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Available online 25 December 2021
Corticodependent bilateral trochleitis
Trocleítis bilateral corticodependiente
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H. Fernández Jiménez-Ortiza,
Corresponding author
hectorfjo@gmail.com

Corresponding author.
, S.M. Escribá de la Fuenteb, R. Sampedro Yáñeza, B. Maroto Rodrígueza, N. Toledano Fernándeza, B. Villarrubia Torcala
a Servicio de Oftalmología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
b Servicio de Medicina Física y Rehabilitación, Hospital de Nuestra Señora del Prado, Hospital General Talavera de la Reina, Toledo, Spain
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Abstract

Trochleitis is usually a transient and non-disabling inflammation of the trochlea of superior oblique. The case is presented of a difficult to manage bilateral trochleitis in a 29-year-old woman. After an exhaustive aetiological study with neuro-imaging tests, as well as an analysis of autoimmunity and infection, no underlying cause was found. Multiple injections of corticosteroids were required in both eyes, with a partial effect. Surgical intervention was finally decided in order to visually examine the trochlea, take biopsies, and inject methylprednisolone. These were effective in relieving the symptoms. This case is exceptional due to it involving both eyes and its severity, and represented a therapeutic challenge for the clinical team.

Keywords:
Trochleitis
Trochleodynia
Corticosteroids
Strabismus surgery
Resumen

La trocleítis es habitualmente una inflamación transitoria, unilateral y no incapacitante de la tróclea del oblicuo superior. Presentamos el caso de una trocleítis bilateral en mujer de 29 años de evolución tórpida. Tras estudio etiológico exhaustivo con pruebas de neuroimagen, análisis de autoinmunidad e infeccioso no se encontró ninguna causa subyacente. Precisó múltiples infiltraciones en ambos ojos con efecto parcial. Finalmente se decidió intervención quirúrgica para exploración visual de la tróclea, toma de biopsias e infiltración de metilprednisolona que resultaron eficaces en el alivio sintomático. Este caso es excepcional por su bilateralidad y severidad, suponiendo un desafío terapéutico para el equipo clínico.

Palabras clave:
Trocleítis
Trocleodinia
Corticosteroides
Cirugía de estrabismo

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