Orbital pseudotumor is a nonspecific inflammation happening in the eye socket, with unknown etiology. Orbital pseudotumor is the third most common eye tumor, after Grave’s ophthalmopathy and lymphoproliferation. The incidence of this disease ranges from 4% to 11% from overall orbital tumor. Orbital pseudotumor is benign, but the management remains a challenge.
The main modality in orbital pseudotumor therapy is corticosteroid. Corticosteroid need to be consume for a long time, therefore there is high risk of drop out caused by resistance, side effects, or dependence.
This causes low recovery rate, and high rate of failed therapy and recurrence. On the other hand, the factors impacting recurrence has not been researched.
The relation between mast cells, immunoglobulin G4 (IgG4), tumor necrosis factor-α (TNF-α), and transforming growth factor-β (TGF-β) with chronic inflammation or autoimmune is proven to have a role in many diseases. However, the impact of IgG4, TNF-α, and TGF-β on orbital pseudotumor recurrence mechanism is still unknown.
Those problems encourage dr. Neni Anggraini, SpM(K) to do a research on Predicting Factors of Orbital Pseudotumor Recurrence, in terms of clinical, histopathology, and tumor marker through number of cell mast, IgG4, TNF-α, also TGF-β.
Tumor markers researched in this study is IgG4, TNF-α, and TGF-β. The result show that eyelids/conjunctival mass, proptosis, decreased visual acuity, restricted eye movement, tumor location, and therapy influenced individual recurrence. On the other hand, histopathology, mast cells, IgG4, TNF-α, also TGF-β can’t be predicting factors of recurrence. This study also resulted in a scoring system of orbital pseudotumor recurrence probability based on the tumor location and therapy, which are anterior tumor location and single corticosteroid therapy, also non anterior tumor location and single corticosteroid therapy.
This result was presented by dr. Neni Anggraini, SpM(K) at her doctoral hearing ceremony on Tuesday, July 2nd 2019 in IMERI Auditorium. The dissertation is titled “Clinicopathologic Predicting Factors for Orbital Pseudotumor Recurrence: A Study on Mast Cells, IgG4, TNF-α, and TGF-β Expression”.
Prof. Dr. dr. Suhendro, SpPD-KPTI(K) acted as the head examiner. The other examiners include Prof. dr. Saptawati Bardosono, MSc; dr. Alida Roswita Harahap, SpPK(K), PhD; Dr. dr. Halimah Pagarra, SpM(K) from Hassanudin University, and Dr. dr. Agus Supartoto, SpM(K) from Gadjah Mada University.
At the end of the hearing, Prof. Dr. dr. Ari Fahrial Syam, SpPD-KGEH, MMB inaugurated dr. Neni Anggraini, SpM(K) as a Doctor in Medical Science of FMUI. Through their closing speech promotor Prof. dr. Rita Sita Sitorus, PhD, SpM(K), and co-promotors Prof. Dr. dr. Nila Djuwita F. Moeloek, SpM(K) and dr. Nurjati Chairani Siregar, MS, SpPA(K), PhD wished this study can improve the quality of orbital pseudotumor in Indonesia.
(Public Relations FKUI)