Title

CHOROIDAL FOLDS AS IDIOPATHIC ORBITAL INFLAMATORY SYNDROME`S FIRST OCULAR SIGN

Introduction

The term “orbital pseudotumor” is currently used to describe a series of orbital lesions composed of benign nonspecific inflammatory infiltrates without known systemic etiology. In this short case report, we summarize a case of Idiopathic orbital inflammatory syndrome (IOIS) presented with painless decrease in visual acuity, providing an overview of the spectrum of these entity, also known as orbital pseudotumor, with emphasis on specific diagnostic challenges in addition to the evaluation and management of patients.

Methods

Review of the literature and summarize recent findings about management and treatment of orbital pseudotumor in addition to the discussion of possible causes for choroidal folds.

Results

Chorioretinal folds are visible striations of the fundus usually arranged horizontally in parallel lines, often associated with different possible ocular and extra ocular pathologies. In the presence of such alterations, retrobulbar changes must be considered and investigation should include orbital inflammatory and noninflammatory diseases even in absence of proptosis or bulb movement restriction.

Discussion

IOIS is considered a benign pathology, however extra orbital involvement may also occur. It is one of the three most common orbital diseases along with thyroid orbitopathy and lymphoproliferative disorder and accounts for 5-10% of orbital processes. The disease usually presents with sudden pain, exophthalmos and eye movement restriction. Choroidal folds in it`s turn have been associated with different ocular and extraocular diseases including IOIS. Since that, in the early clinical period, choroidal folds could be the unique sign of many underlying diseases, specially inflammatory retro orbital process, therefore an appropriate work-up varying according to the specific clinical features is mandatory to define the etiology and begin specific treatment.

Keywords

Orbital Pseudotumor; Idiopathic orbital inflammatory syndrome; Choroidal folds.

Area

CLINICAL CASE

Authors

RAPHAEL SANTANA MIRALDI CLEMENTE, MARINA COSTA LACERDA, FELIPE MANSUR MARTIRES, GRACE KELLY PELICIONI de CASTRO, MARCELLO de QUADROS RIBEIRO, LUIZ GUSTAVO BETASSI NOCERA, CARLOS AUGUSTO MOREIRA NETO, CARLOS AUGUSTO MOREIRA JUNIOR