Alterations of the Internal Reflectivity of Extra-Ocular Muscles Associated with Several Clinical Stages of Graves’ Ophthalmopathy

Pierro, Luisa; Conforto, Eugenio; Resti, Antonio Giordano; Lattanzio, Rosangela; Genovesi-Ebert, Federica; Rizzo, Stanislao; Chiellini, S; Gabbriellini, Gianluca; Laddaga, F.; Nardi, Marco; Romani, Andrea; Sartini, Maria Sole; Sabetti, Lelio; Avitabile, Teresio; Marano, Filippo; Castiglione, Francesco; Reibaldí, A.; Russo, Vincenzo; Uva, Maurizio G.; Marino, A; Zaganelli, E.; Tavola, Alessandra; Muraglia, Mario; Polizzi, Alessandro; Schenone, Maurizio; Ciurlo, C.; Bertagno, R.; Molfino, F; Camoriano, G.P.; Saccà, Sergio Claudio; Perri, Paolo; Pastena, Bruno; Ravalli, L.; Grande, Lorenzo; Rossi, Antonio; Gallenga, P. E.; Mancini, Adriano; Bastiano, W. Di; Ghirlanda, R.; Specchia, Giuśeppe; Toscano, Andrea; Balestrazzi, E.; Motolese, Eduardo; Addabbo, G; Manes, Carlo; Bacchetti, Sonia; Bressan, Paolo; Mea, Giovanni Della; Colangelo, Laura A.; Lapi, G.; Lobefalo, L.; Ciancaglini, Marco; Mastropasqua, Leonardo; Carpineto, Paolo; Attimonelli, P.; Zuppardi, Eduardo; Falconio, Gennaro; Mantovani, E.; Doro, Daniele; Milizia, E.; Steindler, P

doi:10.1159/000055444

Cited by 7 publications

(1 citation statement)

References 9 publications

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“…In the evaluation of the extraocular muscle characteristics in GO, CT, and MRI are the preferred imaging procedures, although US may also be useful (42). In clinical practice, US may conveniently be used to measure the extraocular muscles and exclude other diseases.…”

Section: Introductionmentioning

confidence: 99%

Imaging studies for diagnosing Graves’ orbitopathy and dysthyroid optic neuropathy

Gonçalves¹,

Gebrim²,

Monteiro³

2012

Clinics

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Although the diagnosis of Graves' orbitopathy is primarily made clinically based on laboratory tests indicative of thyroid dysfunction and autoimmunity, imaging studies, such as computed tomography, magnetic resonance imaging, ultrasound and color Doppler imaging, play an important role both in the diagnosis and follow-up after clinical or surgical treatment of the disease. Imaging studies can be used to evaluate morphological abnormalities of the orbital structures during the diagnostic workup when a differential diagnosis versus other orbital diseases is needed. Imaging may also be useful to distinguish the inflammatory early stage from the inactive stage of the disease. Finally, imaging studies can be of great help in identifying patients prone to develop dysthyroid optic neuropathy and therefore enabling the timely diagnosis and treatment of the condition, avoiding permanent visual loss. In this paper, we review the imaging modalities that aid in the diagnosis and management of Graves' orbitopathy, with special emphasis on the diagnosis of optic nerve dysfunction in this condition.

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Section: Introductionmentioning

confidence: 99%

Imaging studies for diagnosing Graves’ orbitopathy and dysthyroid optic neuropathy

Gonçalves¹,

Gebrim²,

Monteiro³

2012

Clinics

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Assessment of extraocular muscles position and anatomy by 3-dimensional ultrasonography: a trial in craniosynostosis patients

Somani

MacKeen

Morad

et al. 2003

Journal of American Association for Pediatric Ophthalmology and

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Ultrasonically measured horizontal eye muscle thickness in thyroid associated orbitopathy: cross‐sectional and longitudinal aspects in a Danish series

Fledelius

Zimmermann-Belsing

Feldt‐Rasmussen

2003

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To analyse horizontal extraocular muscle findings by ultrasound and exophthalmometry in a tertiary endocrinology centre series of patients with thyroid associated orbitopathy (TAO). Methods: The 90 thyroid patients included underwent ultrasonic measurement of horizontal eye muscle thickness by a B-scan based technique carried out in addition to their general ophthalmic evaluation. As an indicator of mainly advanced TAO, longterm prednisone or cyclosporine A was given to many of the patients, and drug-resistant visual loss indicated decompression surgery in four of the 90 patients. Thirty-four patients underwent repeated muscle recordings over 15±49 months; this allowed for cross-sectional analysis and the outlining of longitudinal trends. Results and Conclusions: (A) Although marginally overlapping, all four muscle groups were significantly thicker in the study group than in normal control subjects. The mean of the sum of all four muscles was 16.8 mm (range 13.6±21.7 mm) in the control group versus 22.6 mm (range 15.5±36.4 mm) in the thyroid group. (B) Using the clinical NOSPECS grading, more advanced eye involvement was found to generally result in a higher exophthalmometric measurement of protrusion and eye muscle thickness. However, slender rectus muscles and/or normal exophthalmometric values might occur even in advanced orbitopathy. (C) Over a period of 2±4 years, only a few of 34 patients with satisfactory serial ultrasonic measurements returned to their premorbid ophthalmic status. Typically, the extraocular muscles kept their abnormal size after having become clinically quiescent (fibrotic). (D) We found no safe indication regarding disease stage, active or late, from the ultrasonic appearance of the muscle tissue. (E) Discrepancies between various normative eye muscle studies are discussed with regard to computer tomography and magnetic resonance imaging.

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Alterations of the Internal Reflectivity of Extra-Ocular Muscles Associated with Several Clinical Stages of Graves’ Ophthalmopathy

Cited by 7 publications

References 9 publications

Imaging studies for diagnosing Graves’ orbitopathy and dysthyroid optic neuropathy

Imaging studies for diagnosing Graves’ orbitopathy and dysthyroid optic neuropathy

Assessment of extraocular muscles position and anatomy by 3-dimensional ultrasonography: a trial in craniosynostosis patients

Ultrasonically measured horizontal eye muscle thickness in thyroid associated orbitopathy: cross‐sectional and longitudinal aspects in a Danish series

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