Non-infectious Dacryoadenitis

Surv Ophthalmol. 2022 Mar-Apr;67(2):353-368. doi: 10.1016/j.survophthal.2021.05.011. Epub 2021 May 31.

Abstract

Dacryoadenitis is an inflammation of the lacrimal gland that may have various etiologies with similar presentations. Despite more recent elucidation of specific causes, the management has remained largely unchanged. Hence, the condition remains under biopsied with the rationale that empirical treatment with corticosteroids is effective for many of the causes. Dacryoadenitis, however, dacryoadenitis can be the presenting sign of an undiagnosed systemic disease and a mimick for lymphoma; hence, tissue diagnosis and systemic investigations play a vital role. A significant proportion of dacryoadenitis has a specific etiology, and IgG4-related dacryoadenitis is more frequently identified as a cause. We summarize the different types of immune-mediated dacryoadenitis, their clinical findings, histopathology, management, and prognosis. We have also highlighted and formulated practice guidelines for diagnosis and effective treatment based on the underlying systemic disease.

Keywords: Autoimmune; Dacryoadenitis; Granulomatosis with polyangiitis; IgG4; Lacrimal gland; Orbital inflammatory disease; Sarcoidosis; Sjogren's syndrome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biopsy
  • Dacryocystitis* / diagnosis
  • Dacryocystitis* / drug therapy
  • Dacryocystitis* / pathology
  • Humans
  • Inflammation / pathology
  • Lacrimal Apparatus Diseases* / diagnosis
  • Lacrimal Apparatus* / pathology