[
    {
        "id": "osp-12993",
        "type": "article-journal",
        "title": "Role of antimetabolites in recalcitrant idiopathic orbital inflammatory syndrome",
        "author": [
            {
                "family": "Priya",
                "given": "Yamini"
            },
            {
                "family": "Nithyanandam",
                "given": "Suneetha"
            },
            {
                "family": "Reddy",
                "given": "Manjoo S"
            }
        ],
        "URL": "https://omanscience.com/en/articles/role-of-antimetabolites-in-recalcitrant-idiopathic-orbital-inflammatory-syndrome",
        "language": "en",
        "issued": {
            "date-parts": [
                [
                    2011
                ]
            ]
        },
        "container-title": "Oman Journal of Ophthalmology",
        "volume": "4",
        "issue": "1",
        "page": "21-24",
        "DOI": "10.4103/0974-620x.77658",
        "publisher": "Medknow Publications",
        "ISSN": "0974-620X",
        "abstract": "Background: High-dose systemic steroids are the primary modality of treatment for idiopathic orbital inflammatory syndrome (IOIS). Occasionally patients experience a relapse of symptoms on tapering steroids or require large doses of steroid, predisposing them to the adverse effects of steroids.\n\nAim: We present our experience with the management of three patients with recalcitrant IOIS, with immunosuppressive therapy, using antimetabolites.\n\nMaterials and methods: A retrospective review of the medical records of the patients being reported.\n\nResults: Two patients were treated with Methotrexate and one with Azathioprine for a duration of 6-24 months. Two patients were symptom-free three years after stopping the medication. One was doing well clinically with methotrexate therapy alone, when he was lost to follow-up after six months. No adverse effects of immunosuppressive therapy were encountered.\n\nConclusion: High-dose systemic steroid therapy is the first-line treatment for IOIS, but in refractory or steroid-dependent cases, immunosuppressive therapy with antimetabolites is a safe and effective treatment alternative to steroids. However, treatment with antimetabolites warrants close monitoring for complications like bone marrow suppression and liver dysfunction, especially because long-term treatment is required."
    }
]