| A Case of Surgical Diagnosis and Treatment of Idiopathic Orbital Myositis with Sudden Vision Loss. |
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Dong Eun Lee, Byung Gun Park, Sung Hyuk Moon, Jae Wook Yang |
1Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. oculoplasty@gmail.com
2T2B Infrastructure Center for Ocular Disease, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. |
| 급격한 시력저하를 동반한 특발안와근염의 수술적 진단 및 치료 1예 |
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이동은1,2⋅박병건1,2⋅문성혁1,2⋅양재욱1,2 |
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인제대학교 의과대학 부산백병원 안과학교실1, 인제대학교 의과대학 부산백병원 안과질환 T2B 기반구축센터2 |
Correspondence:
Jae Wook Yang,
Email: oculoplasty@gmail.com
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Received: 3 August 2017 • Revised: 28 August 2017 • Accepted: 20 September 2017 |
| Abstract |
PURPOSE
We report a case of idiopathic orbital myositis with sudden onset of unilateral visual loss and hypertrophy of the lateral rectus muscle at the apex of the orbit that was diagnosed using orbital biopsy and treated with intravenous corticosteroids. CASE SUMMARY: We examined a 20-year-old woman who complained of decreased visual acuity and binocular diplopia for 2 weeks. She showed 40-prism diopter left esotropia at the primary position. Her visual acuity with eyeglasses was 0.7 and 0.2 in the right and left eyes, respectively. Brain magnetic resonance imaging (MRI) revealed a round mass on the left lateral rectus muscle at the apex of the orbit with optic nerve compression. We planned orbital biopsy to exclude orbital lymphoma and other biopsy-requiring diseases. After 3 weeks, the visual acuity of her left eye decreased to 0.02. Repeated MRI revealed enlargement of all extraocular muscles on the left orbit. With biopsy showing several lymphocytes infiltrating muscle fibers, we made a diagnosis of idiopathic orbital myositis. Intravenous injection of corticosteroids was administered during hospitalization. After 2 weeks of corticosteroid therapy, the visual acuity of her left eye was improved to 0.63, the esotropia disappeared, and the enlargement of the left lateral rectus muscle was improved on orbital MRI. CONCLUSIONS: For non-specific idiopathic orbital myositis located at the apex of the orbit and enlargement of the extraocular muscle in a short period with decreased visual acuity, administration of intravenous injection of corticosteroids before orbital biopsy could help restore vision. |
| Key Words:
Idiopathic orbital inflammation;Idiopathic orbital myositis;Orbital lymphoma |
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