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Image-Guided Intensity-Modulated Radiation Therapy for IgG4-Related Ophthalmic Disease

Authors :
Keith C. Ferdinand
Shams Halat
Audrey Dang
Carol Boyd
Angela Traylor
Virginia Bubenzer
Krzysztof Moroz
Rachel A. Sabol
Kendra Harris
Source :
Case Reports in Ophthalmological Medicine, Case Reports in Ophthalmological Medicine, Vol 2020 (2020)
Publication Year :
2020
Publisher :
Hindawi, 2020.

Abstract

Background. IgG4-related ophthalmic disease is a rare, newly recognized entity with high failure rates on first-line therapy of systemic corticosteroids and no other proven management options. Case Presentation. Here, we present the clinical course of a patient with IgG4 ophthalmic disease who achieved a favorable response from radiotherapy. Our patient initially presented with a history of recurrent painful flares of orbital inflammation, a pathologic diagnosis follicular lymphoid hyperplasia from a right lacrimal gland biopsy, and MRI imaging noting expansion of the lateral rectus muscle of the right eye. Initial treatment with dacryoadenectomy and multiple courses of corticosteroids failed to keep his symptoms at bay. Further evaluation revealed florid IgG4 staining. In this context, he was evaluated for image-guided intensity-modulated radiotherapy (IG-IMRT) to the orbit to 20 Gy in 10 fractions. His ophthalmic symptoms resolved. Conclusions. This treatment experience suggests radiotherapy may be a favorable option for symptom relief in patients with IgG4-related ophthalmic disease not controlled by corticosteroids.

Details

Language :
English
ISSN :
20906730 and 20906722
Volume :
2020
Database :
OpenAIRE
Journal :
Case Reports in Ophthalmological Medicine
Accession number :
edsair.doi.dedup.....e1f45b22344930e2b9e5688103e84731