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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">lvrach</journal-id><journal-title-group><journal-title xml:lang="ru">Лечащий Врач</journal-title><trans-title-group xml:lang="en"><trans-title>Lechaschi Vrach</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1560-5175</issn><issn pub-type="epub">2687-1181</issn><publisher><publisher-name></publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.26295/OS.2020.64.89.013</article-id><article-id custom-type="elpub" pub-id-type="custom">lvrach-142</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group></article-categories><title-group><article-title>Идиопатическое воспаление орбиты и глюкокортикостероиды как первая линия терапии: обзор литературы</article-title><trans-title-group xml:lang="en"><trans-title>Idiopathic orbital disease and corticosteroids as first-line treatment: literature review</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Левашов</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Levashov</surname><given-names>I. A.</given-names></name></name-alternatives><email xlink:type="simple">mesmerizz3d@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яровой</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Yarovoy</surname><given-names>A. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff xml:lang="ru" id="aff-1"><institution>ФГАУ НМИЦ «МНТК «Микрохирургия глаза» им. акад. С. Н. Федорова</institution><country>Russian Federation</country></aff><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>23</day><month>06</month><year>2021</year></pub-date><volume>0</volume><issue>6</issue><fpage>69</fpage><lpage>73</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Левашов И.А., Яровой А.А., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Левашов И.А., Яровой А.А.</copyright-holder><copyright-holder xml:lang="en">Levashov I.A., Yarovoy A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.lvrach.ru/jour/article/view/142">https://journal.lvrach.ru/jour/article/view/142</self-uri><abstract><p>Воспаление в глазницах может возникать в качестве локальных проявлений системных заболеваний, при инфекционных и неопластических процессах, а также идиопатически. Дифференциальная диагностика воспалительных заболеваний орбиты является сложной задачей ввиду редкости этих патологий, изолированного анатомического расположения поражаемых структур и крайне разнообразной этиологии воспалительных процессов. Идиопатическое воспаление орбиты (ИВО) является диагнозом исключения при необнаружении системных и локальных заболеваний, способных вызвать воспалительный процесс в орбите. В формате повествовательного обзора проанализировано 30 литературных и сетевых источников при использовании поисковых систем PubMed, Google Scholar и eLIBRARY с ключевыми поисковыми запросами orbital pseudotumor, idiopathic orbital inflammation и orbital inflammatory disease, псевдотумор. Воспаление орбиты может быть проявлением различных системных заболеваний, таких как саркоидоз, гранулематоз Вегенера, болезнь Крона, системная красная волчанка, IgG4-ассоциированное заболевание, синдром ЧергаСтраусса, синдром ЭрдгеймаЧестера, гистиоцитоз X и гигантоклеточный артериит. Несмотря на большое количество проведенных исследований, не существует единого протокола ведения пациентов с ИВО. Различные авторы предлагают разные схемы использования глюкокортикостероидов (ГКС). В качестве альтернативных методов лечения используются лучевая терапия, нестероидные противовоспалительные средства (НПВС), иммуносупрессоры и хирургия. Пероральный прием высоких доз ГКС с постепенным снижением дозировки признается большинством авторов как терапия первой линии, несмотря на неоднозначную эффективность, продемонстрированную многими исследованиями. В отечественной практике предпочитают использовать локальные инъекции ГКС. Для разработки новых протоколов ведения пациентов с ИВО требуется более глубокое понимание патологических основ заболевания и тесное сотрудничество с врачами других специальностей, в особенности ревматологами и трансплантологами.