Biopsy Results in Patients Initially Diagnosed as Idiopathic Orbital Inflammatory Syndrome

Objectives: To present our biopsy results in patients who were referred to our oculoplastic clinic with an initial diagnosis of idiopathic orbital inflammatory syndrome (IOIS). Materials and Methods: We evaluated 22 patients who were referred to our oculoplastic clinic with an initial diagnosis of idiopathic orbital inflammation between 2009 and 2013. We performed biopsy on the patients in whom a differential diagnosis was not possible, or response to steroid treatment was not satisfactory, or recurrence occurred after steroid treatment. According to the histopathological evaluation, treatment protocols were determined. Results: The study included 12 male and 10 female patients. Mean age was 45.6 years (range 16-77 years). Inadequate response to steroid treatment or recurrence in 8 patients and difficulty in differential diagnosis in 4 patients were the indications for the biopsy. One patient declined the biopsy. One patient could not be operated on because of the accompanying systemic diseases. We performed orbital fat tissue biopsy in 7 patients, lacrimal gland biopsy in 2 patients, and extraocular muscle biopsy in 1 patient. Histopathological evaluations demonstrated IOIS in 8 patients. Lymphoma was diagnosed in 2 patients in whom biopsies were taken from the lacrimal gland and retrobulbar fat tissue. Conclusion: We suggest that biopsy should be performed to confirm the diagnosis and to determine the treatment modality in patients with an initial diagnosis of IOIS, when a differential diagnosis is not possible, or response to steroid treatment is not satisfactory, or if recurrence occurs. (Turk J Ophthalmol 2014; 44: 301-5