Orbital myositis secondary to statin therapy

Bahrami, Bobak; Rajak, Saul; Selva, Dinesh

doi:10.5694/mja15.00503

Cited by 9 publications

(4 citation statements)

References 5 publications

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“…The exact mechanism of statin-induced vision impairment is also poorly understood [10,11]. Presentations vary between case series and can include blurred vision, diplopia, and visual field defects [10][11][12]. A retrospective study by Mizranita et al [11] demonstrated that out of 131,755 statin-related adverse events reported to the Food and Drug Administration (FDA) between 1988 and 2013, 2325 (1.8%) were ocular events, out of which blurred vision (48.4%) and visual impairment (25.7%) were most common.…”

Section: Discussionmentioning

confidence: 99%

Concentric Reversible Visual Field Loss, Nyctalopia, and Dyschromatopsia with Ezetimibe Therapy

Preda

Jabbour³

2023

Case Rep Ophthalmol

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This is a case of ezetimibe-induced concentric field loss, dyschromatopsia, and nyctalopia in a patient with no prior history of retinal dystrophy or drug hypersensitivity. A 55-year-old Caucasian woman presents with a 1-year history of increasing concentric visual field loss, nyctalopia, photophobia, and colour vision impairment. These symptoms correlated with the commencement of ezetimibe therapy 10 mg daily for hypercholesterolaemia. She demonstrated repeatable bilateral visual field constriction on 30-2 Humphrey visual filed testing and colour vision impairment on Ishihara plates (OD: 1/17, OS: 1/17). Biochemical and radiological screening for carcinoma-associated retinopathy was unremarkable. A working diagnosis of drug-induced rod-cone dysfunction was made. Her visual symptoms and field changes completely resolved 3 months after cessation of ezetimibe therapy. This case suggests that ezetimibe is a potential cause of rod-cone dysfunction and should be considered as a differential in patients with new unexplained visual symptoms.

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Section: Discussionmentioning

confidence: 99%

Concentric Reversible Visual Field Loss, Nyctalopia, and Dyschromatopsia with Ezetimibe Therapy

Preda

Jabbour³

2023

Case Rep Ophthalmol

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“…There is a single convincing clinical report wherein simvastatin was discontinued with resolution of diplopia and reappearance with rechallenge of the drug. 3 Other presumed statin-associated orbital myositis cases, including rosuvastatin, are limited to “adverse drug reaction” tallies in databases such as Vigibase (World Health Organization global individual case safety reports database). 3…”

Section: Discussionmentioning

confidence: 99%

“…3 Other presumed statin-associated orbital myositis cases, including rosuvastatin, are limited to “adverse drug reaction” tallies in databases such as Vigibase (World Health Organization global individual case safety reports database). 3…”

Section: Discussionmentioning

confidence: 99%

Myositis of an Extraocular Muscle, a Possible Drug Reaction: Histopathologic and Immunopathologic Analysis

Charles

Rebhun²,

Lidder³

et al. 2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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A 58-year-old man presented with left-sided orbital inflammation, including chemosis and a lateral rectus abduction defect. Initially presumed to represent cellulitis, the condition responded poorly to oral and intravenous antibiotics. CT showed the epicenter of an infiltrate to involve the lateral rectus. The patient improved dramatically when oral prednisone was added. Lateral rectus biopsy displayed intramuscular polyclonal lymphoid infiltrates, rich with eosinophils. Complete resolution of the inflammatory process was confirmed by a follow-up CT. The presumptive diagnosis was idiopathic orbital myositis, an uncommon condition of unknown etiology. However, the patient had taken rosuvastatin, which has been rarely associated with diplopia and ophthalmoplegia, raising the question of whether this case was truly idiopathic.

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“…Statins are well-known to cause a widespread myopathy, but have also been reported to cause orbital myositis. 24 In patients with inflammatory bowel disease and orbital myositis, most have multiple muscles involved bilaterally. In some, the myositis precedes the bowel symptoms by many months, is often recurrent and resistant to steroids.…”

Section: Orbital Myositismentioning

confidence: 99%

The 2017 Doyne Lecture: the orbit as a window to systemic disease

McNab

2017

Eye

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A very large number of disorders affect the orbit, and many of these occur in the setting of systemic disease. This lecture covers selected aspects of orbital diseases with systemic associations in which the author has a particular clinical or research interest. Spontaneous orbital haemorrhage often occurs in the presence of bleeding diatheses. Thrombosis of orbital veins and ischaemic necrosis of orbital and ocular adnexal tissues occur with thrombophilic disorders, vasculitis, and certain bacterial and fungal infections. Non-infectious orbital inflammation commonly occurs with specific inflammatory diseases, including Graves' disease, IgG4-related disease, sarcoidosis, Sjögren's syndrome and granulomatosis with polyangiitis, all of which have systemic manifestations. IgG4-related ophthalmic disease is commoner than all these except Graves' orbitopathy. Some of these orbital inflammatory diseases are associated with an increased risk of B-cell lymphoma, usually marginal zone lymphoma of MALT type. Ocular adnexal lymphoma also has an association with infectious agents including Helicobacter pylori and Chlamydia psittaci. Orbital metastasis may be the first presentation of systemic malignancy. A number of orbital neoplasms occur in the setting of familial cancer syndromes, including Neurofibromatosis types 1 and 2. Study of the genetics and molecular biology of orbital diseases such as Graves' orbitopathy and idiopathic orbital inflammatory disease will yield useful information on their diagnosis and management.

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Orbital myositis secondary to statin therapy

Cited by 9 publications

References 5 publications

Concentric Reversible Visual Field Loss, Nyctalopia, and Dyschromatopsia with Ezetimibe Therapy

Concentric Reversible Visual Field Loss, Nyctalopia, and Dyschromatopsia with Ezetimibe Therapy

Myositis of an Extraocular Muscle, a Possible Drug Reaction: Histopathologic and Immunopathologic Analysis

The 2017 Doyne Lecture: the orbit as a window to systemic disease

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