TY - JOUR T1 - Management of IgG4-related orbital disease: when not in doubt, cut it out? JF - BMJ Open Ophthalmology JO - BMJ Open Ophth DO - 10.1136/bmjophth-2019-000401 VL - 4 IS - 1 SP - e000401 AU - Bhupendra C K Patel Y1 - 2019/10/01 UR - http://bmjophth.bmj.com/content/4/1/e000401.abstract N2 - Most retrospective reviews of the efficacy of treatments for orbital inflammation, whether for idiopathic orbital inflammation (IOI) or for IgG4-related ophthalmic disease (IgG4-ROD) are hampered by the fact that many patients receive multiple treatments, frequently overlapping, and often at different dosages and durations. The natural course of the disease is thereby modified in myriad ways, making an accurate assessment of the treatment modalities difficult. Once a treatment has been accepted as the best first-line therapy (corticosteroids in this case), the physician becomes inclined to his purpose to the extent that, to date, there are no well-designed prospective studies of these two conditions where a single treatment has been assessed with defined treatment, dosage duration and outcomes.Although a retrospective study, Ominato et al1 present 15 cases (8 unilateral and 7 bilateral) of IgG4-ROD treated solely with surgical debulking. The study is of interest because no other treatment before, during or after surgery was administered to any of the patients, thereby allowing … ER -