</p></abstract><trans-abstract xml:lang="en"><p>Orbital inflammation may occur as local manifestation of systemic disease, in infections, neoplasms and as idiopathic process. Development of new therapeutic modalities requires more fundamental comprehension of the disease and collaboration with other medical specialists, especially rheumatologists and transplantologists. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>Глюкокортикостероиды</kwd><kwd>Диагноз исключения</kwd><kwd>Идиопатическое воспаление орбиты</kwd><kwd>Терапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>idiopathic orbital disease</kwd><kwd>diagnosis of exclusion</kwd><kwd>corticosteroids</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Yuen S. J. A., Rubin P. A. D. Idiopathic Orbital Inflammation. Distribution, Clinical Features, and Treatment Outcome // Arch Ophthalmol. 2003. Vol. 121, № 4. P. 491.</mixed-citation><mixed-citation xml:lang="en">Yuen S. J. A., Rubin P. A. D. Idiopathic Orbital Inflammation. Distribution, Clinical Features, and Treatment Outcome // Arch Ophthalmol. 2003. Vol. 121, № 4. P. 491.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Mombaerts I. et al. Are Systemic Corticosteroids Useful in the Management of Orbital Pseudotumors? // Ophthalmology. American Academy of Ophthalmology, Inc. 1996. Vol. 103, № 3. P. 521-528.</mixed-citation><mixed-citation xml:lang="en">Mombaerts I. et al. Are Systemic Corticosteroids Useful in the Management of Orbital Pseudotumors? // Ophthalmology. American Academy of Ophthalmology, Inc. 1996. Vol. 103, № 3. P. 521-528.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Bartalena L. et al. Consensus statement of the European Group on Graves’ orbitopathy (EUGOGO) on management of GO // Eur J Endocrinol. 2008. Vol. 158, № 3. P. 273-285.</mixed-citation><mixed-citation xml:lang="en">Bartalena L. et al. Consensus statement of the European Group on Graves’ orbitopathy (EUGOGO) on management of GO // Eur J Endocrinol. 2008. Vol. 158, № 3. P. 273-285.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Birch-Hirschfeld A. Zur diagnostik und pathologie der orbital tumoren // Der Deutsch Ophthalmol Ges. 1905. Vol. 32. P. 127-135.</mixed-citation><mixed-citation xml:lang="en">Birch-Hirschfeld A. Zur diagnostik und pathologie der orbital tumoren // Der Deutsch Ophthalmol Ges. 1905. Vol. 32. P. 127-135.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Lutt J. R. et al. Orbital Inflammatory Disease // Semin Arthritis Rheum. 2008. Vol. 37, № 4. P. 207-222.</mixed-citation><mixed-citation xml:lang="en">Lutt J. R. et al. Orbital Inflammatory Disease // Semin Arthritis Rheum. 2008. Vol. 37, № 4. P. 207-222.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Mombaerts I. et al. What is orbital pseudotumor? // Surv Ophthalmol. 1996. Vol. 41, № 1. P. 66-78.</mixed-citation><mixed-citation xml:lang="en">Mombaerts I. et al. What is orbital pseudotumor? // Surv Ophthalmol. 1996. Vol. 41, № 1. P. 66-78.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Бровкина А. Ф. и др. Офтальмоонкология: руководство для врачей. М.: Медицина, 2002. 424 С.</mixed-citation><mixed-citation xml:lang="en">Бровкина А. Ф. и др. Офтальмоонкология: руководство для врачей. М.: Медицина, 2002. 424 С.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Pakdaman M. N. Orbital inflammatory disease: Pictorial review and differential diagnosis // World J Radiol. 2014. Vol. 6, № 4. P. 106.</mixed-citation><mixed-citation xml:lang="en">Pakdaman M. N. Orbital inflammatory disease: Pictorial review and differential diagnosis // World J Radiol. 2014. Vol. 6, № 4. P. 106.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Chiu C. S., Rubin P. A. D. Pharmacotherapies and nonpharmacotherapies for orbital inflammatory disease // Int Ophthalmol Clin. 2004. Vol. 44, № 3. P. 165-185.</mixed-citation><mixed-citation xml:lang="en">Chiu C. S., Rubin P. A. D. Pharmacotherapies and nonpharmacotherapies for orbital inflammatory disease // Int Ophthalmol Clin. 2004. Vol. 44, № 3. P. 165-185.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Espinoza G. M. Orbital inflammatory pseudotumors: Etiology, differential diagnosis, and management // Curr Rheumatol Rep. 2010. Vol. 12, № 6. P. 443-447.</mixed-citation><mixed-citation xml:lang="en">Espinoza G. M. Orbital inflammatory pseudotumors: Etiology, differential diagnosis, and management // Curr Rheumatol Rep. 2010. Vol. 12, № 6. P. 443-447.