Idiopathic orbital myositis. First report of therapy with the NSAID naproxen

Background. Idiopathic orbital myositis, an inflammatory process of the exterior ocular muscles, clinically manifests as orbital pseudotumor, diplopia, blepharoptosis, periorbital pain and swelling, ophthalmoplegia, and conjunctivitis and/or chemosis. Involvement is generally unilateral. Orbital myositis does not cause visual impairment. Chronic or recurrent myositis may lead to orbital fibrosis or exophthalmos. Differential diagnoses include autoimmune diseases, infectious diseases, paraneoplastic syndromes and,malignancy, Graves' disease,and chronic inflammatory bowel disease. Case report. We report two cases of adolescents with idiopathic recurrent orbital myositis. Although treatment response to systemic glucocorticoids is generally rapid, we chose to treat the girl with the nonsteroidal antiinflammatory drug naproxen because of obesity and polycystic ovary syndrome. Treatment response was rapid at onset and in the course of two relapses. The boy was successfully treated with oral glucocorticoids at onset and during one relapse. Conclusion. Nonsteroidal antiinflammatory drugs should be considered as an alternative. treatment in idiopathic orbital myositis especially when glucocorticoids are contraindicated or in patients suffering from frequent relapses.