Diagnosis of enlarged extraocular muscles: when and how to biopsy

    loading  Checking for direct PDF access through Ovid

Abstract

Purpose of review

To review current knowledge regarding diagnosis of nonthyroid orbital disorders with extraocular muscle enlargement.

Recent findings

Recent publications have focused on immunoglobulin G4-related disease as a possible cause of enlarged extraocular muscles, on patterns of strabismus that raise a clinical suspicion of intramuscular lymphoma, and on surgical techniques to access the muscles for tissue biopsy.

Summary

With enlarged extraocular muscles, features to distinguish between competing diagnostic possibilities are based on imaging in the context of history and clinical signs. Infraorbital nerve enlargement in the presence of muscle enlargement strongly favours a diagnosis of immunoglobulin G4-related disease and reactive lymphoid hyperplasia. As our understanding of minimally invasive orbital surgery evolves, the diagnostic focus is shifting toward earlier identification through muscle biopsy.

Related Topics

    loading  Loading Related Articles