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Carruth B. P., Wladis E. J. Inflammatory modulators and biologic agents in the treatment of idiopathic orbital inflammation // Curr Opin Ophthalmol. 2012. Vol. 23, № 5. P. 420-426.</mixed-citation><mixed-citation xml:lang="en">Carruth B. P., Wladis E. J. Inflammatory modulators and biologic agents in the treatment of idiopathic orbital inflammation // Curr Opin Ophthalmol. 2012. Vol. 23, № 5. P. 420-426.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Char D. H., Miller T. Orbital Pseudotumor: Fine-needle Aspiration Biopsy and Response to Therapy // Ophthalmology. American Academy of Ophthalmology, Inc. 1993. Vol. 100, № 11. P. 1702-1710.</mixed-citation><mixed-citation xml:lang="en">Char D. H., Miller T. Orbital Pseudotumor: Fine-needle Aspiration Biopsy and Response to Therapy // Ophthalmology. American Academy of Ophthalmology, Inc. 1993. Vol. 100, № 11. P. 1702-1710.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Shields J. A., Shields C. L., Scartozzi R. Survey of 1264 patients with orbital tumors and simulating lesions: The 2002 Montgomery Lecture, part 1 // Ophthalmology. 2004. Vol. 111, № 5. P. 997-1008.</mixed-citation><mixed-citation xml:lang="en">Shields J. A., Shields C. L., Scartozzi R. Survey of 1264 patients with orbital tumors and simulating lesions: The 2002 Montgomery Lecture, part 1 // Ophthalmology. 2004. Vol. 111, № 5. P. 997-1008.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Belanger C. et al. Inflammatory Disorders of the Orbit in Childhood: A Case Series // Am J Ophthalmol. 2010. Vol. 150, № 4. P. 460-463.</mixed-citation><mixed-citation xml:lang="en">Belanger C. et al. Inflammatory Disorders of the Orbit in Childhood: A Case Series // Am J Ophthalmol. 2010. Vol. 150, № 4. P. 460-463.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Gordon L. K. Orbital inflammatory disease: A diagnostic and therapeutic challenge // Eye. 2006. Vol. 20, № 10. P. 1196-1206.</mixed-citation><mixed-citation xml:lang="en">Gordon L. K. Orbital inflammatory disease: A diagnostic and therapeutic challenge // Eye. 2006. Vol. 20, № 10. P. 1196-1206.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Umehara H. et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011 // Mod Rheumatol. 2012. Vol. 22, № 1. P. 21-30.</mixed-citation><mixed-citation xml:lang="en">Umehara H. et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011 // Mod Rheumatol. 2012. Vol. 22, № 1. P. 21-30.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Sah R. P., Chari S. T. Serologic issues in IgG4-related systemic disease and autoimmune pancreatitis // Curr Opin Rheumatol. 2011. Vol. 23, № 1. P. 108-113.</mixed-citation><mixed-citation xml:lang="en">Sah R. P., Chari S. T. Serologic issues in IgG4-related systemic disease and autoimmune pancreatitis // Curr Opin Rheumatol. 2011. Vol. 23, № 1. P. 108-113.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Colombo F., Holbach L. M., Naumann G. O. H. Chronic inflammation in dermoid cysts: a clinicopathologic study of 115 patients // Orbit. 2000. Vol. 19, № 2. P. 97-107.</mixed-citation><mixed-citation xml:lang="en">Colombo F., Holbach L. M., Naumann G. O. H. Chronic inflammation in dermoid cysts: a clinicopathologic study of 115 patients // Orbit. 2000. Vol. 19, № 2. P. 97-107.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Goh A. S. et al. Orbital inflammation in a patient with extrascleral spread of choroidal malignant melanoma // Clin Exp Ophthalmol. 2001. Vol. 29, № 2. P. 97-99.</mixed-citation><mixed-citation xml:lang="en">Goh A. S. et al. Orbital inflammation in a patient with extrascleral spread of choroidal malignant melanoma // Clin Exp Ophthalmol. 2001. Vol. 29, № 2. P. 97-99.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Foley M. R. et al. Orbital Inflammatory Syndromes with Systemic Involvement May Mimic Metastatic Disease // Ophthalmic Plast Reconstr Surg. 2003. Vol. 19, № 4. P. 324-327.</mixed-citation><mixed-citation xml:lang="en">Foley M. R. et al. Orbital Inflammatory Syndromes with Systemic Involvement May Mimic Metastatic Disease // Ophthalmic Plast Reconstr Surg. 2003. Vol. 19, № 4. P. 324-327.