ステロイド局所治療が奏効した眼窩筋炎の1例

Topical corticosteroid was effective in a case of orbital myositis

　副腎皮質ステロイド薬（ステロイド）の局所投与が奏効した眼窩筋炎の1例を報告した。症例は41歳の女性で1左眼の鈍痛，結膜充血，眼瞼腫脹を自覚し，MRIにより左眼外直筋の腫大がみられた。血液検査では血沈のみ亢進しており，甲状腺機能は正常であった。ステロイドの全身投与で症状は軽減したが，ステロイドの中止により再発を繰り返した。眼窩筋炎の診断の下にステロイドの結膜下注射を試みたところ，症状が消失し，MRI上，筋腫大の著日月な減少がみられた。現在のところ再発はみられていない。眼窩筋炎の治療として，ステロイドの局所投与は文献上記載がないが，有効であると思われた。

A 41-year-old woman developed ocular pain, conjunctival injection and lid swelling in her left eye. Systemic dexamethasone was effective but the symptoms and signs recurred after cessation of the treatment. She was referred to us three months after onset of the disease. Magnetic resonance imaging (MRI) showed sweling of the left lateral rectus muscle. The erythrocyte sedimentation rate was elevated. Other hematological data and thyroid function were normal. These findings led to the diagnosis of orbital myositis. She was treated by injection of dexamethasone under the temporal conjunctiva of the left eye. The clinical signs disappeared after 6 weeks of 8 injections totalling 5.6 mg. MRI showed marked reduction in the swelling of the lateral rectus muscle. No recurrence during the follow up of 5 months.