  • Orbital inflammatory disease
  • Idiopathic orbital inflammation
  • Nonspecific orbital inflammation
  • Risk factors for multiple recurrences