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Type: Journal article
Title: Intraorbital corticosteroid injection for the treatment of IgG4-related ophthalmic disease
Author: Andrew, N.
Gajdatsy, A.
Selva, D.
Citation: British Journal of Ophthalmology, 2016; 100(5):644-647
Publisher: BMJ Publishing
Issue Date: 2016
ISSN: 0007-1161
Statement of
Nicholas H Andrew, Adam Gajdatsy, Dinesh Selva
Abstract: AIM: To review the efficacy of intraorbital corticosteroid injection for the treatment of IgG4-related ophthalmic disease (IgG4-ROD). METHODS: This study was a retrospective twin-centre histopathology review and observational case series. A chart review was undertaken for 10 cases of biopsy-confirmed IgG4-ROD treated with intraorbital corticosteroid injection. The main outcome measures were the magnitude, onset and duration of the clinical response. RESULTS: All cases received intraorbital injection(s) of 20 or 40 mg doses of triamcinolone acetonide suspension (Kenacort-A 40, Bristol-Myers Squibb, Australia). Intraorbital corticosteroid injection was associated with a swift positive response in all cases. 50% of cases achieved complete and sustained clinical remission during mean follow-up of 41 months. This was achieved with a single injection in three cases and with repeat injections in two cases. Peak clinical improvement was reached in ≤7 days following 61% of injections. 60% of cases suffered relapse and 56% of relapses occurred during weeks 3 or 4 following injection. Sclerosing histology was associated with a clinical response that was gradual in onset (p=0.01) and that tended to be incomplete (p=0.4). There were no complications of injection other than brief discomfort. CONCLUSIONS: Intraorbital injection of corticosteroid may be a useful treatment option for IgG4-ROD. It may have a role as a first-line therapy in selected cases of IgG4-ROD centred in the anterior orbit. However, most cases require repeat injections due to incomplete response and relapse.
Keywords: Inflammation
Treatment Medical
Rights: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
DOI: 10.1136/bjophthalmol-2015-307164
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