Management of strabismus due to orbital myositis
Management of strabismus due to orbital myositis
复制标题
眼眶肌炎引起的斜视的治疗
作者：
D. Bessant;J. P. Lee
我们报告了在 Moorfields 眼科医院肉毒杆菌毒素诊所就诊的连续 5 名患有继发于眼眶肌炎的眼球运动障碍的患者。 CT 扫描显示，所有 5 名患者的炎症过程均涉及一侧或两侧内直肌。此外，1 名患者的外直肌和右上直肌均受累。 2 名患者接受了口服类固醇治疗，3 名患者接受了非类固醇抗炎药治疗，1 名患者接受了眼眶放射治疗。在注射毒素之前，3名患者出现内斜视（范围从4Δ至30Δ），两名患者出现外斜视（52Δ和85Δ）。 3 名患者存在垂直不平衡，所有 5 名患者均出现复视症状。 5名患者总共接受了6次注射，其中2人随后接受了手术。注射毒素使 4 名患者的偏差角度降至 10Δ 以下，目前所有患者均无症状。第五名患者尽管进行了两次矫正大外斜视的手术，但仍存在持续性复视。我们讨论肉毒杆菌毒素和手术在治疗眼眶肌炎引起的斜视中的作用。
We report on 5 consecutive patients seen at the botulinum toxin clinic at Moorfields Eye Hospital with an ocular motility disorder secondary to orbital myositis. CT scans demonstrated involvement of one or both of the medial recti in the inflammatory process in all 5 patients. In addition 1 patient had involvement of both the lateral recti and the right superior rectus. Two patients had been treated with oral steroids, 3 with non-steroidal anti-inflammatory agents, and 1 with orbital radiotherapy. Prior to toxin injection 3 patients had an esotropia (ranging from 4Δ to 30Δ) and two an exotropia (52Δ and 85Δ). A vertical imbalance was present in 3, and all 5 patients had symptomatic diplopia. A total of six injections were given to 5 patients, 2 of whom later went on to have surgery. Toxin injection reduced the angle of the deviation to less than 10Δ in 4 patients, all of whom are now asymptomatic. The fifth patient has persistent diplopia despite two operations to correct a large exotropia. We discuss the role of botulinum toxin and surgery in the management of strabismus due to orbital myositis.