Division of Ophthalmic Plastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey.
Division of Cornea and Ocular Surface, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey.
Ocul Immunol Inflamm. 2021 May 19;29(4):669-670. doi: 10.1080/09273948.2021.1887282. Epub 2021 Apr 2.
The authors present a case of unilateral orbital myositis of new onset following COVID-19 without a severe course. The patient had been received topical treatment with a preliminary diagnosis of conjunctivitis but no recovery had been noticed. The history revealed that the ocular signs had started 1 week after the COVID-19. The examination revealed sectoral hyperemia of the temporal region in the bulbar conjunctiva together with marked limitation of right inward gaze. MRI of the orbits demonstrated diffuse fusiform enhancing enlargement of the right lateral rectus and superior rectus. The results of the laboratory tests and examination findings were normal. Systemic corticosteroids were started for the orbital myositis. Although conjunctivitis is the more common ocular disease following COVID-19, the possibility of orbital myositis should be considered in cases with resistance to topical treatment and/or gaze limitation. The possible role of orbital myositis as a trigger for COVID-19 could be explained with an immune-mediated mechanism.
作者报告了一例 COVID-19 后新发单侧眼眶肌炎病例，病情不严重。患者曾接受局部治疗，初步诊断为结膜炎，但未见好转。病史显示眼部症状在 COVID-19 后 1 周开始出现。检查发现球结膜颞侧扇形充血，右眼内转明显受限。眼眶 MRI 显示右侧外直肌和上直肌弥漫性梭形增强扩大。实验室检查和检查结果均正常。给予患者眼眶肌炎全身皮质类固醇治疗。虽然结膜炎是 COVID-19 后更常见的眼部疾病，但对于局部治疗抵抗和/或眼球运动受限的患者，应考虑眼眶肌炎的可能性。眼眶肌炎作为 COVID-19 的触发因素可能与免疫介导机制有关。
