Pseudotumeur inflammatoire de l’orbite associée à une névrite optique au cours d’une maladie de Behçet

Diffuse orbital inflammation: an atypical manifestation of Behcet's disease

Behcet's disease is a chronic, relapsing systemic vasculitis characterised by multisystem involvement from small, medium and large vessel inflammation. Common manifestations include oral and genital ulcers, rash, uveitis and neurological symptoms, while orbital inflammation is rare. An Asian man in his 40s with Behcet's disease on immunosuppression presented with 10 days of unilateral periorbital swelling and painful eye movements, unresponsive to oral antibiotics. Imaging revealed diffuse orbital inflammation and optic neuritis. Investigations excluded an infectious cause. Despite broad-spectrum intravenous antibiotics, his condition worsened until typical Behcet's disease mucocutaneous symptoms emerged, indicating a Behcet's flare. Treatment with high-dose corticosteroids, followed by cyclophosphamide and azathioprine resolved the diffuse orbital inflammation. Unfortunately, the visual outcome was poor as he remained blind in the affected eye from optic neuritis and corneal ulceration. This case highlights the importance of early diagnosis and treatment of diffuse orbital inflammation in Behcet's disease to prevent severe ocular complications.

Unilateral optic perineuritis due to nonspecific orbital inflammation: A case report

Nonspecific orbital inflammation is an idiopathic chronic tumor-like inflammation process that usually affects the orbital tissues of both eyes. Isolated optic nerve involvement by an idiopathic inflammatory process is a rare finding. Here, we report a patient with unilateral sudden onset severe orbital pain and headache with visual loss to no light perception that could only be attributed to perineuritis. Radiological findings enabled making the correct diagnosis. Various relevant diagnoses are also discussed.