Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi University, Tıp Fakültesi, GÖZ HASTALIKLARI ANABİLİM DALI, Turkey
Approval Date: 2018
Thesis Language: Turkish
Student: GÖKÇEN DENİZ GÜLPINAR İKİZ
Supervisor: Onur Konuk
Abstract:
The purpose of this study is; retrospective analysis of patients diagnosed
with orbital myositis, dacryioadenitis, scleritis, Tolosa-Hunt syndrome or
pseudotumor orbita, under the heading of idiopathic orbital inflammation (IOI) and
to determine the prevalence of IgG4-related orbital disease in this group of patient.
Between the years 2003 and 2017, 133 patients enrolled with IOI and
reactive lymphoid hyperplasia in the Ophthalmology and Orbital Surgery
Department of Gazi University Faculty of Medicine (GÜTF) were reviewed
retrospectively. 3 patients diagnosed with lenfoma and exculuded. Serum samples
were taken from the patients who came for control visits and evaluated with the
IgG4 ELISA kit in the GÜTF Biochemistry Laboratory. Histopathological
diagnosis of orbital biopsy specimens were recorded. Medical files of 130
patients(47 male, 83 female) who were diagnosed with idiopathic orbital
inflammation, were retrospectively reviewed. The ages of the cases were in the
range of 4-80 years and the average age was 40.9 ± 1,4. It has been shown that after
2010, the prevalence of the disease increases, autoimmune thyroid disease can be
accompanied, and they are frequently admitted to the clinic with acute pain. The
cases are confronted with diplopia, especially eyelid edema, conjunctiva
115
hyperemia, proptosis, limitation of eye movement, and decrease in visibility at least
occasionally. For the localized disease, extraocular muscle involvement was
remarkably the most common finding, where, medial rectus is the most common
site of inflammation. Lacrimal gland involvement was seen at the second most
frequent occurrence. It was determined that the main treatment regimen was
systemic steroid administration, with this treatment, the success rate was found to
be %95, in which recuurence rate was 13.1%. 18 of the 33 patients who had tissue
specimens optimally analysed with IgG4 tissue dye, were histopathologically IgG4
positive and IgG4 serum marker positivity was found to be 66.7% in this group.
Retrospective analysis of the clinical characteristics of IOI patients
revealed that the data are consistent with the disease profile in the literature. On the
other hand, when compared with the total number of IOI patients, the number of
patients having histopathologic samples and serum marker levels are limited, which
is an important scantiness when evaluating the prevalence of IgG4-related disease
as a subgroup. Even within this limited sample group, 54.5% of the IgG4-related
disease rate supports the fact that a significant proportion of the IOI patient group
may actually be the orbital manifestation of the IgG4-related disease, as noted in
the literature. For this reason, it is necessary to conduct studies to search for
noninvasive tests that are more sensitive and more reliable than serum marker levels
in the diagnosis of IgG4 related disease.