Clinical Features of Different Forms of Orbital Inflammation in GPA

Relevance Visual damage in granulomatosis with polyangiitis (GPA) occurs in 29–58% of patients and can significantly reduce the patient's quality of life, leading to severe cosmetic defects, vision loss, loss of the eye, and complications are potentially life-threatening [1–5]. Objective To study the clinical features of orbital GPA Material and methods The study included 218 patients with GPA, diagnosed with GPA, including 143 women and 75 men, aged from 16 to 86 years. Results Among all patients, visual damage was detected in 48.2% of patients (105/218), in 5.5% of patients it led to a significant decrease or loss of vision (12/218). Orbital damage was detected in 74 patients. In 35.1% of patients, the lesion was limited to the development of dacryoadenitis, in 4% of patients - myositis, and in the remaining 70.8%, a space-occupying inflammatory lesion of the orbit was determined. In patients with a space-occupying lesion of the orbit, the disease was systemic - 51.1% versus 7.7% (p = 0.00) in patients with dacryoadenitis. The clinical course in patients with a space-occupying lesion of the orbit was severe and was characterized by pronounced exophthalmos, edema and redness of the periorbital tissues. In patients with dacryoadenitis, the symptoms were generally not so pronounced. The outcome of the disease was also worse in patients with a space-occupying lesion of the orbit. Conclusion Patients with orbital lesions in GPA can be characterized by a different clinical course of the disease depending on the localization of inflammation. Key words: granulomatosis with polyangiitis; orbital neoplasm; dacryoadenitis; myositis