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Clinical features and therapeutic responses of idiopathic orbital myositis
Author(s) -
Ota Makiko,
Shimizu Toshio,
Yoshida Hiroshi,
Kawata Akihiro,
Kinoshita Masako,
Nakano Satoshi,
Isozaki Eiji,
Matsubara Shiro
Publication year - 2015
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.151
Subject(s) - medicine , myositis , prednisolone , methylprednisolone , magnetic resonance imaging , extraocular muscles , surgery , therapeutic effect , radiology
Abstract Background Orbital myositis is a rare and relatively rapid‐onset disease, resulting in inflammation mainly of the single or multiple extraocular muscles, for which the optimal treatment has not yet been fully established. Aim To evaluate clinical features, therapeutic responses and prognostic factors of idiopathic orbital myositis. Methods In five patients diagnosed with idiopathic orbital myositis (age of the disease onset 20–81 years), the clinical features, laboratory and radiographic findings, therapeutic response, and prognosis were analyzed retrospectively. Results All patients showed restriction of ocular movements or orbital pain aggravated by the movements, and one of them showed a visual disturbance caused by the optic nerve compression. Their magnetic resonance imaging showed a thickening of the orbital eye muscles. Two patients who started steroid hormone therapy within 1 month from the disease onset (starting dose: more than prednisolone 50 mg/day) showed quick recovery; both of them had a relapse and they improved again by steroid therapy. Another patient who was started with prednisolone 30 mg/day at the 34th day showed slight residual limitation of ocular movement. However, in the other two patients who received steroid therapy later than 6 months (starting dose: methylprednisolone 1000 mg/day or prednisolone 30 mg/day), the symptoms were intractable, and one of them underwent surgical treatment. Conclusion Early initiation of appropriate immunotherapy using a sufficient amount of steroid hormone is essential to improve the prognosis of idiopathic orbital myositis.