Retinal cases & brief reports · 2026
CHORIORETINAL FINDINGS IN INTRAOCULAR IGG4-RELATED DISEASE: A CASE REPORT AND REVIEW OF THE LITERATURE.
СтатьяКлинический случайОбзорНазвание и аннотация: Перевод в очереди
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Magazin Maja, Jones Skyler G, Fazio Alexis, Thomas Dilip A, Espinosa-Heidmann Diego
Аннотация
PURPOSE: This article reports intraocular IgG4-related disease presenting as panuveitis with a large subretinal mass and contralateral orbital mass. It includes a literature review highlighting IgG4-related disease's diagnostic challenges, emphasizing clinical, histopathologic, and multimodal imaging findings.
METHODS: PubMed was searched for "all fields" with keywords "IgG4" AND "retina" AND "choroid" from 1974 to March 2024, revealing 16 cases of 23 eyes detailing IgG4-related chorioretinal manifestations.
RESULTS: The most common presenting symptom was painful vision loss (31%). Chorioretinal findings included large subretinal or choroidal masses (35%), multifocal subretinal lesions (26%), and retinal detachment (22%). Associated ophthalmic findings included scleritis or sclerouveitis (52%), vitritis (48%), orbital disease (13%), and papillitis (9%). IgG4+/IgG ratios in ocular tissue varied 20% to 54.5%. IgG4+ plasma cells per high-power field ranged from 50 to 133. Ophthalmic modalities used to aid in diagnosis included B-scan ultrasonography (US-B, 56%), optical coherence tomography (31%), fluorescein angiography (25%), fundus autofluorescence (13%), and indocyanine green angiography (13%). Masses on B-scan were heterogeneous or homogeneous with medium-to-high reflectivity. Magnetic resonance imaging evaluation was hypointense on T2-weighted imaging (75%) and hyperintense on T1-weighted imaging (38%) with progressive contrast enhancement (50%). Management required a multidisciplinary approach with steroid and steroid-sparing agents.
CONCLUSION: IgG4-related disease has diverse and variable ocular presentations and diagnostic manifestations. Definitive diagnosis is made through biopsy. Further studies are necessary for noninvasive diagnosis.
METHODS: PubMed was searched for "all fields" with keywords "IgG4" AND "retina" AND "choroid" from 1974 to March 2024, revealing 16 cases of 23 eyes detailing IgG4-related chorioretinal manifestations.
RESULTS: The most common presenting symptom was painful vision loss (31%). Chorioretinal findings included large subretinal or choroidal masses (35%), multifocal subretinal lesions (26%), and retinal detachment (22%). Associated ophthalmic findings included scleritis or sclerouveitis (52%), vitritis (48%), orbital disease (13%), and papillitis (9%). IgG4+/IgG ratios in ocular tissue varied 20% to 54.5%. IgG4+ plasma cells per high-power field ranged from 50 to 133. Ophthalmic modalities used to aid in diagnosis included B-scan ultrasonography (US-B, 56%), optical coherence tomography (31%), fluorescein angiography (25%), fundus autofluorescence (13%), and indocyanine green angiography (13%). Masses on B-scan were heterogeneous or homogeneous with medium-to-high reflectivity. Magnetic resonance imaging evaluation was hypointense on T2-weighted imaging (75%) and hyperintense on T1-weighted imaging (38%) with progressive contrast enhancement (50%). Management required a multidisciplinary approach with steroid and steroid-sparing agents.
CONCLUSION: IgG4-related disease has diverse and variable ocular presentations and diagnostic manifestations. Definitive diagnosis is made through biopsy. Further studies are necessary for noninvasive diagnosis.