Idiopathic granulomatous orbital inflammation: case series and literature review
Bibliographic record
Abstract
OBJECTIVE: Idiopathic granulomatous orbital inflammation is an uncommon histological finding that remains poorly defined due to its overlap with specific causes of granulomatous orbital inflammation, such as orbital sarcoidosis. We aim to identify clinico-radiological features that may differentiate it from other aetiologies of granulomatous inflammation. METHODS: Retrospective case series involving 12 patients and review of the literature. RESULTS: Eight patients (66.7%) were female. The mean age at presentation was 57.8 ± 9.1 years of age. Eleven cases were unilateral (91.7%). The most common presenting symptoms and signs were palpable mass (n = 10; 83.3%), lid swelling (n = 9; 75%) decreased extraocular movements (n = 4; 33.3%), and proptosis (n = 4; 33.3%). One patient (8.3%) had signs consistent with optic neuropathy on presentation. The lacrimal glands were involved in 6 (50%) cases. For initial management, 2 patients (16.7%) underwent observation only, 8 patients (66.7%) were managed with immunosuppressive drugs, and 2 patients (16.7%) were managed with surgical excision or debulking. Four patients (33.3%) required additional management with either methotrexate or intralesional triamcinolone. Patients were followed up for a mean of 68.4 months. At last follow-up, 7 patients (63.6%) had complete resolution, and 5 (41.7%) had stable disease without further progression. CONCLUSION: We present a case series of idiopathic granulomatous orbital inflammation. We found that those with idiopathic disease often had unilateral presentations and appeared to present at a later age than those with orbital sarcoidosis in the literature. Although the differentiation between orbital sarcoidosis and idiopathic disease remains difficult, the features described in this series contribute to a greater understanding of the latter condition.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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 source (direct Gemma or distilled Codex), 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".