{
  "abstract": "Purpose: To analyze the etiology, clinicoradiological features, and treatment outcomes of orbital inflammation presenting with isolated superior rectus-levator complex (SR-LC) enlargement. Methods: We retrospectively reviewed patients treated for orbital inflammation with isolated SR-LC enlargement, assessing the underlying etiologies, including thyroid eye disease (TED), idiopathic orbital myositis (IOM), and immunoglobulin G4-related ophthalmic disease (IgG4-ROD). The IOM group was further divided by the presence of upper lid ptosis. Clinicoradiological findings and outcomes were compared between the TED and IOM groups. Results: Among the 58 patients, 39 (67.2%) had TED, 17 (29.3%) had IOM (10 without ptosis and seven with ptosis), and two (3.4%) had IgG4-ROD. Upper lid retraction was observed in both TED (79.5%) and IOM without ptosis (90.0%). SR tendon involvement was significantly less common in TED than in IOM (13.3% vs. 78.6%, p < 0.001). Infraduction limitation was more prevalent in TED (94.7%) and IOM with ptosis (100%) than in IOM without ptosis (25.0%), while supraduction limitation was noted in IOM without ptosis (75.0%). Compared to IOM without ptosis, IOM with ptosis had a shorter time to diagnosis (0.5 vs. 1.5 months, p = 0.088) and better clinical outcomes following steroid treatment (lid level asymmetry: 0% vs. 50.0%, p = 0.044). Conclusion: TED and IOM are the most common etiologies of orbital inflammation with isolated SR-LC enlargement. IOM can manifest as either ptosis or retraction, with the latter distinguishable from TED by clinicoradiological features. Early initiation of systemic steroids can be associated with favorable clinical responses, especially for suspected IOM cases; however, further prospective studies are warranted.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ophthalmology, Asan Medical Center, Seoul, Republic of Korea"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Min Kyu Yang"
    },
    {
      "name": "Seong Jung Ha"
    },
    {
      "name": "Ho-Seok Sa"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8wx479qjm5may.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0338854",
  "fulltext_url": null,
  "id": "8wx479qjm5may",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0338854",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2734|Ophthalmology and Eye Disorders"
    ],
    [
      "plos",
      "/Biology and life sciences/Anatomy/Biological tissue/Connective tissue/Tendons"
    ],
    [
      "plos",
      "/Biology and life sciences/Anatomy/Endocrine system/Thyroid"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Proteins/Immune system proteins/Antibodies"
    ],
    [
      "plos",
      "/Biology and life sciences/Immunology/Clinical immunology/Autoimmune diseases/Myositis"
    ],
    [
      "plos",
      "/Biology and life sciences/Immunology/Immune response/Inflammation"
    ],
    [
      "plos",
      "/Biology and life sciences/Immunology/Immune system proteins/Antibodies"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Immune physiology/Antibodies"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Biological tissue/Connective tissue/Tendons"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Endocrine system/Thyroid"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Clinical immunology/Autoimmune diseases/Myositis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Inflammation"
    ],
    [
      "plos",
      "/Medicine and health sciences/Diagnostic medicine/Diagnostic radiology/Magnetic resonance imaging"
    ],
    [
      "plos",
      "/Medicine and health sciences/Immunology/Clinical immunology/Autoimmune diseases/Myositis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Immunology/Immune response/Inflammation"
    ],
    [
      "plos",
      "/Medicine and health sciences/Immunology/Immune system proteins/Antibodies"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Inflammatory diseases/Myositis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Etiology"
    ],
    [
      "plos",
      "/Medicine and health sciences/Radiology and imaging/Diagnostic radiology/Magnetic resonance imaging"
    ],
    [
      "plos",
      "/Medicine and health sciences/Rheumatology/Myositis"
    ],
    [
      "plos",
      "/Physical sciences/Chemistry/Chemical compounds/Organic compounds/Steroids"
    ],
    [
      "plos",
      "/Physical sciences/Chemistry/Organic chemistry/Organic compounds/Steroids"
    ],
    [
      "plos",
      "/Research and analysis methods/Imaging techniques/Diagnostic radiology/Magnetic resonance imaging"
    ]
  ],
  "openalex": "W7214127066",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0338854&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-23",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/8wx479qjm5may.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:43Z",
      "native_id": "10.1371/journal.pone.0338854",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0338854"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "plos:immunology",
      "subfield": "immunology"
    },
    {
      "field": "medicine",
      "origin": "plos:diagnostic radiology",
      "subfield": "imaging"
    },
    {
      "field": "medicine",
      "origin": "plos:anatomy",
      "subfield": "physiology"
    }
  ],
  "title": "Isolated superior rectus-levator complex enlargement: Inflammatory etiology, clinicoradiological features, and treatment outcomes",
  "title_text": "Isolated superior rectus-levator complex enlargement: Inflammatory etiology, clinicoradiological features, and treatment outcomes",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:43Z",
  "url": "https://research.draconitic.com/paper/8wx479qjm5may",
  "venue": "PLOS One",
  "versions": []
}