A 41-year-old
Japanese female was admitted to our
hospital with a
history of right
abducens nerve palsy, right gaze
diplopia, right
eye pain and
double vision.
Thyroid function,
thyroid autoantibody levels, and tests for other
pathologies were normal. Orbital contrast-enhanced short-TI Inversion Recovery-
magnetic resonance imaging before
treatment showed contrast-enhanced, severe lateral rectus and rectus superior
muscle swelling in the right
eye. We therefore diagnosed this
patient as
orbital myositis. Intravenous
glucocorticoid pulse therapy with
methylprednisolone (mPSL) was initiated. After prescribing a daily
dose of 1,000 mg of mPSL three times a week, all symptoms, including physical
abnormalities, disappeared. The
patient was discharged on day 14 after
hospitalization and was prescribed oral PSL (30 mg/day). This
report indicates that early and initial adequate
treatment with a high
dose of mPSL is very effective for
orbital myositis treatment. However, the possibility of
recurrences must be always considered at subsequent follow-up.