Orbital and adnexal sarcoidosis: Clinical presentations and management outcomes

Purpose: To present the clinical features and management outcomes in a series of patients with orbital and adnexal sarcoidosis. Methods: This was a retrospective analysis of 19 histopathologically proven cases of orbital and adnexal sarcoidosis over the past ten years. The data analyzed included dem...

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Main Authors: Shebin Salim, Md Shahid Alam, Sonam Ahuja, Kirthi Koka, Marian Pauly, Subramanian Krishnakumar, Bipasha Mukherjee
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-02-01
Series:Indian Journal of Ophthalmology
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Online Access:https://journals.lww.com/10.4103/IJO.IJO_1289_24
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author Shebin Salim
Md Shahid Alam
Sonam Ahuja
Kirthi Koka
Marian Pauly
Subramanian Krishnakumar
Bipasha Mukherjee
author_facet Shebin Salim
Md Shahid Alam
Sonam Ahuja
Kirthi Koka
Marian Pauly
Subramanian Krishnakumar
Bipasha Mukherjee
author_sort Shebin Salim
collection DOAJ
description Purpose: To present the clinical features and management outcomes in a series of patients with orbital and adnexal sarcoidosis. Methods: This was a retrospective analysis of 19 histopathologically proven cases of orbital and adnexal sarcoidosis over the past ten years. The data analyzed included demographic details, clinical and imaging features, and management outcomes. The response to treatment was categorized based on clinical improvement at the last follow-up as complete resolution, partial resolution, or no resolution. Results: There were 15 (78.9%) females and four (21%) males. The mean age at presentation was 51.05 ± 14.35 years. Upper lid swelling was the most common sign (n = 6), followed by lacrimal gland enlargement (n = 5). The specific locations of involvement were orbital soft tissues (n = 8), lid (n = 5), lacrimal gland alone (n = 3), lacrimal sac (n = 1), extra ocular muscles (n = 1), and conjunctiva (n = 1). An incisional biopsy was performed on 16 patients, and an excisional biopsy on three. Of those undergoing excisional biopsy, the lesion was located in the superonasal extraconal space in one and in the superotemporal lid in two. Twelve patients (63.2%) had systemic involvement at presentation. No further treatment was necessary for patients who underwent excisional biopsy. Additional treatments included oral steroids (n = 10) and systemic immunosuppressants (n = 5). Six patients were lost to follow-up. Complete resolution of signs and symptoms was noted in 11 patients (84.6%), while partial resolution was seen in two patients. The mean duration of follow-up was 7.56 ± 12.63 months. Conclusion: Sarcoidosis can affect any part of the orbit or adnexa, with varied presentations depending on the involvement. Excisional or incisional biopsies, along with systemic steroids and immunosuppressants in select cases, remain the mainstay of treatment.
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spelling doaj-art-2ecb6d10983d4b81a38595dc415006612025-02-06T05:39:35ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892025-02-0173221422010.4103/IJO.IJO_1289_24Orbital and adnexal sarcoidosis: Clinical presentations and management outcomesShebin SalimMd Shahid AlamSonam AhujaKirthi KokaMarian PaulySubramanian KrishnakumarBipasha MukherjeePurpose: To present the clinical features and management outcomes in a series of patients with orbital and adnexal sarcoidosis. Methods: This was a retrospective analysis of 19 histopathologically proven cases of orbital and adnexal sarcoidosis over the past ten years. The data analyzed included demographic details, clinical and imaging features, and management outcomes. The response to treatment was categorized based on clinical improvement at the last follow-up as complete resolution, partial resolution, or no resolution. Results: There were 15 (78.9%) females and four (21%) males. The mean age at presentation was 51.05 ± 14.35 years. Upper lid swelling was the most common sign (n = 6), followed by lacrimal gland enlargement (n = 5). The specific locations of involvement were orbital soft tissues (n = 8), lid (n = 5), lacrimal gland alone (n = 3), lacrimal sac (n = 1), extra ocular muscles (n = 1), and conjunctiva (n = 1). An incisional biopsy was performed on 16 patients, and an excisional biopsy on three. Of those undergoing excisional biopsy, the lesion was located in the superonasal extraconal space in one and in the superotemporal lid in two. Twelve patients (63.2%) had systemic involvement at presentation. No further treatment was necessary for patients who underwent excisional biopsy. Additional treatments included oral steroids (n = 10) and systemic immunosuppressants (n = 5). Six patients were lost to follow-up. Complete resolution of signs and symptoms was noted in 11 patients (84.6%), while partial resolution was seen in two patients. The mean duration of follow-up was 7.56 ± 12.63 months. Conclusion: Sarcoidosis can affect any part of the orbit or adnexa, with varied presentations depending on the involvement. Excisional or incisional biopsies, along with systemic steroids and immunosuppressants in select cases, remain the mainstay of treatment.https://journals.lww.com/10.4103/IJO.IJO_1289_24adnexaorbitsarcoidosis
spellingShingle Shebin Salim
Md Shahid Alam
Sonam Ahuja
Kirthi Koka
Marian Pauly
Subramanian Krishnakumar
Bipasha Mukherjee
Orbital and adnexal sarcoidosis: Clinical presentations and management outcomes
Indian Journal of Ophthalmology
adnexa
orbit
sarcoidosis
title Orbital and adnexal sarcoidosis: Clinical presentations and management outcomes
title_full Orbital and adnexal sarcoidosis: Clinical presentations and management outcomes
title_fullStr Orbital and adnexal sarcoidosis: Clinical presentations and management outcomes
title_full_unstemmed Orbital and adnexal sarcoidosis: Clinical presentations and management outcomes
title_short Orbital and adnexal sarcoidosis: Clinical presentations and management outcomes
title_sort orbital and adnexal sarcoidosis clinical presentations and management outcomes
topic adnexa
orbit
sarcoidosis
url https://journals.lww.com/10.4103/IJO.IJO_1289_24
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AT kirthikoka orbitalandadnexalsarcoidosisclinicalpresentationsandmanagementoutcomes
AT marianpauly orbitalandadnexalsarcoidosisclinicalpresentationsandmanagementoutcomes
AT subramaniankrishnakumar orbitalandadnexalsarcoidosisclinicalpresentationsandmanagementoutcomes
AT bipashamukherjee orbitalandadnexalsarcoidosisclinicalpresentationsandmanagementoutcomes