ABSTRACT
Background Idiopathic orbital inflammatory pseudotumor (IOIP) is a commom orbital disease,with serious eye symptoms and replase tendency,and its pathogenesis is still unclear.Nuclear factor-κB (NF-κB)-related proteins participate in many important pathophysiological process,however,whether NF-κB plays a role in the IOIP process is worthy of attention.Objective This study was to explore the roles of NF-κB pathway in IOIP pathogenesis.Methods Twenty-four IOIP specimens were collected during surgery in Beijing Tongren Hospital from September 2010 to May 2016.The histopathological characteristics of IOIP were examined by hematoxylin and eosin staining.The expression and location of NF-κB/p65,p-p65,p50 and inhibitor of κB (IκB-ot) were detected by immunohistochemistry and verified by immunocytochemistry and Western blot assay.Results The histopathological features of IOIP were numerous small lymphocyte infiltraion and fibrous tissue proliferation,and a lot of epithelioid cells were seen in lacrimal gland-involved specimens.NF-κB/p65 was positively expressed in the cytoplasm of all 24 specimens and the nucleus in 15 specimens with the expressing rate of 62.5％.p50 was expressed in the cytoplasm in 22 specimens with the expressing rate of 91.7％ and in the nucleus in 17 specimens with the expressing rate of 70.8％.The positive expression of p-p65 was found in 22 specimens with the expressing rate of 91.7％,and IκB-α was expressed in the cytoplasm of 11 specimens with the expressing rate of 45.8％.These results were confirmed by immunocytochemistry and Western blot assay.Conclusions NF-κB pathway is activiated during IOIP process,and NF-κB pathway may be involved in the pathogenesis of IOIP.
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AIM: To observe the effect of intravenous methylprednisolone combined with peri - orbital injection of triamcinolone acetonide for diffuse - type orbital inflammatory pseudotumor. METHODS: Diffuse - type orbital inflammatory pseudotumor in 15 cases ( 19 eyes ) were treated. Intravenous implosive methylprednisolone therapy (0. 5g/ d) was used in the first 3d, and 0. 5g once a week in the following 3wk, ended by 0. 25g once a week in the last 6wk, which meant the total dose was 4. 5g and the whole course lasted for 10wk. At the same time, peri - orbital injection of triamcinolone acetonide ( 40mg ) was performed once in every 3wk, totally 2-4 times. RESULTS: Eight eyes from 7 cases were completely cured, 11 eyes from 8 cases were partly cured. No recurrence and severe complications were observed in the treatment duration. CONCLUSION: Intravenous methylprednisolone combined with peri - orbital injection of triamcinolone acetonide is effective, safe and feasible in treatment of diffuse type orbital pseudotumor with less complications.
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PURPOSE: To evaluate the clinical features and treatment outcomes of steroid therapy for orbital inflammatory pseudotumor. METHODS: Sixty-four patients diagnosed with orbital inflammatory pseudotumor were reviewed retrospectively. Patients with a follow-up period of less than 6 months were excluded from the study. The pseudotumor was classified into myositic, lacrimal, anterior, diffuse, or apical type according to orbital computed tomography findings. All patients were initially treated with systemic corticosteroids and evaluated for response to the treatment. Treatment outcome was considered a "success" if the patient had complete relief of symptoms with no recurrence, and a "failure" if the patient had no or only partial relief of symptoms or showed relapse. Factors affecting the treatment outcome were analyzed. RESULTS: The most frequent lesion subtype was myositis. Periorbital edema was the most common symptom and was evident in 53.1% of the patients. Thirty-eight patients (59.4%) showed treatment success. Age, sex, bilaterality, and mean follow-up length did not correlate with the treatment outcome. A short interval from symptom onset to treatment time and apical subtype were significantly associated with good steroid response (p < 0.05). CONCLUSIONS: In orbital inflammatory pseudotumor, myositis was the most common subtype. A short interval from symptom onset to treatment time and apical subtype were associated with good steroid response.
Subject(s)
Humans , Adrenal Cortex Hormones , Edema , Follow-Up Studies , Myositis , Orbit , Orbital Pseudotumor , Recurrence , Retrospective Studies , Treatment OutcomeABSTRACT
Idiopathic orbital inflammatory pseudotumor (IOIP) is a common ophthalmic disease with uncertain etiology and pathogenesis.It charactarized by chronic inflammatory cell infiltration and connective tissue proliferation.At present,its clinical treatments mainly include pharmacotherapy,radiation therapy and surgery,and the primary treating drugs include glucocorticosteroids and immunosuppressive agents.The mainstay of therapy is systemic glucocorticosteroids,although there is an increasing trend toward the use of alkylating agents,antimetabolites,monoclonal antibodies and other immunosuppressive agents.The progress in clinical treatment of IOIP was reviewed.
ABSTRACT
Idiopathic orbital inflammatory pseudotumor (IOIP) is a common ophthalmic disease that severely damages the visual acuity and countenance of the patient,its etiology and pathogenesis are unclear.Many hypotheses have been proposed,including infection,autoimmunity and neuroendocrine mechanism,etc..These hypotheses reflect certain aspects of the etiology and pathogenesis of IOIP and provide information for further understanding of the disease.The research progression in the etiology and pathogenesis of IOIP was reviewed.