Analysis of the correlation between imaging features and disease severity in IgG4-related ophthalmic disease
Journal Title: Eye Science (Yanke Xuebao) - Year 2025, Vol 40, Issue 1
Abstract
[Objective:] To investigate the correlation between the imaging characteristics of patients with IgG4-related ophthalmic disease (IgG4-ROD) and the serum immunoglobulin G4 (IgG4) levels, providing new insights for assessing the systemic severity of IgG4-related diseases. [Methods:] This study collected postoperative tissue samples from 29 patients with histopathologically confirmed IgG4-ROD at the Ophthalmology Department of Jilin University Second Hospital from August 2023 to September 2024. This study retrospectively analyzed the correlation between patients' orbital imaging features and serum IgG4 levels, and explored the proportion of characteristic imaging changes including enlargement of the lacrimal gland, thickening of the trigeminal nerve branches, thickening of the extraocular muscles, inflammatory-like changes of the nasal mucous membranes, hypertrophy of the eyelid soft tissues, as well as hyperplasia of other intraorbital soft tissues in the imaging. A grading score for affected tissue structures was established to evaluate the correlation between characteristic imaging changes and serum IgG4 levels. [Results:] Among the 29 patients diagnosed with IgG4-ROD, lacrimal gland involvement was observed in all patients (100%). Extraocular muscle involvement was present in 17 patients (58.62%). Five patients had involvement of the trigeminal nerve branches (including 4 with infraorbital nerve involvement and 3 with frontal nerve involvement, with 2 patients having simultaneous involvement of both nerves), accounting for 17.24% of the cases. Eyelid soft tissue hypertrophy was observed in 24 patients (82.76%), and nasal mucosal inflammatory responses were noted in 15 patients (51.72%). Additionally, two patients (6.90%) presented with other proliferative lesions within the orbit. The correlation analysis between the grading scores for imaging features and serum IgG4 levels demonstrated a significant positive correlation. [Conclusions:] The extent of characteristic structural involvement observed in the imaging features of IgG4-ROD is significantly correlated with serum IgG4 levels. This correlation can assist in evaluating the systemic severity of IgG4-related diseases and provides clinical evidence supporting the need for comprehensive systemic evaluations, such as PET-CT, in patients whose initial presentation is IgG4-related ophthalmic disease.
Authors and Affiliations
Qing JIAO, Shuting CHEN, Shiwei HUANG, Guangyu LI
Keywords
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