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1.
Arch Soc Esp Oftalmol (Engl Ed) ; 97(6): 340-343, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35676027

RESUMO

Trochleitis is usually a transient and non-disabling inflammation of the trochlea of superior oblique. The case is presented of a difficult to manage bilateral trochleitis in a 29-year-old woman. After an exhaustive aetiological study with neuro-imaging tests, as well as an analysis of autoimmunity and infection, no underlying cause was found. Multiple injections of corticosteroids were required in both eyes, with a partial effect. Surgical intervention was finally decided in order to visually examine the trochlea, take biopsies, and inject methylprednisolone. These were effective in relieving the symptoms. This case is exceptional due to it involving both eyes and its severity, and represented a therapeutic challenge for the clinical team.


Assuntos
Metilprednisolona , Músculos Oculomotores , Adulto , Biópsia , Olho , Feminino , Humanos , Metilprednisolona/uso terapêutico , Músculos Oculomotores/patologia
2.
Arch. Soc. Esp. Oftalmol ; 97(6): 340-343, jun. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-208914

RESUMO

La trocleítis es habitualmente una inflamación transitoria, unilateral y no incapacitante de la tróclea del oblicuo superior. Presentamos el caso de una trocleítis bilateral en mujer de 29 años de evolución tórpida. Tras estudio etiológico exhaustivo con pruebas de neuroimagen, análisis de autoinmunidad e infeccioso no se encontró ninguna causa subyacente. Precisó múltiples infiltraciones en ambos ojos con efecto parcial. Finalmente se decidió intervención quirúrgica para exploración visual de la tróclea, toma de biopsias e infiltración de metilprednisolona que resultaron eficaces en el alivio sintomático. Este caso es excepcional por su bilateralidad y severidad, suponiendo un desafío terapéutico para el equipo clínico (AU)


Trochleitis is usually a transient and non-disabling inflammation of the trochlea of superior oblique. The case is presented of a difficult to manage bilateral trochleitis in a 29-year-old woman. After an exhaustive aetiological study with neuro-imaging tests, as well as an analysis of autoimmunity and infection, no underlying cause was found. Multiple injections of corticosteroids were required in both eyes, with a partial effect. Surgical intervention was finally decided in order to visually examine the trochlea, take biopsies, and inject methylprednisolone. These were effective in relieving the symptoms. This case is exceptional due to it involving both eyes and its severity, and represented a therapeutic challenge for the clinical team (AU)


Assuntos
Humanos , Feminino , Adulto , Doenças do Nervo Troclear/diagnóstico por imagem , Doenças do Nervo Troclear/tratamento farmacológico , Músculos Oculomotores/fisiopatologia , Metilprednisolona/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Índice de Gravidade de Doença , Espectroscopia de Ressonância Magnética
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