Serum IgE Levels: An Effective Diagnostic Tool for Evaluation and Monitoring of Orbital Fungal Granuloma.

OBJECTIVE To determine the changes in IgE levels in diagnosis and postoperative monitoring of orbital fungal granuloma. STUDY DESIGN Descriptive analytical study. PLACE AND DURATION OF STUDY Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan, from July 2012 to June 2013. METHODOLOGY Cases with clinically high index of suspicion for orbital fungal granuloma and 50 healthy volunteers were inducted as control subjects. Patients with recurrent cases of orbital fungal granuloma, previous orbital surgery, and those with very low clinical suspicion of fungal granuloma were excluded. Total serum IgE level (IU/ml), eosinophil counts and skin prick test were performed in all subjects. Independent t-test was used for comparison of healthy volunteers and patients with biopsy proven orbital fungal granuloma. Repeated measures ANOVA was used for comparing the preoperative and postoperative total serum IgE level of patients with biopsy proven fungal granuloma. RESULTS The mean total serum IgE level for the healthy volunteers was 208.82 ±41.43 IU/ml. The mean pre-operative IgE value of histologically confirmed cases of fungal granuloma was 1613.72 ±282.83 IU/ml. The total serum IgE level gradually declined after surgery and anti-fungal treatment. The mean serum IgE level 3, 6 and 9 months postoperatively were 1039.48 ±308.40, 568.77 ±162.01 and 224.92 ±51.55 IU/ml respectively. These tests showed that the drop in IgE level in cases of fungal granuloma with treatment was statistically significant (p < 0.001). CONCLUSION Total serum IgE level can be used as a reliable diagnostic and postoperative monitoring tool in orbital fungal granuloma.