Sato Yohei, Mano Natsuko, Watanabe Hiroko, Miyamoto Makiko, Shimizu Kazuhiro, Mukai Noriko, Mimura Masashi, Oku Hidehiro, Ikeda Tsunehiko
Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan.
Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.
Case Rep Ophthalmol. 2020 Jan 7;11(1):8-15. doi: 10.1159/000505314. eCollection 2020 Jan-Apr.
We report a case of idiopathic orbital inflammation with a shallow anterior chamber and choroidal detachments. This study involved an 87-year-old female patient who presented at our department after becoming aware of the progression of diplopia. Examination of the patient's right eye revealed proptosis, as well as conjunctival edema with dilated and tortuous blood vessels. The right-eye anterior chamber was shallow, and fundus examination revealed marked choroidal detachments. Magnetic resonance imaging revealed enlargement of the right-orbit extraocular muscles and a suspected compression of the right-orbit superior and inferior ophthalmic veins, yet no expansion of the cavernous sinus. We diagnosed the patient as having idiopathic orbital inflammation in her right orbit, and subsequently started corticosteroid therapy. One week after initiating treatment, the anterior chamber was found to be nearing a normal depth, and the choroidal detachments were found to have disappeared. Our findings revealed that the inflammatory swelling of the extraocular muscle due to idiopathic orbital inflammation resulted in compression of the right-orbit superior and inferior ophthalmic veins, thus leading to an apparent choroidal circulation disorder that presented with a shallow anterior chamber and marked choroidal detachments.
我们报告一例伴有前房变浅和脉络膜脱离的特发性眼眶炎症。本研究涉及一名87岁女性患者，她在意识到复视进展后前来我科就诊。对患者右眼的检查发现眼球突出，以及结膜水肿伴血管扩张和迂曲。右眼的前房变浅，眼底检查发现明显的脉络膜脱离。磁共振成像显示右眼眶眼外肌增大，怀疑右眼眶上下眼静脉受压，但海绵窦无扩张。我们诊断该患者右眼患有特发性眼眶炎症，随后开始使用皮质类固醇治疗。开始治疗一周后，发现前房接近正常深度，脉络膜脱离消失。我们的研究结果表明，特发性眼眶炎症导致的眼外肌炎性肿胀压迫了右眼眶上下眼静脉，从而导致明显的脉络膜循环障碍，表现为前房变浅和明显的脉络膜脱离。
