Non specific orbital inflammatory diseases

Abstract

The understanding of 'pseudotumors' has significantly changed with the advent of modern imaging techniques by which the tissues affected in the orbit can be identified, and nonspecific orbital inflammatory disease is classified according to the tissue involved. Twenty cases of nonspecific orbital inflammatory diseases were treated between July 1987 and September 1991. Eight patients had myositis, 6 had diffuse disease, 2 each had dacryoadenitis, periscleritis and perineuritis. Involvement of all four recti in one patient and isolated superior rectus and superior oblique each in 2 others are the unusual forms of myositis. Perineuritis presented as diffuse thickening of the optic nerve on CT scan with disc edema and normal vision in both patients with external ophthalmoplegia in one of them. All patients responded to oral steroids while the patient with myositis of all four recti required radiotherapy in addition. This series documents the spectrum of clinical presentation, diagnosis and management of nonspecific orbital inflammatory disease.

Acute Suppurative Dacryoadenitis

“…Acute suppurative dacryoadenitis has been reported to be caused by a crysticercus cellulosae [7]. Non-infective causes such as pseudotumour can give rise to dacryoadenitis [8,9]. This patient had acute bacterial suppurative dacryoadenitis.…”

Idiopathic Orbital Myositis

“…3Y5,13 Whereas there exists 1 report from India indicating a male preponderance, in contrast to other forms of IOIP, myositis has a female predilection, with a female-to-male ratio of 2:1 or greater. 5,14 The majority of patients present for the first time between the ages of 18 and 40 years, but an age range of 9 to 84 years has been reported. 1,5,6,13 In our study, the ratio of acute to subacute stages was 1:3, with a female predominance (female-male ratio,1.32:1).…”

Methylprednisolone pulse therapy in patient with isolated superior oblique myositis

“…Only five patients with isolated SO myositis have been reported, including the present case. [2][3][4][5] Table 1 summarizes their clinical presentation. Due to their nonspecific clinical manifestations, early recognition seems to be difficult.…”

“…Especially, isolated SO myositis is very rare, and often causes persistent gaze restriction. [2][3][4][5] We report one patient with isolated SO myositis treated successfully with pulse intravenous methylprednisolone, and also reviewed the clinical presentation and treatment outcome of previously reported four cases.…”