Orbital manifestations of granulomatosis with polyangitis
Reviewed by Rina Bhatt

This a retrospective, observational study where authors looked at the ophthalmological examination, biopsy, antibodies and CT scan results of all patients diagnosed with granulomatosis with polyangitis (GPA) from January 2007-January 2019. Out of 101 patients with diagnosis of GPA, 15 (14.8%) with orbital manifestations were included in the study. Eleven (73.3%) were female and mean age at diagnosis was 46.20 years. Proptosis was seen in 11 (73.3%) cases and another four had dacryocystitis, a palpebral laceration, a nasal septum destruction with extraconal mass and diplopia. The lacrimal gland was involved on CT scan in five (33.3%) cases. Other radiological findings were a diffuse extraconal or intraconal mass, lacrimal sac involvement and extraocular muscle involvement; 14 (93.3%) were biopsy confirmed. Histology showed necrosis surrounded by granulomatous inflammation and sectorial fibrinoid necrosis in walls of small calibre blood vessels. Once diagnosed, patients were treated with Prednisone 1mg/kg and referred to rheumatology for joint management.

Orbital manifestations of granulomatosis with polyangitis: 12-year experience in Mexico City.
Davila-Camargo A, Tovilla-Canales JL, Rodrigues-Cabrera L, et al.
ORBIT
2020;39:357-64.