Search Our Scientific Publications & Authors

Endocr Connect 2021 Jun 1. Epub 2021 Jun 1.

H Chen, Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Purpose: To evaluate the value of magnetic resonance imaging (MRI)-based texture analysis of extraocular muscle (EOM) and orbital fat (OF) in monitoring and predicting the response to glucocorticoid (GC) therapy in patients with thyroid-associated ophthalmopathy (TAO).

Methods: Thirty-seven active and moderate-to-severe TAO patients (responders, n=23; unresponders, n=14) were retrospectively enrolled. MRI-based texture parameters (entropy, uniformity, skewness and kurtosis) of EOM and OF were measured before and after GC therapy, and compared between groups. Read More

Clin Nucl Med 2021 May 12. Epub 2021 May 12.

From the Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province; and Academician (Expert) Workstation of Sichuan Province, Luzhou, Sichuan, China.

Abstract: 68Ga-FAPI PET/CT has been used in the assessment of a variety of malignancies. In addition, FAPI uptake in nonmalignant diseases has also been reported. Herein, we present a case of Graves ophthalmopathy detected by 68Ga-FAPI PET/CT. Read More

Sichuan Da Xue Xue Bao Yi Xue Ban 2021 May;52(3):510-515

Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China.

Objective: To explore the clinical features of thyroid-associated ophthalmopathy (TAO) with extraocular muscle involvement.

Methods: The data of 2170 TAO patients who were seen at the Orbital Disease Clinic, West China Hospital, Sichuan University from September, 2009 to January, 2020 were collected retrospectively. The extraocular muscle involvement of these patients was confirmed by CT or MRI. Read More

Ophthalmic Plast Reconstr Surg 2021 May-Jun 01;37(3):296

Ophthalmic Plast Reconstr Surg 2021 May-Jun 01;37(3):296

Eur Radiol 2021 May 15. Epub 2021 May 15.

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.

Objectives: To evaluate the optic nerve and CSF in the optic nerve sheath as imaging markers of dysthyroid optic neuropathy (DON).

Methods: In this single-centre retrospective study, orbital images of 30 consecutive participants (54 orbits) with DON, 30 patients (60 orbits) with thyroid-associated ophthalmopathy (TAO) without DON, and 19 healthy controls (HCs; 38 orbits) were analysed. The diameter and cross-sectional area of the optic nerve and its sheath, water fraction of the optic nerve, and volume of the fluid in the optic nerve sheath were measured and compared. Read More

Eye Vis (Lond) 2021 Apr 30;8(1):18. Epub 2021 Apr 30.

Department of Surgical, Ophthalmology Unit, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Savi, 10, 56126, Pisa, Italy.

Background: Hemodynamic changes have been observed in patients with Graves' disease. The aim of our study was to evaluate choroidal vascular change using the choroidal vascularity index (CVI) in patients with thyroid-associated ophthalmopathy (TAO).

Methods: In this cross-sectional observational study, 40 patients affected by TAO were recruited. Read More

Clinics (Sao Paulo) 2021 9;76:e2592. Epub 2021 Apr 9.

Laboratorio de Investigacao em Oftalmologia (LIM 33), Divisao de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Objectives: To compare the surgical outcomes of inferomedial wall orbital decompression (IM-OD) and balanced medial plus lateral wall orbital decompression (ML-OD) in patients with inactive Graves' orbitopathy (GO) with regard to exophthalmos reduction and ocular motility abnormalities.

Methods: Forty-two patients with inactive GO eligible for OD were randomly assigned to either the IM-OD or ML-OD groups. Pre and postoperative evaluations included Hertel exophthalmometry, sensory, and motor extraocular motility assessment, standardized photographs in the nine gaze positions, and computed tomography (CT) of the orbits. Read More

BMC Ophthalmol 2021 Apr 13;21(1):176. Epub 2021 Apr 13.

Department of Radiology, Chengdu First People's Hospital, Chengdu, Sichuan Province, China.

Purpose: A new radiological method was used to evaluate the plastic effect of modified transconjunctival orbital fat decompression surgery in patients with inactive thyroid-associated ophthalmopathy.

Methods: In this study, 10 inactive patients (14 eyes) with moderate to severe thyroid-associated ophthalmopathy were selected. The patients underwent modified transconjunctival orbital fat decompression surgery. Read More

Medicine (Baltimore) 2021 Apr;100(14):e25062

Department of Ophthalmology, Osaka Medical College, Osaka, Japan.

Rationale: Enlargemento of the medial rectus is the most predominant factor of compressive optic neuropathy (CON) in Graves' disease. This case report indicates that CON could develop only from the hypertrophic superior levator and superior rectus (SL/SR) muscle in a patient with poorly controlled Graves' disease, and described the possible risk of FT3-thyrotoxicosis with a prominent goiter to develop the current rare case with a review of the literature.

