Evidence map›Paper›PMID 40146480›Full record

ArticleJournal of ophthalmic inflammation and infection2025

IgG4-related ophthalmic disease presenting as posterior scleritis in a pediatric patient.

Irmak Karaca, Albert John Bromeo, Azadeh Mobasserian, Amir Akhavanrezayat, Charles DeBoer, Zheng Xian Thng, Jia-Horung Hung, Woong-Sun Yoo, Anadi Khatri, Negin Yavari and 11 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of ophthalmic inflammation and infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Irmak KaracaSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Albert John BromeoSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Azadeh MobasserianSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Amir AkhavanrezayatSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Charles DeBoerSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Zheng Xian ThngSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Jia-Horung HungSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Woong-Sun YooSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Anadi KhatriSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Negin YavariSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Ba Trung NguyenSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Dalia El FekySpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Cigdem YasarSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Osama ElarabySpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Aim-On SaengsirinavinSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Xiaoyan ZhangSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Frances Andrea AnoverSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Ankur Sudhir GuptaSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Diana V DoSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Christopher OrSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA.
Quan Dong NguyenSpencer Center for Vision Research, Byers Eye Institute, School of Medicine, Stanford University, 2370 Watson Court, Palo Alto, CA, USA. ndquan@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo report IgG4-related ophthalmic disease (IgG4-ROD) presenting as posterior scleritis in a pediatric patient. OBSERVATIONS: A 7-year-old girl presented with proptosis, painful eyelid swelling, and restricted extraocular movements (EOM) of her left eye (OS). Visual acuity (VA) was 20/20 in right eye (OD) and counting fingers (CF) at 1 foot in OS. Slit lamp examination revealed 2 + anterior chamber (AC) cells, optic disc edema (ODE) with elevated appearance of macula in OS. Optical coherence tomography (OCT) showed significant subretinal fluid (SRF) in macula, B-scan ultrasound (US) demonstrated T-sign in OS. Orbital MRI was also consistent with posterior scleritis and periorbital inflammation. Extensive systemic work-up was unremarkable. Thus, the patient was started on intravenous methylprednisolone (IVMP) 30 mg/kg/day for 3 days, along with topical therapy in OS, which led to an improvement of proptosis, EOM restriction, AC cells, as well as ODE and SRF in macula in OS. Fluorescein angiography (FA) showed leakage from optic disc in OS. The patient was then switched to oral prednisone with slow tapering and started on methotrexate (MTX). Given the recurrence of proptosis and painful eyelid swelling on systemic steroid tapering, serum IgG4 levels were ordered and found to be elevated at 149.9 mg/dL (range, 1-99). Therefore, the patient was diagnosed as 'possible' IgG4-ROD (based on diagnostic criteria) and started on infliximab (7.5 mg/kg) and IVMP monthly infusions with continuation of MTX 20 mg weekly and slower tapering of oral prednisone, which led to resolution of clinical findings, improvement of VA to 20/20 in OS. CONCLUSION AND IMPORTANCE: Posterior scleritis may be the initial presentation of IgG4-ROD in children. Refractory course is not uncommon. Biologics are effective in the long-term control of inflammation.

Indexed as

IgG4-related ophthalmic diseaseInfliximabPediatricPosterior scleritis

Identifiers

PMID40146480
PMCPMC11950618

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.