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Bernardino C. R. et al. Angle-closure glaucoma in association with orbital pseudotumor // Ophthalmology. 2001. Vol. 108, № 9. P. 1603-1606.</mixed-citation><mixed-citation xml:lang="en">Bernardino C. R. et al. Angle-closure glaucoma in association with orbital pseudotumor // Ophthalmology. 2001. Vol. 108, № 9. P. 1603-1606.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Leone C. R., Lloyd W. C. Treatment Protocol for Orbital Inflammatory Disease // Ophthalmology. 1985. Vol. 92, № 10. P. 1325-1331.</mixed-citation><mixed-citation xml:lang="en">Leone C. R., Lloyd W. C. Treatment Protocol for Orbital Inflammatory Disease // Ophthalmology. 1985. Vol. 92, № 10. P. 1325-1331.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Harris G. J. Idiopathic orbital inflammation: A pathogenetic construct and treatment strategy: The 2005 ASOPRS Foundation Lecture // Ophthal Plast Reconstr Surg. 2006. Vol. 22, № 2. P. 79-86.</mixed-citation><mixed-citation xml:lang="en">Harris G. J. Idiopathic orbital inflammation: A pathogenetic construct and treatment strategy: The 2005 ASOPRS Foundation Lecture // Ophthal Plast Reconstr Surg. 2006. Vol. 22, № 2. P. 79-86.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">I. Leibovitch et al. Intraorbital injection of triamcinolone acetonide in patients with idiopathic orbital inflammation: Commentary // Evidence-Based Ophthalmol. 2008. Vol. 9, № 3. P. 182-183.</mixed-citation><mixed-citation xml:lang="en">I. Leibovitch et al. Intraorbital injection of triamcinolone acetonide in patients with idiopathic orbital inflammation: Commentary // Evidence-Based Ophthalmol. 2008. Vol. 9, № 3. P. 182-183.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Патент 2164140. РФ. Способ лечения псевдоопухолевых заболеваний орбиты: заявл. 28.12.1999, опубл. 20.03.2001 / Бровкина А. Ф. и др.</mixed-citation><mixed-citation xml:lang="en">Патент 2164140. РФ. Способ лечения псевдоопухолевых заболеваний орбиты: заявл. 28.12.1999, опубл. 20.03.2001 / Бровкина А. Ф. и др.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Гайсина Г. Ф. Оптимизация комплексной диагностики и консервативного лечения псевдотумора орбиты: автореф. дис.. .. к.м.н. Самара, 2008. 22 с.</mixed-citation><mixed-citation xml:lang="en">Гайсина Г. Ф. Оптимизация комплексной диагностики и консервативного лечения псевдотумора орбиты: автореф. дис.. .. к.м.н. Самара, 2008. 22 с.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Mazlumzadeh M. et al. Treatment of giant cell arteritis using induction therapy with high-dose glucocorticoids: A double-blind, placebo-controlled, randomized prospective clinical trial // Arthritis Rheum. 2006. Vol. 54, № 10. P. 3310-3318.</mixed-citation><mixed-citation xml:lang="en">Mazlumzadeh M. et al. Treatment of giant cell arteritis using induction therapy with high-dose glucocorticoids: A double-blind, placebo-controlled, randomized prospective clinical trial // Arthritis Rheum. 2006. Vol. 54, № 10. P. 3310-3318.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Kahaly G. J. et al. Randomized, Single Blind Trial of Intravenous versus Oral Steroid Monotherapy in Graves’ Orbitopathy // J Clin Endocrinol Metab. 2005. Vol. 90, № 9. P. 5234-5240.</mixed-citation><mixed-citation xml:lang="en">Kahaly G. J. et al. Randomized, Single Blind Trial of Intravenous versus Oral Steroid Monotherapy in Graves’ Orbitopathy // J Clin Endocrinol Metab. 2005. Vol. 90, № 9. P. 5234-5240.</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Bijlsma W. R., Paridaens D., Kalmann R. Treatment of severe idiopathic orbital inflammation with intravenous methylprednisolone // Br J Ophthalmol. 2011. Vol. 95, № 8. P. 1068-1071.</mixed-citation><mixed-citation xml:lang="en">Bijlsma W. R., Paridaens D., Kalmann R. Treatment of severe idiopathic orbital inflammation with intravenous methylprednisolone // Br J Ophthalmol. 2011. Vol. 95, № 8. P. 1068-1071.</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Rootman J. et al. Idiopathic Sclerosing Inflammation of the Orbit // Ophthalmology. 1994. Vol. 101, № 3. P. 570-584.</mixed-citation><mixed-citation xml:lang="en">Rootman J. et al. Idiopathic Sclerosing Inflammation of the Orbit // Ophthalmology. 1994. Vol. 101, № 3. P. 570-584.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
