Die alte und neu aufgetretene endokrine Ophthalmopathie in der Computertomographie: Gemeinsamkeiten - Unterschiede

Abstract

Thirty patients are described on whom computed tomography was carried out because of endocrine ophthalmopathies. Fifteen patients had had the disease for more than two years, in the others it was acute. Determinations of muscle thickness and Hertel values show that there is no thickening of the extraocular muscles in patients with longstanding disease, but a significant increase in the Hertel values. Patients with recent disease show a definite increase in muscle thickness and corresponding protrusion of the globe, which can be explained by the changes in the muscles. The computer tomographic appearances of the striated ocular muscles in long-standing disease can be explained by fibrosis. These characteristics are of significance when considering the indications for radiation therapy.

Computed tomography in Graves' ophthalmopathy — evaluation regarding the muscle size and density units

“…In a previously published study we were able to demonstrate an effect of the duration of disease on the size of the muscles and conversely no effect on the values of HERTEL [9]. However, these preliminary results were obtained on a small group of patients.…”

“…Systematical evaluations by some working groups led to more exact information about the pattern of alterations in the orbit muscles and the other retrobulbar structures [3,4,9,10]. In a previously published study we were able to demonstrate an effect of the duration of disease on the size of the muscles and conversely no effect on the values of HERTEL [9].…”

“…The value of computed tomography in clarifying the alterations in the orbit in the case of Graves"ophthalmopathy has been underlined in several papers [3,4,6,9,10,12]. There is agreement that only thin slices, wherever possible in both axial and coronal scan directions, guarantee a complete overview over the extent of the muscular alterations (Figure 8).…”

“…The superior rectus muscle and levator palpebrae muscle were measured together, because a differentiation between these two muscles is often not possible behind the bulbus. The evaluation of muscle size was made by using a staging publishedearlier [6,9]. The stages are based on the fact, that the muscles appear nearly rectangular on coronal scans, so multiplication of length and width is justifiable.…”