AB0403 ORBITAL MYOSITIS: AN UNCOMMON OPHTHALMIC PRESENTATION IN RHEUMATIC DISEASES - CASE SERIES AND SYSTEMIC REVIEW OF CASE REPORTS

Background: Ophthalmic conditions are common manifestations in patients with rheumatic diseases (RDs), orbital myositis (OM) remain rare. Only 1 case each for scleroderma and undifferentiated connective tissue disease (UCTD) reported. Objectives: Report frequency of Rheumatic Diseases OM (RDs-OM), diagnosis treatments. Methods: Patients database were obtained from trust electronic record literature review reports performed. Results: 4 out 7 our clinic RDs-OM. Both Scleroderma-myositis (SCM) positive anti-PM/SCL antibody. All received glucocorticosteroid (GCS) Mycophenolate as steroid-sparing or rescue therapy good tolerance outcome. One idiopathic has residual muscle paresis. Table 1. Case series Orbital Myositis Idiopathic (n=3 ) Rheumatology (n=4 p-value Age (years) 48 (27-72) 42.75 (21-60) P= 0.8571 Gender – Female (Male) 2 (1) 4(0) Median Period Of Follow Up (months) 24.60 (7-37) 47.25(1-120) Underlying RD I.UCTD - II.Overlap Scleromyositis III.Behcet’s Disease Biopsy I.Pathological significant II.Normal III.Not done Total 93 cases RDs-OM reviewed the characteristic represented Figure Characteristics diseases. F: female, M:male, NS: not-specified, PrePD: onset before RD, AtD: RD,PostPD: after GCS st : Glucocorticoid first line treatment, res: responder, BxEOM: biopsy extra-ocular muscle, OtherTs: Other A: age at diagnosis, Sarc: sarcoidosis, SLE: Lupus, EGPA: Eosinophilic Granulomatous Polyangitis, GPA: RA: rheumaoid Arthritis, BD: Behcet;s Disease, RP: Relapsing Polychondritis, DM: Dermatomyositis, LoSSC: Localized Sclerderma, SPA: Spondyloarthropathy, ASOD: Adult Onset Still’s RPF: Retroperitoneal Fibrosis, GCOM: Giant Cell OM, SJS: Sjogren Syndrome, DL: Discoid KD: Kawasaki SAPHO: Synovitis, acne, pustulosis, hyperostosis, osteitis, APLS: Antiphospholipid Syndrome. although is rare but can present most RDs. Our showed commonest RA, GPA, EGPA sarcoidosis. SCM, APLS, UCTD, SAPHO Disease. Most female. 89.2% diagnosed concurrently primary diagnosis. Majority BD GPA developed along course RDs (83%-90%). Except routine screening, thyroid eye disease, infections, malignancy (eg. lymphoma) myasthenia gravis, atypical infective screenings include mycobacterium, fungal, Borrelia spirochetes excluded. Histopathological important diagnostic tool IgG4 neoplasm, sarcoidosis vasculitis. 59% underwent biopsy, 71% these sampled EOM, some involved organs. MRI CT imaging, 5 reported had Ocular ultrasound single complementary imaging PET-CT exclusion other 40% 20% ANCA either c-ANCA, p-ANCA MPO which similar literatures. 97.8% (n=91) 79% improvement resolution ocular symptom without agents. Immunosuppressants used those not foreign among rheumatologists while biologics prescribed refractory Rituximab(2), Infliximab(4), Adalimumab(2) Tocilizumab(1). decompression radiation measures. 13 EOM Conclusion: 1.RDs-OM increasing recognized. 2.Most occurs its 3.40% positive. 4.GCS three quarter responded. References: [1]Murray PI. The inflammatory Best Practice & Research Clinical Rheumatology. 2016. Disclosure Interests: None declared