# Epidemiology of orbital diseases in a tertiary ophthalmic outpatient clinic in Sao Paulo, Brazil

## TL;DR

This study analyzed the prevalence of orbital diseases in a Brazilian hospital, finding that Graves’ orbitopathy was the most common condition.

## Contribution

The study provides new epidemiological data on orbital diseases in a tertiary ophthalmic setting in Brazil.

## Key findings

- Graves’ orbitopathy was the most common orbital disease (55% of cases).
- Tumors and inflammatory disorders were the second and third most frequent diagnoses.
- Orbital diseases accounted for 0.4% of all ophthalmology appointments.

## Abstract

This study aimed to evaluate the prevalence of orbital conditions in a
tertiary ophthalmic outpatient hospital in Sao Paulo, Brazil, with a focus
on the main diagnoses and their distribution.

A retrospective chart review was conducted involving patients registered and
admitted to the orbital disease unit at the Department of Ophthalmology,
University of São Paulo Medical School, from January 2004 to March
2018. A total of 838 medical charts were analyzed, of which 37 were excluded
due to incomplete data. The remaining charts were categorized into eight
diagnostic groups: Graves’ orbitopathy , inflammatory disorders, tumors,
vascular lesions, acquired structural abnormalities, congenital structural
abnormalities, infectious diseases, and others.

Of the 837,300 ophthalmological appointments, 3,372 (0.4%) were related to
orbital diseases. The study included 801 patients, of whom 63.45% were
women. The patients’ mean age was 42.86 years. Graves’ orbitopathy was the
most common (55%), followed by tumor (17%), inflammatory disorders (9%),
vascular lesions (7%), acquired structural abnormalities (5%), congenital
structural abnormalities (4%), others (2%), and infectious diseases (1%).
The study found significant differences in the incidence and types of
orbital diseases, indicating the specialized nature of tertiary care and
referral biases.

Published data on epidemiological orbital diseases is scarce. Therefore, this
study focused on the diverse nature of orbital diseases and their low
incidence among ophthalmology appointments. The major trends align with
other epidemiological studies, demonstrating a preponderance of
Graves’ orbitopathy in middle-aged adults and a bimodal distribution of
tumors. These findings are essential in shaping resident training
programs and healthcare policies, particularly in tertiary
settings. Understanding the epidemiology of orbital diseases can improve
diagnostic accuracy, treatment approaches, and patient outcomes as well as
support future systemic prospective studies.