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Clinics, biopsy and pathology
Author(s) -
ROBERT P
Publication year - 2013
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2013.2242.x
Subject(s) - medicine , biopsy , pathology , vasculitis , lacrimal gland , inflammation , optic nerve , orbit (dynamics) , etiology , lesion , disease , anatomy , engineering , aerospace engineering
Etiological diagnosis of orbital inflammation drives the general handling, states on specific/non specific status of inflammation, and may lead to simple survey of long‐lasting immunosuppressive treatment. Handling a orbital patient is always challenging for the clinician, but specific signs from clinical exam, imaging, biological checkup or histological samples may be critical. Clinical exam of the orbit must be directed towards ocular inflammation, sensitive and oculomotor signs, optic nerve function, and comparative orbital morphology. Imaging can disclose vascular, inflammatory, compressive, or bone‐desctructive lesions. Biological and systemic checkup must target signs of granulomatous, vasculitis, infectious, hematological and immunological diseases. Fine‐needle biopsy is still controversial since it allows a first histological exploration under local anesthesia, but may be at risk of bleeding, perforating a noble organ (globe, muscle, optic nerve, lacrimal gland) or misdiagnosing a heterogenous or small lesion, when compared to explorative biopsy under general anesthesia. Progresses on immunohistochemistry and histological markers have made the proportion of “non‐specific” orbital inflammation decrease these 10 last years We review these techniques through demonstrative clinical cases.