Müllerotomy with anterior graded Müller muscle disinsertion for Graves upper eyelid retraction: validation of surgical outcomes using Bézier curves

Sales‐Sanz, Marco; Huelin, Fernando; Ye‐Zhu, Cristina; Cruz, Anna Bárbara de Souza; Muñoz‐Negrete, Francisco J.; Rebolleda, Gema

doi:10.1007/s00417-022-05853-w

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…Only a few studies have compared the effectiveness of these two medications [17,18] and there is little information available on their combined use. In terms of surgical treatment for eyelid retraction, there have been signi cant advancements in recent years [19,20], but the design of surgical volumes can be di cult to quantify accurately. The main problems include overcorrection, undercorrection, or recurrence after surgery.…”

Section: Results 1 Comparison Of General Data Before Injectionmentioning

confidence: 99%

Triamcinolone Acetonide and Botulinum Toxin A in the Treatment of Upper Eyelid Retraction in Thyroid-Associated Ophthalmopathy: A Clinical Study

Huang,

Xu,

Zhang

et al. 2024

Preprint

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Purpose To observe the therapeutic effect of subconjunctival injection of botulinum toxin A (BTX-A) combined with periorbital injection of triamcinolone acetonide (TA) in the treatment of upper eyelid retraction (UER) caused by thyroid-associated ophthalmopathy (TAO). Methods Fifty eyes diagnosed with TAO-associated UER were divided into two groups. Group 1 received TA periorbital injection, while group 2 received BTX-A subconjunctival injection combined with TA periorbital injection. Marginal reflex distance (MRD1) and graine sign (GS) were assessed at baseline and at various time points post-injection. The incidence of elevated intraocular pressure was also observed. Results Group 1 showed significant decrease in MRD1 at 1, 3, and 6 months post-injection (P < 0.05) and increase in GS at 3 months post-injection (P < 0.05). Group 2 showed significant decrease in MRD1 at 1w, 1, 3, and 6 months post-injection (P < 0.05) and increase in GS at 1w, 1, and 3 months post-injection (P < 0.05). After one week of the first injection, group 2 had lower MRD1 and higher GS values than group 1 (P < 0.001 and P = 0.013, respectively). The incidence of elevated IOP was significantly lower in group 2 than in group 1 (P < 0.05). Conclusion In a six-month study, patients with TAO related UER treated with BTX-A and TA demonstrated a faster onset of therapeutic effect compared to those treated with TA alone. This combined treatment approach sustained stable efficacy with a reduced dosage of local steroid and a lower incidence of intraocular pressure elevation. Trial registration number: ChiCTR2300077958

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Section: Results 1 Comparison Of General Data Before Injectionmentioning

confidence: 99%

Triamcinolone Acetonide and Botulinum Toxin A in the Treatment of Upper Eyelid Retraction in Thyroid-Associated Ophthalmopathy: A Clinical Study

Huang,

Xu,

Zhang

et al. 2024

Preprint

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“…Recently, the Bezier curve was used as a new approach to analyzing eyelid contour. 8 , 26 It simplified the manual annotation process of intersections by adjusting Bezier lines to the lid margins. However, the location of the pupil center and the adjustments of Bezier curves were performed manually, and the need for these human processes makes the process more labor-intensive and may introduce errors.…”

Section: Discussionmentioning

confidence: 99%

Automatic Measurement and Comparison of Normal Eyelid Contour by Age and Gender Using Image-Based Deep Learning

Shao,

Cao,

Wang

et al. 2024

Ophthalmology Science

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“…Some researchers have attempted to quantitatively describe the eyelid contour on digital face images (11)(12)(13)(14)(15)(16)31,32,(37)(38)(39)(40)(41)(42). Cruz et al (37) measured the upper eyelid contour in ptosis and Graves disease and fitted the contours with second-degree polynomial functions.…”

Section: Discussionmentioning

confidence: 99%

Deep learning-based image analysis of eyelid morphology in thyroid-associated ophthalmopathy

Shao¹,

Huang²,

Gao³

et al. 2023

Quant Imaging Med Surg

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Background:We aimed to propose a deep learning-based approach to automatically measure eyelid morphology in patients with thyroid-associated ophthalmopathy (TAO).Methods: This prospective study consecutively included 74 eyes of patients with TAO and 74 eyes of healthy volunteers visiting the ophthalmology department in a tertiary A hospital. Patients diagnosed as TAO and healthy volunteers who were age-and gender-matched met the eligibility criteria for recruitment.Facial images were taken under the same light conditions. Comprehensive eyelid morphological parameters, such as palpebral fissure (PF) length, margin reflex distance (MRD), eyelid retraction distance, eyelid length, scleral area, and mid-pupil lid distance (MPLD), were automatically calculated using our deep learningbased analysis system. MRD1 and 2 were manually measured. Bland-Altman plots and intraclass correlation coefficients (ICCs) were performed to assess the agreement between automatic and manual measurements of MRDs. The asymmetry of the eyelid contour was analyzed using the temporal: nasal ratio of the MPLD. All eyelid features were compared between TAO eyes and control eyes using the independent samples t-test.Results: A strong agreement between automatic and manual measurement was indicated. Biases of MRDs in TAO eyes and control eyes ranged from −0.01 mm [95% limits of agreement (LoA): −0.64 to 0.63 mm] to 0.09 mm (LoA: −0.46 to 0.63 mm). ICCs ranged from 0.932 to 0.980 (P<0.001). Eyelid features were significantly different in TAO eyes and control eyes, including MRD1 (4.82±1.59 vs.2.99±0.81 mm; P<0.001), MRD2 (5.89±1.16 vs. 5.47±0.73 mm; P=0.009), upper eyelid length (UEL) (27.73±4.49 vs. 25.42±4.35 mm; P=0.002), lower eyelid length (LEL) (31.51±4.59 vs. 26.34±4.72 mm; P<0.001), and total scleral area (SA TOTAL ) (96.14±34.38 vs. 56.91±14.97 mm 2 ; P<0.001). The MPLDs at all angles showed significant differences in the 2 groups of eyes (P=0.008 at temporal 180°; P<0.001 at other angles). The greatest temporal-nasal asymmetry appeared at 75° apart from the midline in TAO eyes.Conclusions: Our proposed system allowed automatic, comprehensive, and objective measurement of eyelid morphology by only using facial images, which has potential application prospects in TAO. Future work with a large sample of patients that contains different TAO subsets is warranted.

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Müllerotomy with anterior graded Müller muscle disinsertion for Graves upper eyelid retraction: validation of surgical outcomes using Bézier curves

Cited by 3 publications

References 35 publications

Triamcinolone Acetonide and Botulinum Toxin A in the Treatment of Upper Eyelid Retraction in Thyroid-Associated Ophthalmopathy: A Clinical Study

Triamcinolone Acetonide and Botulinum Toxin A in the Treatment of Upper Eyelid Retraction in Thyroid-Associated Ophthalmopathy: A Clinical Study

Automatic Measurement and Comparison of Normal Eyelid Contour by Age and Gender Using Image-Based Deep Learning

Deep learning-based image analysis of eyelid morphology in thyroid-associated ophthalmopathy

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