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Erschienen in:
20.06.2017 | Original Paper
Factors associated with multiple recurrences of nonspecific orbital inflammation aka orbital pseudotumor
Erschienen in: International Ophthalmology | Ausgabe 4/2018
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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.