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Orbital Myositis and Strabismus: Clinical Profile, Management, and Predictive Factors for Recurrence

Year: 2024

Type: article

Abstract: Purpose To study the clinical profile of patients with orbital myositis and their management modalities and predictive factors for recurrence. Methods The records of all consecutive patients diagnosed as having orbital myositis from 2010 to 2022 were reviewed. Patient demographics, presenting complaints, visual function, primary gaze deviation, and extraocular muscle involved were studied in the clinical profile. The radiological modalities and their management along with the recovery status and need for surgical intervention were documented. Results Fifty-two patients (55 eyes) (69% women) were diagnosed as having orbital myositis with a mean age of 36 ± 16 years presenting with periocular pain (55%) followed by diplopia (49%). Disease was unilateral in 94%. Sixty percent had ocular misalignment in primary gaze. The medial rectus was the most involved muscle (58%), with abduction limitation in 73%. Computed tomography (42%), magnetic resonance imaging (42%), and combined imaging (16%) were used in localizing the disease. Muscle biopsy was done in 38% of patients. Systemic immunomodulators were required in 16%. Strabismus surgery was planned in 15% of patients and done in 11%. Recurrence was noted in 43%. Abrupt cessation of steroids was a significant risk factor in recurrence of the disease ( P = .046). Recovery was partial in 44% of patients and complete in 47%. Conclusions Systemic steroids with slow taper has satisfactory outcomes in orbital myositis. Patients refractory to treatment ideally should undergo biopsy and begin taking steroid-sparing agents. Once the disease is in remission, residual disease can be surgically treated for better functional outcome. [ J Pediatr Ophthalmol Strabismus . 2025;62(1):57–66.]

Source: Journal of Pediatric Ophthalmology & Strabismus

DOI: 10.3928/01913913-20240926-04

Authors: Adeline Shona Lasrado, Goura Chattannavar, Saumya Jakati, Ashik Mohamed, Ramesh Kekunnaya

Institution: L V Prasad Eye Institute

Language: English

Topic: Ophthalmology and Eye Disorders

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funder: Hyderabad Eye Research Foundation