{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T09:52:27Z","timestamp":1762077147175,"version":"build-2065373602"},"reference-count":12,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Idiopathic sclerosing orbital inflammation (ISOI) is a distinct entity among other orbital diseases. It is characterized by marked fibrosis and inflammatory cell infiltration that can damage orbital structures. Clinical manifestations were variable, including ocular and periocular redness, proptosis, and pain. Ocular motor restrictions and optic nerve dysfunction might occur in severe cases. We herein report a patient of ISOI who presented with total ophthalmoplegia and acute vision loss. His symptoms were relieved mainly as his vision improved to 20\/25 after receiving corticosteroid and immunosuppressant therapies. Therefore, ISOI should be one of the deferential diagnoses when we encounter cases with acute orbital apex syndrome. With prompt evaluation and in-time treatment, a favorable outcome is possible.<\/jats:p>","DOI":"10.3390\/diagnostics12123003","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T02:24:46Z","timestamp":1669861486000},"page":"3003","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Acute Orbital Apex Syndrome Caused by Idiopathic Sclerosing Orbital Inflammation"],"prefix":"10.3390","volume":"12","author":[{"given":"Chung-Chih","family":"Chang","sequence":"first","affiliation":[{"name":"School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yung-Ching","family":"Chang","sequence":"additional","affiliation":[{"name":"Departments of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7927-2310","authenticated-orcid":false,"given":"Kuei-Ying","family":"Su","sequence":"additional","affiliation":[{"name":"School of Medicine, Tzu Chi University, Hualien 970, Taiwan"},{"name":"Division of Allergy, Immunology and Rheumatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8486-8549","authenticated-orcid":false,"given":"Yuan-Chieh","family":"Lee","sequence":"additional","affiliation":[{"name":"Departments of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"},{"name":"Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien 970, Taiwan"},{"name":"Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang-Ling","family":"Chang","sequence":"additional","affiliation":[{"name":"Departments of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Hsun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1268-904X","authenticated-orcid":false,"given":"Yen-Chang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"},{"name":"Department of Pathology, School of Medicine, Tzu Chi University, Hualien 970, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7649-2246","authenticated-orcid":false,"given":"Nancy","family":"Chen","sequence":"additional","affiliation":[{"name":"Departments of Ophthalmology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1001\/archopht.124.9.1244","article-title":"Idiopathic Sclerosing Orbital Inflammation","volume":"124","author":"Hsuan","year":"2006","journal-title":"Arch. 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Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/IOP.0b013e318238ecf7","article-title":"Idiopathic sclerosing orbital inflammation: A review of demographics, clinical presentation, imaging, pathology, treatment, and outcome","volume":"28","author":"Pemberton","year":"2012","journal-title":"Ophthalmic Plast Reconstr. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1136\/bjophthalmol-2014-305528","article-title":"IgG4-related disease in idiopathic sclerosing orbital inflammation","volume":"99","author":"Sa","year":"2015","journal-title":"Br. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/IOP.0000000000001975","article-title":"Clinical Outcomes of IgG4-Related Ophthalmic Disease and Idiopathic Sclerosing Orbital Inflammation","volume":"38","author":"Son","year":"2022","journal-title":"Ophthalmic Plast Reconstr. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1038\/sj.eye.6701780","article-title":"Idiopathic orbital inflammation with extraorbital extension: Case series and review","volume":"20","author":"Zborowska","year":"2006","journal-title":"Eye"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"183","DOI":"10.3928\/01913913-20060301-11","article-title":"Sclerosing idiopathic orbital inflammation","volume":"43","author":"Brannan","year":"2006","journal-title":"J. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1111\/j.1442-9071.2011.02561.x","article-title":"Mycophenolate mofetil treatment of steroid-resistant idiopathic sclerosing orbital inflammation","volume":"39","author":"Patel","year":"2011","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"176","DOI":"10.3109\/09273948.2013.863943","article-title":"Complete resolution of idiopathic sclerosing orbital inflammation after treatment with rituximab","volume":"23","author":"Abell","year":"2015","journal-title":"Ocul Immunol. Inflamm."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e91","DOI":"10.1097\/IOP.0000000000001843","article-title":"Rituximab Therapy for Recalcitrant Idiopathic Sclerosing Orbital Inflammation","volume":"37","author":"Yazici","year":"2021","journal-title":"Ophthalmic Plast Reconstr. 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