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A case of orbital inflammation with sinusitis and difficulty in deciding to opt for steroid therapy Azuma Oike 1 , Kensuke Goto 1,2 , Jiro Hiraiwa 1 1Department of Ophthalmology, Konan Kosei Hospital 2Department of Ophthalmology, Nagoya University pp.498-504
Published Date 2024/4/15
DOI https://doi.org/10.11477/mf.1410215150
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Abstract Purpose:To report a case of a patient with concurrent sinusitis and orbital inflammation. Decision for treatment with steroid therapy was difficult.

Case:A-48-year old male had decreased visual acuity in the right eye for the past 2 months.

Findings and Clinical Course:Corrected visual acuity was 0.15 in the right eye. The right eye showed diplopia with upward vision. Computed tomography(CT)and magnetic resonance imaging(MRI)showed orbital myositis and compressive optic neuropathy in the right eye, and right sinusitis. We considered idiopathic orbital inflammation, orbital inflammation due to autoimmune disease and orbital complications of sinusitis(inflammation and infection from sinusitis, rhinogenic optic neuropathy)as the differential diagnoses. We performed endoscopic sinus surgery to rule out orbital complications of sinusitis. Orbital inflammation worsened after surgery and was not considered to be related to sinusitis. We started oral steroid therapy. Steroid treatment was effective, and orbital myositis and compressive optic neuropathy improved. Corrected visual acuity improved to 1.2 and diplopia improved.

Conclusion:We experienced a concurrent case of sinusitis and orbital inflammation. When steroid therapy is considered, ruling out orbital complications of sinusitis before treatment is important.


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