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Case Reports
. 2020 Jan 7;11(1):8-15.
doi: 10.1159/000505314. eCollection 2020 Jan-Apr.

A Case of Idiopathic Orbital Inflammation with Shallow Anterior Chamber and Choroidal Detachment

Yohei Sato  1   2 , Natsuko Mano  1   2 , Hiroko Watanabe  1   2 , Makiko Miyamoto  1   2 , Kazuhiro Shimizu  1   2 , Noriko Mukai  2 , Masashi Mimura  2 , Hidehiro Oku  2 , Tsunehiko Ikeda  2
Affiliations
Case Reports

A Case of Idiopathic Orbital Inflammation with Shallow Anterior Chamber and Choroidal Detachment

Yohei Sato et al. Case Rep Ophthalmol. .

Abstract

We report a case of idiopathic orbital inflammation with a shallow anterior chamber and choroidal detachments. This study involved an 87-year-old female patient who presented at our department after becoming aware of the progression of diplopia. Examination of the patient's right eye revealed proptosis, as well as conjunctival edema with dilated and tortuous blood vessels. The right-eye anterior chamber was shallow, and fundus examination revealed marked choroidal detachments. Magnetic resonance imaging revealed enlargement of the right-orbit extraocular muscles and a suspected compression of the right-orbit superior and inferior ophthalmic veins, yet no expansion of the cavernous sinus. We diagnosed the patient as having idiopathic orbital inflammation in her right orbit, and subsequently started corticosteroid therapy. One week after initiating treatment, the anterior chamber was found to be nearing a normal depth, and the choroidal detachments were found to have disappeared. Our findings revealed that the inflammatory swelling of the extraocular muscle due to idiopathic orbital inflammation resulted in compression of the right-orbit superior and inferior ophthalmic veins, thus leading to an apparent choroidal circulation disorder that presented with a shallow anterior chamber and marked choroidal detachments.

Keywords: Choroidal detachment; Idiopathic orbital inflammation; Shallow anterior chamber.

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Conflict of interest statement

There are no conflicts of interest to report for all authors.

Figures

Fig. 1
Fig. 1
Funduscopy images of the patient's right eye. Retinal vein dilation and marked choroidal detachments can be seen at the initial examination (a), but choroidal detachments disappeared 7 days after the start of corticosteroid therapy (b).
Fig. 2
Fig. 2
Anterior segment optical coherence tomography images. The ACD was 2.53 mm, and the ACV was 88 mm3 in the patient's right eye (a), although the ACD was 3.48 mm and the ACV was 167 mm3 in the left eye (b) before treatment. After treatment, ACD and ACV increased to 3.74 and 178 mm3, respectively (c).
Fig. 3
Fig. 3
Orbital MRI scans obtained before and after corticosteroid therapy. Coronal STIR (a), T1W1 (b), and axial STIR (c) MRI scans obtained before treatment. Coronal STIR (d), T1W1 (e), and axial STIR (f) MRI scans obtained after treatment. Enlargement of the right extraocular muscles, especially the lateral and inferior rectus (a), marked choroidal detachments of the right eye (b), and expansion of the superior ocular vein (c), all showing complete regression after treatment (d–f).
See this image and copyright information in PMC

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