RT Journal Article SR Electronic T1 Fibrosis, gene expression and orbital inflammatory disease JF British Journal of Ophthalmology JO Br J Ophthalmol FD BMJ Publishing Group Ltd. SP 1424 OP 1429 DO 10.1136/bjophthalmol-2015-306614 VO 99 IS 10 A1 Rosenbaum, James T A1 Choi, Dongseok A1 Wilson, David J A1 Grossniklaus, Hans E A1 Harrington, Christina A A1 Dailey, Roger A A1 Ng, John D A1 Steele, Eric A A1 Czyz, Craig N A1 Foster, Jill A A1 Tse, David A1 Alabiad, Chris A1 Dubovy, Sander A1 Parekh, Prashant A1 Harris, Gerald J A1 Kazim, Michael A1 Patel, Payal A1 White, Valerie A1 Dolman, Peter A1 Edward, Deepak P A1 Alkatan, Hind A1 al Hussain, Hailah A1 Selva, Dinesh A1 Yeatts, Patrick A1 Korn, Bobby A1 Kikkawa, Don A1 Stauffer, Patrick A1 Planck, Stephen R YR 2015 UL http://bjo.bmj.com/content/99/10/1424.abstract AB Background/aims To clarify the pathogenesis of fibrosis in inflammatory orbital diseases, we analysed the gene expression in orbital biopsies and compared our results with those reported for idiopathic pulmonary fibrosis.Methods We collected 140 biopsies from 138 patients (58 lacrimal glands; 82 orbital fat). Diagnoses included healthy controls (n=27), non-specific orbital inflammation (NSOI) (n=61), thyroid eye disease (TED) (n=29), sarcoidosis (n=14) and granulomatosis with polyangiitis (GPA) (n=7). Fibrosis was scored on a 0–3 scale by two experts, ophthalmic pathologists. Gene expression was quantified using Affymetrix U133 plus 2.0 microarray.Results Within orbital fat, fibrosis was greatest among subjects with GPA (2.75±0.46) and significantly increased in tissue from subjects with GPA, NSOI or sarcoidosis (p<0.01), but not for TED, compared with healthy controls (1.13±0.69). For lacrimal gland, the average score among controls (1.36±0.48) did not differ statistically from any of the four disease groups. Seventy-three probe sets identified transcripts correlating with fibrosis in orbital fat (false discovery rate <0.05) after accounting for batch effects, disease type, age and sex. Transcripts with increased expression included fibronectin, lumican, thrombospondin and collagen types I and VIII, each of which has been reported upregulated in pulmonary fibrosis.Conclusions A pathologist's recognition of fibrosis in orbital tissue correlates well with increased expression of transcripts that are considered essential in fibrosis. Many transcripts implicated in orbital fibrosis have been previously implicated in pulmonary fibrosis. TED differs from other causes of orbital fat inflammation because fibrosis is not a major component. Marked fibrosis is less common in the lacrimal gland compared with orbital adipose tissue.