Abstract
Objective: To elucidate the clinical features of ocular motility and the risk factors for recurrence in idiopathic orbital myositis. Methods: The medical records of 31 patients diagnosed with idiopathic orbital inflammation between 2003 and 2019 were retrospectively reviewed. All patients were initially treated with corticosteroids. Treatment outcome and ocular motility were noted. Results: Twenty-six patients (84%) had unilateral involvement and five patients (16%) were bilateral. Of the 31 patients, 22 patients (71%) showed ocular motility limitation. The mean grading scale of extraocular muscle (EOM) limitation was −1.65 ± 1.80. EOM limitation was found in the same direction of the most affected muscle in 14 patients (64%), while 8 patients (36%) showed duction limitation in the opposite direction. Nine patients (35%) suffered from recurrence. Recurrence was more likely to occur in patients with multiple muscle involvement (p < 0.001). The interval to relapse of symptoms after discontinuation of steroids was significantly shorter in patients with multiple recurrences compared to those with a single recurrence (1.8 ± 0.8 weeks versus 6.0 ± 1.4 weeks, p = 0.020). Conclusions: Idiopathic orbital myositis showed variable degrees of ocular motility limitation, and limitation in the same direction of the action of the affected muscle was more frequent. Recurrent myositis was more likely to have multiple muscle involvement. Rapid relapse of symptoms after discontinuation of steroids was a significant indicator of multiple recurrences.
Highlights
Idiopathic orbital inflammatory syndrome (IOIS), previously referred to as pseudotumor, is a broad term covering all inflammatory diseases that influence the structures contained within the orbit external to the ocular globe [1,2,3]
A retrospective review was performed on 31 patients who visited the Department of Ophthalmology, Seoul National University Bundang Hospital between the years 2003 to 2019 and were confirmed to have extraocular muscles (EOM) affected by idiopathic orbital inflammation
We found that multiple muscle involvement was likely to contribute to recurrence in orbital myositis
Summary
Idiopathic orbital inflammatory syndrome (IOIS), previously referred to as pseudotumor, is a broad term covering all inflammatory diseases that influence the structures contained within the orbit external to the ocular globe [1,2,3]. The diagnosis of idiopathic orbital inflammatory syndrome is challenging because of the clinical diversity, i.e., from being acute to chronic, mild to severe, isolated to associated with systemic diseases, number of the affected muscles, presence of symptoms, or recurrences [1]. A large scale case series depicting the clinical manifestations of ocular motility limitations associated with IOIS, including orbital myositis, are rare. Avni-Zauberman et al [21] reported a case series with recurrent migratory IOIS involving different EOM. They reported only which muscles were involved without a detailed description on ocular motility
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
