Intraorbital injection of triamcinolone acetonide in patients with idiopathic orbital inflammation

Objective: To present findings of a pilot study on intraorbital corticosteroid therapy in the management of idiopathic orbital inflammation. Methods: This prospective, noncomparative, interventional case series included patients with clinically, radiologically, and histologically confirmed idiopathic orbital inflammation with an anterior orbital mass. Twenty to 40 mg/mL of triamcinolone acetonide was injected intraorbitally (intralesionally or perilesionally) in all patients. The injection was repeated at 4-week intervals if complete resolution was not achieved. Patients were assessed for local and systemic complications of corticosteroid injection. Visual acuity, fundus examination, intraocular pressure, blood pressure, and serum glucose levels were measured at each visit. Results: Ten patients (5 men and 5 women; mean age, 49.8 years [age range, 25-82 years]) received treatment. In 4 patients, an orbital mass was noted; in 6 patients, the lacrimal gland was involved (dacryoadenitis). Substantial improvement (1 patient) or complete resolution (8 patients) was noted during a follow-up of 9.8 months (range, 3-24 months). Conclusion: Intraorbital injection of a corticosteroid is an effective treatment for idiopathic orbital inflammation and may be considered first-line treatment in selected patients.