Matsuo Toshihiko
Department of Ophthalmology, Okayama University Hospital and Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan.
Jpn Clin Med. 2019 Aug 12;10:1179670719866525. doi: 10.1177/1179670719866525. eCollection 2019.
Idiopathic orbital myositis, a rare disease of unknown cause, presents a diagnostic puzzle because the diagnosis is based on the exclusion of other diseases. This study aims at elucidating its long-term outcome to answer a clinical question whether idiopathic orbital myositis would be a distinct clinical entity.
Retrospective review was made on 7 consecutive patients (6 men and 1 woman) with the age at the initial visit ranging from 33 to 69 years (mean, 45.8 years) who were diagnosed with idiopathic orbital myositis and followed for 5 years or more (mean, 9.2 years) at a referral-based hospital.
Chief complaint at the initial visit was diplopia in 4 patients, blurred vision in 2 patients, and proptosis in 1 patient. On magnetic resonance imaging, 4 patients showed enlargement of a single extraocular muscle on unilateral side while 3 patients showed enlargement of multiple extraocular muscles on unilateral side or bilateral sides. No patient developed systemic diseases or other orbital lesions in the long-term follow-up. All patients at the last visit were free from symptoms, including diplopia, after tapering of prednisolone at the initial dose of 20 to 60 mg daily.
Idiopathic orbital myositis had a favorable long-term outcome with corticosteroid administration and appears to be a distinct clinical entity without systemic involvement.
特发性眼眶肌炎是一种病因不明的罕见疾病，由于其诊断基于排除其他疾病，因此存在诊断难题。本研究旨在阐明其长期预后，以回答特发性眼眶肌炎是否为一种独特临床实体这一临床问题。
对一家转诊医院连续7例（6例男性，1例女性）初诊年龄在33至69岁（平均45.8岁）、被诊断为特发性眼眶肌炎且随访5年或更长时间（平均9.2年）的患者进行回顾性研究。
初诊时的主要症状为，4例患者出现复视，2例患者视力模糊，1例患者眼球突出。在磁共振成像检查中，4例患者表现为单侧单条眼外肌增粗，3例患者表现为单侧或双侧多条眼外肌增粗。在长期随访中，无患者出现全身性疾病或其他眼眶病变。在初始剂量为每日20至60毫克的泼尼松龙逐渐减量后，所有患者在最后一次就诊时均无包括复视在内的症状。
特发性眼眶肌炎经皮质类固醇治疗后长期预后良好，似乎是一种无全身累及的独特临床实体。
