Retrobulbar Ocular Blood Flow Changes after Orbital Decompression in Graves' Ophthalmopathy Measured by Color Doppler Imaging

Pérez-López, Marta; Sales‐Sanz, Marco; Rebolleda, Gema; Casas-Llera, Pilar; González-Gordaliza, C.; Jarrín, E.; Muñoz‐Negrete, Francisco J.

doi:10.1167/iovs.10-6907

Cited by 65 publications

(44 citation statements)

References 25 publications

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“…After decompression surgery, the authors observed a significant decrease of calculable US parameters, such as resistive index (RI), which occurred in both ocular arteries mentioned above. These results may indicate that increased RI of inactive GO might be due to orbital extrinsic compression of vascular structures and decompression surgery leads to significant decreases of the RIs of different orbital arteries [30]. Moreover, Doppler ultrasound parameters of the retrobulbar arteries have been related to the clinical activity score, suggesting increased arterial blood flow velocity in patients with active GO due to inflammation of the orbital tissues [31].…”

Section: Ultrasound-based Imaging Evaluation Of Graves' Ophthalmopathymentioning

confidence: 93%

Graves’ Ophthalmopathy Imaging Evaluation

Kawa¹,

Machalińska²,

Wilk³

et al. 2014

Thyroid Disorders - Focus on Hyperthyroidism

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Graves ophthalmopathy GO , known as Graves orbitopathy or thyroid eye disease TED , is an autoimmune disorder and the main extrathyroidal expression of Graves' disease GD . GO occurs mainly, but not exclusively, in patients with Graves disease up to % of GD patients have clinically apparent ophthalmopathy . The major clinical risk factor for developing thyroid eye disease is smoking. Moreover, radioactive iodine used to treat hyperthyroidism can worsen GO. There is an age-specific and gender-related distribution of GO, and the annual incidence is . % for women and . % for men but this largely reflects the increased incidence of GD in women [ ]. In addition to GD, thyroid eye disease can also be seen in chronic autoimmune thyroiditis, albeit is far less common and occurs in % of these patients [ ]. "lthough the link between GD and GO is still not totally clear, the close association between onset of GD and the development of GO suggests that both disorders would have common pathogenic mechanisms [ ]. The ocular involvement of GD is explained by the expression of receptor for thyroid-stimulating hormone TSH-R present not only in the thyroid follicular cells but also in adipocytes, and fibroblasts located in the orbit, and lymphocytes infiltrating orbit tissues [ ]. Likewise, the signs and symptoms of GO occur due to inflammatory reaction and subsequent fibrosis of the orbital components, including orbital connective tissue, and the extraocular muscles [ ]. Inflammatory cell infiltration of extraocular muscles is associated with increased secretion of glycosaminoglycans and osmotic retention of water. The muscles become enlarged, sometimes up to eight times their normal size, and may compress the optic nerve. Subsequent degeneration of muscle fibers eventually leads to fibrosis, which exerts a tethering effect on the involved muscle resulting in the muscle dysfunction and ophthalmoplegia. Infiltration of interstitial tissues, orbital fat and lacrimal glands with lymphocytes, plasma cells, macrophages and mast cells along with accumulation of glycosaminoglycans and

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Section: Ultrasound-based Imaging Evaluation Of Graves' Ophthalmopathymentioning

confidence: 93%

Graves’ Ophthalmopathy Imaging Evaluation

Kawa¹,

Machalińska²,

Wilk³

et al. 2014

Thyroid Disorders - Focus on Hyperthyroidism

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“…Thyroid eye disease (TED) is characterized in most cases by an expansion in the fat and/or muscle in the orbit . Being an enclosed and fixed space, such alterations would be presumed to result in changes to intra‐orbital pressure and in compliance of the orbit, leading to decreased retrodisplacement of the orbit with supine positioning …”

Section: Ancova Modelmentioning

confidence: 99%

“…In normal subjects, the free flowing fat may allow for some compression when affected by increasing gravitational forces . However, the muscle‐involving TED orbit is less compliant and the stiffer tissue is thought to resist small changes in gravitational force. Furthermore, the generally elevated orbital and venous pressures in the supine position may lead to engorgement of the orbital tissues, and the small mean increase in proptosis was noted in this investigation.…”

Section: Ancova Modelmentioning

confidence: 99%

“…However, the muscle‐involving TED orbit is less compliant and the stiffer tissue is thought to resist small changes in gravitational force. Furthermore, the generally elevated orbital and venous pressures in the supine position may lead to engorgement of the orbital tissues, and the small mean increase in proptosis was noted in this investigation. These theories will require further investigation to elucidate, however offer physiologically plausible explanations for the observed effect.…”

Section: Ancova Modelmentioning

confidence: 99%

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Ocular protrusion in sitting and supine position

Golan

Rootman

Lambros

et al. 2018

Clinical Exper Ophthalmology

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“…These factors induce and maintain the infl amma-from macrophages and tumor cells [ 12 ] . In TO, the restricted orbital compartment is associated with compression of orbital tissue and slow venous return [ 13 ] . This may result in a limitation in the oxygen supply, lower pH, and a higher concentration of lactate which could stimulate the proangiogenic factors expression, independently of other mechanisms such as infl ammation.…”

mentioning

confidence: 99%