Comparative study between Corticosteroid and Methotrexate treatment for patients with orbital pseudo tumor

Resumen

Orbital pseudotumor (OST) is a chronic inflammatory disease affecting Orbital tissue around the eye in a behavior just like a tumor but it does not invade or metastasize. Treatment of OST may be conservative in mild cases while in patients with significant moderate to severe course need treatment that may be medical or surgical. Objective: Compare between corticosteroid and methotrexate effectiveness and less complications in treatment of OST. Method: A case series study (47 females and 28 males) with proptosis of one or both eyes, redness of the eye or periorbital pain either alone or in combination. Patients having clinical feature suggestive of OST with threat to the eye function or its surrounding muscles and neurovascular tissue that need medical treatment included in this study while others that need surgical treatment excluded from this study. Results: This study made on 75 patients having clinical feature rise the suspension of OST, all ages involved with high incidence at 6^th decade followed by the 2^nd decade. Group A patients get response to treatment progressively in the 1^st three months but later after one year of follow up the percentage decrease to about 45% while in group B although there is slow response to the treatment but with follow up after one year about 87.5% have a good response to treatment. Conclusion: This study suggest that Methotrexate is a well-tolerated medication in patients with Orbital Pseudotumor disease to avoid Corticosteroid therapy failure.