Suspected orbital myositis associated with COVID-19

Armstrong, Blair K.; Murchison, Ann P.; Bilyk, Jurij R.

doi:10.1080/01676830.2021.1962366

Cited by 17 publications

(20 citation statements)

References 12 publications

(24 reference statements)

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“…5 Orbital inflammation associated with COVID-19 remains far less common, with only 6 reports in the literature to date including orbital myositis, orbital inflammatory disease, optic perineuritis, and dacryoadenitis. 6–11 In contrast to the most of COVID-19-associated ocular manifestations, systemic symptoms of COVID-19 were either absent or mild in each of these cases.…”

Section: Discussionmentioning

confidence: 89%

Orbital Inflammation Following COVID-19 Vaccination

Reshef

Freitag

Lee

2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Three patients presented with periorbital swelling, pain with extraocular movements, and binocular diplopia 1–4 days after receiving an mRNA Coronavirus Infectious Disease-19 (COVID-19) vaccine (BNT162b2, Pfizer/BioNTech; mRNA-1273, Moderna). All patients had a normal afferent function, unilateral limitation of extraocular motility, proptosis, and periorbital inflammation. Neuroimaging of the orbits with contrast revealed inflammation and enlargement of extraocular muscles in 2 cases and the lacrimal gland in 1 case. In all 3 cases, an extensive infectious and inflammatory laboratory work-up was unremarkable and signs and symptoms of orbital inflammation rapidly improved to complete resolution after treatment with high-dose oral prednisone. This is the first reported series of orbital inflammation occurring shortly after administration of the COVID-19 vaccine. Clinicians may consider an inflammatory postvaccine etiology as an alternative to presumed idiopathic diagnosis in such cases.

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Section: Discussionmentioning

confidence: 89%

Orbital Inflammation Following COVID-19 Vaccination

Reshef

Freitag

Lee

2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…13 To our knowledge, orbital inflammatory diseases have only been reported in six patients with COVID-19 (Table 1). [4][5][6][7][8][9] These patients shared some similarities in ophthalmic presentation and imaging. All the patients showed a favorable response to high-dose systemic corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical presentations ranged from orbital myositis, dacryoadenitis, and optic perineuritis, which were hypothesized to represent immune consequences of the interaction between SARS-CoV-2 and the host. [4][5][6][7][8][9] This article describes the case of a healthy young woman who developed bilateral eye redness, periorbital pain with edema, and proptosis during hospitalization for mild COVID-19 pneumonia. The patient provided written informed consent for the publication of the photographs in this article.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Orbital Inflammation Associated with COVID-19 Infection: A Case Report and Brief Review of the Literature

Tungsattayathitthan

Nonboonyawat

Phinitkitanan

et al. 2022

J Health Sci Med Res

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A 31-year-old woman with no history of systemic autoimmune disease developed bilateral pain, redness, periorbital edema, and proptosis while being hospitalized for mild coronavirus disease 2019 (COVID-19) pneumonia. The onset of ocular symptoms occurred six days after systemic COVID-19 symptoms. Computed tomography examination of the orbit revealed diffuse inflammation involving multiple orbital structures. A complete systemic workup was performed to exclude other systemic inflammatory diseases. She was initially diagnosed with probable orbital cellulitis secondary to sinusitis. However, she did not improve with antibiotic therapy. Empirical administration of systemic corticosteroids led to a dramatic clinical response. The patient has been maintained on a gradual steroid taper without inflammation relapse. This article describes a potential causal association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and orbital inflammation. Ophthalmologists should be aware of this presentation when assessing patients with COVID-19 who present with orbital inflammatory symptoms.

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“…Table 1 provides a simplified classification of all forms of orbital myositis [3 ••]. The list of causes is not limitative, considering a recently reported case with presumed orbital myositis following SARS-CoV19 infection [30].…”

Section: Differential Diagnosismentioning

confidence: 99%

Idiopathic Orbital Myositis Revisited

Mombaerts¹,

McNab

2022

Curr Rheumatol Rep

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Purpose of ReviewTo review current knowledge regarding idiopathic orbital myositis. Recent Findings Recent publications have focused on possible causes of orbital myositis and the process to reach a diagnosis of idiopathic orbital myositis. With inflamed and enlarged extraocular muscles, features to distinguish between competing diagnostic possibilities are based on imaging in the context of history and clinical signs. Idiopathic orbital myositis is characterized by the clinical triad of acute onset of orbital pain exacerbated on eye movement, double vision, and redness or swelling of the eyelids or conjunctiva, along with the radiological finding of homogeneous, fusiform enlargement of one or more extraocular muscles. In atypical or inconclusive clinico-radiological findings for a diagnosis of idiopathic orbital myositis, or where the clinical behavior changes or fails to respond to corticosteroid treatment, a systemic and oncologic work-up and muscle biopsy are warranted to exclude specific local or systemic disease as cause of the inflamed and enlarged muscle. Summary As our understanding of idiopathic orbital myositis evolves, the diagnostic focus is shifting toward earlier identification of underlying local or systemic disease through systemic work-up and muscle biopsy.

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Suspected orbital myositis associated with COVID-19

Cited by 17 publications

References 12 publications

Orbital Inflammation Following COVID-19 Vaccination

Orbital Inflammation Following COVID-19 Vaccination

Bilateral Orbital Inflammation Associated with COVID-19 Infection: A Case Report and Brief Review of the Literature

Idiopathic Orbital Myositis Revisited

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