Idiopathic apical orbital inflammation: clinical features and outcomes
Bibliographic record
Abstract
Background: Idiopathic apical orbital inflammation (AOI) is used to describe inflammation involving the posterior third of the orbit where no specific cause can be identified.It is a rare entity in which the presentation can vary widely.We aim to describe a case series of patients with idiopathic AOI and their clinicoradiological features and visual outcomes.Method: Retrospective multi-centre case series involving patients with idiopathic AOI.Results: Seven patients were included.The mean age was 50.3 18.4 years (range: 3184 years).The left eye was involved in the majority of patients (4, 57.1%), with the most common presenting clinical symptoms and signs being limitation of extraocular movements (6, 85.7%), periorbital pain (4, 57.1%), and blurred vision (4, 57.1%).Optic neuropathy was present in 3 (42.9%)patients.Three patients (42.9%) underwent an orbital biopsy, which were all consistent with nonspecific inflammation.Medical treatment was used for all patients in the form of oral steroids (5, 71.4%) or nonsteroidal anti-inflammatories (1, 14.3%).Two (28.6%) patients had additional immunosuppression.At last follow-up, 2 (28.6%) patients had achieved complete resolution of all of their symptoms, 2 (28.6%) patients had significant clinical improvement with mild residual disease, 2 (28.6%) had stable disease, and 1 (28.6%) was lost to follow-up.Conclusion: Idiopathic AOI is a rare condition that can present with a wide variety of symptoms and be potentially blinding.Patients responded well to oral corticosteroids, but biopsy and additional immunosuppressive agents should be considered in those with recurrent, poorly responsive, or atypical disease.Contexte: L'inflammation orbitaire apicale (IOA) idiopathique dcrit une inflammation qui touche le tiers postrieur de l'orbite sans cause spcifique.Il s'agit d'une affection rare dont les caractristiques initiales peuvent varier grandement.Nous nous proposons de dcrire les caractristiques cliniques et radiologiques de mme que les rsultats visuels de l'IOA idiopathique chez une srie de patients.Mthode: tude multicentrique rtrospective portant sur une srie de cas d'IOA idiopathique.Rsultats: Notre tude regroupait 7 patients, dont l'ge moyen s'levait 50,3 18,4 ans (fourchette : 31-84 ans).C'est l'oeil gauche qui tait atteint chez la majorit des patients (4; 57,1 %).Les signes et symptmes cliniques initiaux les plus frquents taient la limitation des mouvements extraoculaires (6; 85,7 %), la douleur priorbitaire (4; 57,1 %) et la vision brouille (4; 57,1 %).On a not la prsence d'une neuropathie optique chez 3 patients (42,9 %), et 3 patients (42,9 %) ont subi une biopsie orbitaire, les rsultats ayant fait ressortir une inflammation non spcifique dans tous les cas.Le traitement mdical de tous les patients a repos sur les strodes par voie orale (5; 71,4 %) ou les anti-inflammatoires non strodiens (1; 14,3 %).Par ailleurs, 2 patients (28,6 %) prsentaient une immunosuppression supplmentaire.Lors de la dernire visite de suivi, on a not une disparition complte de tous les symptmes chez 2 patients (28,6 %), une amlioration clinique significative s'accompagnant de symptmes rsiduels lgers chez 2 patients (28,6 %) et une stabilisation de l'affection chez 2 patients (28,6 %).Un seul patient (14,3 %) a t perdu de vue lors du suivi.Conclusion: L'IOA idiopathique est une affection rare qui se manifeste par une grande varit de symptmes et qui risque d'entraner la ccit.Les patients rpondent bien la corticothrapie orale, mais on doit envisager la biopsie et la prescription d'immunosuppresseurs supplmentaires en prsence d'une atteinte rcurrente, atypique ou rfractaire au traitement.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".