graves' ophthalmopathy (go) is an inflammatory autoimmune disorder of the orbital adipose tissue and extraocular muscles, and it is associated with graves' disease (gD). go is triggered by binding and activation of orbital fibroblasts by autoantibodies (tsi) direct against thyroid-stimulating hormone receptor (tsHr) and insulin-like growth factor 1 (igF-1r), which is highly expressed within the orbit. Moreover, interaction of t cells with orbital fibroblasts that involve t-cell receptor (tcr), autoantigen, and major histocompatibility complex class ii (MHc ii) molecule, as well as cD40:cD154 signalling, activates p38, erK 1/2, and jnK pathways. these processes induce fibroblast activation, proliferation, and secretion of chemokines and inflammatory cytokines to maintain inflammation within the orbit. Furthermore, increased hyaluronic acid production and fibroblast differentiation into adipocytes and myofibroblasts leads to development of go. the elevated number of molecular factors such as PDgF, iL1-β, iL-4, iL-6, iL10, iL-8, iL-16, iL-33, HgF, icaM-1, osteopontin, ctLa-4, and tgF-β are discussed in the paper. some of them are key markers of disease stage. better understanding of go pathogenesis leads to development of new therapeutic options.

Introduction: In this article, we propose a new application for eyelid surface electromyography (sEMG). By placing the electrode in the mid-pretarsal area of the upper eyelid, one can easily perform a fast examination and achieve repeatable results. We believe that this technique may increase the feasibility of eyelid sEMG in clinical practice. Methods: 126 sEMG examinations of the upper eyelid were performed by using the above-described method. Thirty-nine controls and 29 ptotic patients were enrolled. The controls underwent one measurement while the ptotic patients were employed for four sessions: Before anterior approach levator aponeurosis advancement (LAA), 2 weeks, 3 months, and more than 6 months after surgery. The relaxation and maximal contraction of the orbicularis oculi muscle (OOM) using root mean square (RMS) values were measured. Results: The results showed a statistically significant decrease in RMS values of the maximal contraction of the OOM 2 weeks after surgery (p < 0.05) and 3 months after surgery (p = 0.03). Six months postoperatively, there were no statistically significant differences in OOM activity compared to preoperative values (p = 0.2). Conclusions: Eyelid sEMG may be a useful diagnostic tool in post-operative OOM recovery monitoring. sEMG parameters of the maximal contraction of the OOM normalize within 6 months after anterior approach LAA. Electrode placement in the mid-pretarsal area of the upper eyelid offers several advantages and therefore may enhance the feasibility of sEMG in clinical practice.

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