Verma R, Choi D, Chen AJ, et al. - Since orbital inflammatory disease (OID) involves a wide range of pathology including thyroid-associated orbitopathy (TAO), granulomatosis with polyangiitis (GPA), sarcoidosis and non-specific orbital inflammation (NSOI), accounting for up to 6% of orbital diseases, researchers tested the assumption that shared signalling pathways are activated in different forms of OID. Pathway analysis was performed on previously recorded differentially expressed genes from orbital adipose tissue in patients with OID and healthy controls who were characterised by microarray in this secondary analysis. The sample consisted of 83 patients (mean (SD) age, 52.8 (18.3) years; 70% (n = 58) female). Although OID involves a heterogenous group of pathologies, TAO, GPA, sarcoidosis and NSOI share enrichment of common gene signalling pathways, ie, IGF-1R, peroxisome proliferator-activated receptor-γ, adipocytokine and AMPK. Pathway analyses of gene expression indicate that other forms of orbital inflammation other than TAO may benefit from blockade of IGF-1R signalling pathways.