Ophtalmoplégie indolore et récidivante révélatrice d’une myosite orbitaire

Idiopathic inflammatory orbital myositis presenting with vision loss

We present a first case of 58-year-old man with vision loss in a biopsy-proven idiopathic inflammatory orbital tendon sparing myositis. Tests for thyroid autoantibodies were negative at the initial presentation and at 10-month follow-up period. The diagnosis was confirmed on histopathological examination and was also supported by avid sarcolemmal staining for MHC-1 and MHC-2.

Cutting the edge of idiopathic recurrent orbital myositis

The spectrum of orbital inflammatory diseases ranges broadly from specific diseases as connective tissue disorders, thyroid ophthalmopathy to non-specific inflammations, which may involve one or multiple structures of the orbit and/ or the surrounding sinus. Idiopathic orbital myositis (IOM) may be a localized process or it can be secondary to systemic diseases. We report 4 patients affected by IOM; in all relapsing diplopia was the main complaint, associated with orbital pain in 3 and with abnormal visual evoked responses in 2. Computed tomography (CT), magnetic resonance imaging (MRI) supported the diagnosis revealing enlargement, altered signal intensity of affected muscles. Repeated MRI scans and extensive laboratory examinations comprising of the search for a remote malignacy, lymproliferative, connective tissue diseases, thyroid ophthalmopathy were necessary to confirm the diagnosis. Oral or/and intravenous steroids were main treatments; relapses often occurred when steroid was tapered down. Intravenous immuneglobulins and azathioprine was used in one refractory case