Intramuscular Steroid Injection for Extraocular Myositis

Cisca Kuswidyati¹, Sagung Indrawati ², Purjanto Tepo U²

Ophthalmology Department, Medical Faculty of Universitas Gadjah Mada Yogyakarta, Indonesia.

Purpose: To report a short-term observation on intramuscular injection for refractory extramuscular myositis.

Methods: a- 32 years –old female was referred to Sardjito General Hospital with undiminished protusion on the right eye caused by extraocular inflammation that been suffered for 6 months which had been treated by oral steroid for 2 months.

Physical examination showed axial protusion with Hertel exopthalmometer disparity for both eyes were 6 mm and ciliar injection was founded. Visual acuity for the both eyes 6/6 (Log Mar 0.00). Intraocular pressures were normal.

CT-Scan examination exhibited: the presence of enlarged and swelling of right medial, lateral and inferior recti.

Laboratory examination for blood routine and thyroid function were in the normal limit.
After completed examination, we conducted conjunctival incision 5 mm from limbus and identified extraocular muscle. Dexametasone 0,5 mg (0,1 ml dexametason vial 5 mg) was injected in to the muscles. Injection was performed in three muscles; medial, lateral and inferior.

Result: After seven days post-injection showed the protussion was significantly reduced up to 4 mm and disparity for both eyes had achieved 2 mm with hertel exopthalmometer.

Conclusions: Isolated myositis was a rare case. Current treatment for extraocular inflammation was oral steroid but in a refractory case, steroid intramuscular injection is a promiseable treatment, however a long-term evaluation is still required.

Keywords: Myositis, Extraocular inflammation, Intramuscular injection