[A case of idiopathic orbital inflammatory disease with variable ocular manifestations]

We present a case of idiopathic orbital inflammatory disease with dilatation and tortuosity of the retinal veins.

A 74-year-old man presented at his local eye hospital with left conjunctival edema and pain. He was referred to our hospital. At the initial examination, the intraocular pressure was 19 mmHg OD and 40 mmHg OS. Examination of the left eye revealed conjunctival edema with dilated and tortuous blood vessels, and dilatation and tortuousity of the retinal veins. Magnetic resonance imaging showed marked thickening of the left extraocular muscles, and suspected compression of the left superior and inferior ophthalmic veins. We diagnosed left idiopathic orbital inflammatory disease, and administered a tapering course of prednisolone starting at 40 mg daily. Thirteen days later, the conjunctival findings improved, but the left fundus showed signs of non-ischaemic central retinal vein occlusion. Subsequently, the dilatation and tortuousity of the retinal veins gradually improved. At the final examination, recurrence was not noted.

We report a case of idiopathic orbital inflammatory diseases with central retinal vein occlusion. The dilatation and tortuousity of the conjunctiva and central retinal vein occlusion improved with steroid therapy only. These Conditions improved because the inflammatory swelling of the extraocular muscle disappeared and the pressure to the vein was relieved.