Ophthalmic manifestations of endocrine disorders—endocrinology and the eye

Kamboj, Alisha; Lause, Michael; Kumar, Priyanka

doi:10.21037/tp.2017.09.13

Cited by 16 publications

(7 citation statements)

References 56 publications

(77 reference statements)

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“…It has been suggested that autoimmune-related disorders, endocrine disorders, systemic infections, and neuromuscular disorders are likely to present a wide spectrum of symptoms, often mimicking the manifestations of somatoform disorders. [ 21 22 23 24 25 ] Most of these symptoms usually require an early and correct diagnosis for selecting appropriate, effective therapies. [ 24 26 ] If these conditions are not diagnosed correctly, they can impair the quality of life of the affected individuals.…”

Section: Discussionmentioning

confidence: 99%

Somatic symptoms with psychogenic or psychiatric background

Akaishi

Abe

Masaura

et al. 2021

Journal of Family Medicine and Primary Care

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Introduction: The characteristics of somatic symptoms seen at the first hospital visit in patients with psychogenic backgrounds remain poorly elucidated till date. Methodology: A total of 277 patients who visited the Department of General Medicine at a single university hospital with somatic symptoms were prospectively enrolled in this study. The eventual definite diagnoses were classified into the following three groups: non-psychogenic disease ( n = 128), psychogenic symptoms ( n = 131), and mental illness ( n = 18). Subsequently, the chief complaints and other background information of the patient obtained at the first visit were compared among the three groups. Results: More than half of the patient with non-psychogenic diseases (60.2%) presented with a single complaint at their first hospital visit; contrarily, less than half of the patients with psychogenic symptoms (23.7%) or mental illnesses (22.2%) presented with a single complaint at the first visit. Approximately, <10% of the patients with non-psychogenic diseases had four or more multisystemic presentations at the first visit. The results of the receiver operating characteristic curve analysis revealed a fair discriminatory ability of the number of complaints to identify patients with psychogenic diseases or psychiatric backgrounds. Almost half of the non-psychogenic patients with four or more multisystemic presentations were eventually diagnosed with autoimmune-related disorders, such as Sjögren's syndrome or Behçet's disease. In conclusion, the general notion that patients with psychogenic somatic symptoms are likely to present with more complaints than patients with non-psychogenic diseases is correct. However, not a few patients who present with multiple indefinite complaints would certainly have organic diseases such as autoimmune-related disorders or neuromuscular diseases. A careful diagnostic process is required in such patients before attributing their symptoms to psychogenic or psychiatric factors.

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Section: Discussionmentioning

confidence: 99%

Somatic symptoms with psychogenic or psychiatric background

Akaishi

Abe

Masaura

et al. 2021

Journal of Family Medicine and Primary Care

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“…T-lymphocytes, production of pro-inflammatory substances (interleukin [IL]1-β, IL-6, IL-8, and PGE 2 ), migration of B-lymphocytes, and production of autoantibodies ultimately lead to production and deposition of glycosaminoglycans in the orbital tissue as well as adipocytes hyperplasia 9 that will generate the characteristic clinical signs in thyroid-associated ophthalmopathy. This inflammatory process will involve the orbit connective tissue as well as the extraocular muscles of the eye, with remodeling of the orbit 10 .…”

Section: Pathophysiologymentioning

confidence: 99%

Thyroid disease and associated ophthalmopathy

Concepción¹,

Marte²,

Escalante³

2022

HGMX

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Thyroid-associated ophthalmopathy is a complex pathology most of the time accompanying Graves' disease, also present in other thyroid states, such as Hashimoto's hypothyroidism and euthyroid states. The term Grave's disease associated ophthalmopathy can be misleading as it does not include all thyroid states associated to this eye condition. Its pathophysiology includes complex autoimmune mechanisms associated with fibroblasts, T-lymphocytes, myocytes, thyroid cells, adipocytes, and pro-inflammatory molecules, leading to several changes in the orbital content, including limitation of space, functional impairment, and complications secondary to the initial process. Reviewing its diagnostic methods and treatments is necessary due to new insights into the pathophysiology. The complexity of its pathogenesis is accompanied by a practical assessment and classification that allows clinicians to obtain significant amount of success when treating it.

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“…Graves’ orbitopathy (GO) is an inflammatory autoimmune disease. The remodeling of the orbit that occurs with this disease can lead to a number of complications, including photophobia, proptosis, eyelid retraction, and even vision loss ( 1 ). GO is considered a biphasic disease ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of activity of Graves’ orbitopathy with multiparameter orbital magnetic resonance imaging (MRI)

Cheng¹,

Zhang²,

Lian³

et al. 2023

Quant Imaging Med Surg

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Background: When quantitative magnetic resonance imaging (MRI) is used to assess the activity of Graves' orbitopathy (GO), the examination is generally focused on a specific orbital tissue, especially the extraocular muscles (EOMs). However, GO usually involves the entire intraorbital soft tissue. The aim of this study was to use multiparameter MRI on multiple orbital tissues to distinguish the active and inactive GO. Methods: From May 2021 to March 2022, consecutive patients with GO were prospectively enrolled at Peking University People's Hospital (Beijing, China) and divided into those with active disease and those with inactive disease based on a clinical activity score. Patients then underwent MRI, including sequences of conventional imaging, T1 mapping, T2 mapping, and mDIXON Quant. Width, T2 signal intensity ratio (SIR), T1 values, T2 values, and fat fraction of EOMs, as well as water fraction (WF) of orbital fat (OF), were measured. Parameters were compared between the 2 groups, and a combined diagnostic model was constructed using logistic regression analysis. Receiver operating characteristic analysis was used to test the diagnostic performance of the model. Results: Sixty-eight patients with GO (27 with active GO, 41 with inactive GO) were included in the study.The active GO group had higher values of EOM thickness, T2 SIR, and T2 values, as well as higher WF of OF. The diagnostic model, which included EOM T2 value and WF of OF, demonstrated a good ability to distinguish between active and inactive GO (area under the curve, 0.878; 95% CI: 0.776-0.945; sensitivity, 88.89%; specificity, 75.61%).Conclusions: A combined model incorporating the T2 value of EOMs and the WF of OF was able to identify cases of active GO, potentially offering an effective and noninvasive method to assess pathological changes in this disease.

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Ophthalmic manifestations of endocrine disorders—endocrinology and the eye

Cited by 16 publications

References 56 publications

Somatic symptoms with psychogenic or psychiatric background

Somatic symptoms with psychogenic or psychiatric background

Thyroid disease and associated ophthalmopathy

Evaluation of activity of Graves’ orbitopathy with multiparameter orbital magnetic resonance imaging (MRI)

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