Orbital disease in neuro-ophthalmology

Abstract

Purpose of review Orbital disease represents a diverse spectrum of pathology and can result in a variety of neuro-ophthalmic manifestations. The aim of this review is to provide updates on recent advances in our understanding of orbital disease secondary to thyroid eye disease, myositis, IgG4-related disease, sarcoidosis, granulomatosis with polyangiitis and various tumours. Recent findings With regards to thyroid eye disease, there have been recent advances in the development of steroid-sparing therapies, new modalities for objectively monitoring disease activity and increased understanding of the role of environmental risk factors. There has been interest in characterizing the clinical course and underlying mechanism of optic nerve disease secondary to orbital disorders, which has led to advances in how we monitor for and prevent permanent vision loss. Increased knowledge of orbital tumour subtype histopathology and the development of novel classification systems has had prognostic value and aided medical decision-making. Summary Orbital disease occurs secondary to a wide variety of diseases and can lead to neuro-ophthalmic manifestations with significant morbidity. Advances in our understanding of different subtypes of orbital disease have improved our ability to treat these potentially debilitating conditions.

Systemic Steroids for Otolaryngology–Head and Neck Surgery Disorders: An Evidence‐Based Primer for Clinicians

“…Use of SCS is well established for optic neuritis and compressive optic neuropathy related to thyroid eye disease, both of which have a known inflammatory bases; however, ischemic and traumatic causes are more controversial 120,121 …”

“…Use of SCS is well established for optic neuritis and compressive optic neuropathy related to thyroid eye disease, both of which have a known inflammatory bases; however, ischemic and traumatic causes are more controversial. 120,121 Traumatic optic neuropathy (TON) is relevant to the otolaryngologist in the setting of facial trauma. The 1999 International Optic Nerve Trauma Study found that SCS administered within 7 days of injury did not provide an advantage over no treatment; however, this study was nonrandomized with an uneven group distribution.…”