Mombaerts I, Schlingemann R O, Goldschmeding R, Koornneef L
Department of Ophthalmology, Academic Medical Center, University of Amsterdam, The Netherlands.
Ophthalmology. 1996 Dec;103(12):2135-41. doi: 10.1016/s0161-6420(96)30378-3.
Granulomatous orbital inflammation may occur as an isolated condition of unknown origin. These idiopathic granulomatous lesions are believed to belong to the orbital pseudotumor group by some authors, whereas others consider them sarcoidosis limited to the orbit. The aim of this study is to define the clinicotherapeutic aspects of these lesions.
The records of all patients with diagnosis of orbital pseudotumor and orbital sarcoidosis from the Orbital Center Amsterdam in the period between 1976 and 1994 were reviewed to define those with idiopathic granulomatous orbital inflammation. The authors studied the clinicotherapeutic aspects and histopathology of idiopathic granulomatous orbital inflammation by analysis of their own series and the literature.
Their study group encompassed seven patients with idiopathic granulomatous orbital inflammation. The mean follow-up was 9.5 years (range, 3.5-16.0 years). All had unilateral orbital presentation, with localization in the lacrimal gland in three patients. The lesions clinically presented with signs of mass effect or inflammation or both and were treated successfully with surgery, systemic corticosteroids, a combination of surgery and systemic corticosteroids, or systemic corticosteroids followed by irradiation. Histopathologic analysis showed a spectrum of granulomatous inflammation, admixed with nongranulomatous inflammation and fibrosis. There have been 30 similar cases described in the literature with comparable clinicotherapeutic characteristics.
Based on this study and the literature, it appears that idiopathic granulomatous orbital inflammation is more related to orbital pseudotumor than to orbital sarcoidosis.
肉芽肿性眼眶炎症可能作为一种病因不明的孤立病症出现。一些作者认为这些特发性肉芽肿性病变属于眼眶假瘤组，而另一些人则认为它们是局限于眼眶的结节病。本研究的目的是明确这些病变的临床治疗方面。
回顾了1976年至1994年间阿姆斯特丹眼眶中心所有诊断为眼眶假瘤和眼眶结节病的患者记录，以确定患有特发性肉芽肿性眼眶炎症的患者。作者通过分析自己的系列病例和文献，研究了特发性肉芽肿性眼眶炎症的临床治疗方面和组织病理学。
他们的研究组包括7例特发性肉芽肿性眼眶炎症患者。平均随访时间为9.5年（范围3.5 - 16.0年）。所有患者均为单侧眼眶受累，3例病变位于泪腺。病变临床上表现为占位效应或炎症或两者皆有的体征，并通过手术、全身用皮质类固醇、手术与全身用皮质类固醇联合治疗或全身用皮质类固醇后放疗成功治愈。组织病理学分析显示一系列肉芽肿性炎症，伴有非肉芽肿性炎症和纤维化。文献中描述了30例具有类似临床治疗特征的类似病例。
基于本研究和文献，似乎特发性肉芽肿性眼眶炎症与眼眶假瘤的关系比与眼眶结节病的关系更密切。
