NGHIÊN CỨU ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG VIÊM TỔ CHỨC HỐC MẮT TRÊN NGƯỜI TRƯỞNG THÀNH

Abstract

Objective: To describe the clinical and paraclinical characteristics of orbital inflammatory disease (OID) in adults and analyze putative etiologies. Subjects and Methods: Cross-sectional descriptive study of 17 patients (19 eyes) diagnosed with OID at the Oculofacial Plastic and Cosmetic Department, Vietnam National Institute of Ophthalmology, from January to September 2025. Clinical, laboratory, and imaging data were collected and analyzed with SPSS 20.0. Results: Among 17 patients, males comprised 35.3% and females 64.7%; mean age was 49.71±17.15 years. Unilateral involvement predominated (88.2%; p=0.002). Prominent clinical features included ocular pain (100%), pain with eye movements (47.4%), proptosis (73.7%), extraocular motility restriction (73.7%), and high intraocular pressure (57.9%); onset was predominantly < 1 month. B-scan ultrasound showed a periscleral hypoechoic rim in 68.4%. CT/MRI demonstrated extraocular muscle involvement affecting both the muscle bellies and tendinous insertions, lacrimal gland involvement in 47.4%, orbital fat infiltration in 26.3%, and optic nerve abnormalities in 36.8%; with two cases accompanied by polysinusitis. Mean white blood cell count was 11.34±3.15×G/L. Immunologic testing showed one case of low-titer antinuclear antibody (ANA) positivity, one anti-SSB-positive case, and one case with elevated serum IgG4 accompanied by IgG4-positive histopathology. Culture/gram staining identified Staphylococcus aureus, Gram-positive cocci, and Gram-negative rods. Conclusion: In adults, orbital inflammatory disease typically presents acutely or subacutely and is most often unilateral; infectious etiologies predominate, and an underlying cause can often be identified, although idiopathic cases still occur. An integrated diagnostic approach - combining clinical evaluation, orbital imaging, immunologic testing, and microbiology is essential to optimize patient management.