Wan W L, Cano M R, Green R L
Department of Ophthalmology, University of Southern California, School of Medicine, Los Angeles.
Ophthalmology. 1988 Nov;95(11):1522-8. doi: 10.1016/s0161-6420(88)32987-8.
Idiopathic orbital myositis is a common nonspecific orbital inflammatory syndrome that can involve one or more of the extraocular muscles. Oblique muscle involvement is infrequently reported, possibly because such involvement is difficult to identify clinically or by computed tomography (CT). The authors reviewed seven cases of orbital myositis involving the oblique muscles solely or in association with rectus muscle involvement. Standardized echography demonstrated homogeneous low-reflective enlargement, diagnostic of myositis, of the superior and inferior oblique muscles and tendons along their courses. The finding of massive inferior chemosis was associated with involvement of the inferior oblique muscle. Although the disease typically responds to therapy with systemic steroids, residual gaze restriction may occur. The oblique muscles may be frequently involved in idiopathic orbital myositis when evaluated by standardized orbital echography. In these cases, echography provides rapid, accurate, and reliable confirmation of the diagnosis of myositis, differentiates other orbital inflammatory diseases, and provides an objective measure of the therapeutic response.
特发性眼眶肌炎是一种常见的非特异性眼眶炎症综合征，可累及一条或多条眼外肌。斜肌受累的报道较少，可能是因为这种受累在临床上或通过计算机断层扫描（CT）难以识别。作者回顾了7例眼眶肌炎病例，这些病例仅累及斜肌或同时伴有直肌受累。标准化超声检查显示上、下斜肌及其肌腱在走行过程中呈均匀低回声增粗，提示为肌炎。大量下睑结膜水肿的表现与下斜肌受累有关。尽管该病通常对全身类固醇治疗有反应，但可能会出现残留的眼球运动受限。通过标准化眼眶超声检查评估时，斜肌可能经常受累于特发性眼眶肌炎。在这些病例中，超声检查能快速、准确且可靠地确诊肌炎，鉴别其他眼眶炎症性疾病，并提供治疗反应的客观指标。