Patient Concerns: A 66-year-old woman undergoing endocrine management of hyperthyroidism with prominent goiter visited the Department of Ophthalmology due to right-eye upper-eyelid retraction. Read More

Invest Ophthalmol Vis Sci 2021 Apr;62(4)

Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Purpose: Increasing evidence indicated that thyroid-associated ophthalmopathy (TAO) might be a neural related disease more than an ocular disease. In this study, we aimed to investigate the alterations of structural brain connectome in patients with TAO.

Methods: Twenty-seven patients with TAO and 27 well-matched healthy controls underwent diffusion tensor imaging. Read More

Clin Transl Sci 2021 Mar 20. Epub 2021 Mar 20.

Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Thyroid-associated ophthalmopathy (TAO) is a serious, progressive, vision-threatening and difficult-to-treat organ-specific autoimmune disease. The course, therapeutic effects and prognosis of moderate to severe TAO vary greatly. High-dose intravenous glucocorticoid (IVGC) therapy is considered a first-line treatment for active moderate-to-severe TAO, but there is still insufficient evidence regarding the treatment duration. Read More

Klin Monbl Augenheilkd 2021 Mar 17. Epub 2021 Mar 17.

Ophthalmology, Samsun Gazi Community Hospital, Samsun, Turkey.

Purpose: The study was conducted for the assessment of the retinal nerve fiber layer, ganglion cell layer, and subfoveal choroidal thickness changes in patients with inactive Graves' ophthalmopathy (GO) using swept-source optical coherence tomography (SS-OCT) before the development of active GO findings.

Materials And Methods: The cross-sectional designed study consisted of patients with inactive Graves' ophthalmopathy (study group) and healthy subjects (control group). The thicknesses of the retinal ganglion cell layer, retinal nerve fiber layer, and subfoveal choroid (SFCT) were measured using SS-OCT with deep range imaging technology to compare these parameters between the study and control groups. Read More

Front Endocrinol (Lausanne) 2021 25;12:614536. Epub 2021 Feb 25.

Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.

Objective: Prediction of therapy response to intravenous methylprednisolone pulses (ivMP) is crucial for thyroid-associated ophthalmopathy (TAO). Image histograms may offer sensitive imaging biomarkers for therapy effect prediction. This study aimed to investigate whether pretherapeutic, multiparametric T2 relaxation time(T2RT) histogram features of extraocular muscles (EOMs) can be used to predict therapy response. Read More

Endocr Pract 2021 Mar 15;27(3):198-205. Epub 2020 Dec 15.

Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, 200011; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China, 200011. Electronic address:

Objective: To evaluate magnetic resonance imaging parameters, T2 signal intensity ratios (SIRs), and normalized apparent diffusion coefficients (n-ADC) of the extraocular muscles (EOMs) in the identification of different stages of Graves' ophthalmopathy (GO) and to find out the correlation of T2-SIRs and n-ADC values with disease changes after anti-inflammatory treatment.

Methods: Altogether, 43 patients (86 orbits) were enrolled and classified into "active" or "inactive" stages by clinical activity score (CAS). Twenty-three (53. Read More

Front Endocrinol (Lausanne) 2020 10;11:621321. Epub 2021 Feb 10.

Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.

Background: Previous studies showed that patients with Graves' orbitopathy (GO) had concomitant mucosal abnormality within the paranasal sinuses. It remains unknown whether the immunological reactions in sinus mucosa affect the orbit inflammation in GO.

Methods: Patients with GO underwent sinus computed tomography (CT) scans for sinus mucosal disease by two independent reviewers using the Lund-MacKay systems. Read More

Endocr Pract 2021 Mar 23;27(3):191-197. Epub 2020 Dec 23.

Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. Electronic address:

Objective: To evaluate the performance of T2 mapping in detecting intraorbital optic nerve (ON) changes in patients with thyroid-associated ophthalmopathy (TAO) before the onset of dysthyroid optic neuropathy (DON).

Methods: Thirty-five patients with TAO and without DON (21 active, 14 inactive) and 21 healthy controls (HCs) were enrolled. Magnetic resonance imaging-derived parameters of T2 relaxation time (T2RT) at the intraorbital ON, extraocular muscle (EOM), orbital fat, exophthalmos, summed thickness of EOMs, orbital fat thickness, and clinical variables were compared. Read More

Q J Nucl Med Mol Imaging 2021 Jun 10;65(2):132-137. Epub 2021 Feb 10.

Clinic of Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland.

Graves' disease (GD), the most common cause of hyperthyroidism, is an autoimmune disease directly caused by circulating autoantibodies that bind and activate the TSH receptor, inducing metabolic activation of the thyroid gland; this may be associated with important cardiac (atrial fibrillation) and ocular (ophthalmopathy) complications. Treating GD with real curative intent implies the full elimination of the functioning thyroid parenchyma using surgery or radioactive iodine therapy (RAI). RAI has been used in humans with hyperthyroidism since 1941, thanks to the pioneering work of a physician (Dr. Read More

J Ophthalmol 2021 29;2021:9736247. Epub 2021 Jan 29.

Department of Ophthalmology, Daping Hospital, Army Medical University, No. 10,Changjiang Branch,Daping,Yuzhong District, Chongqing, China.

Objective: We aimed to evaluate the effect of inferior rectus muscle thickening on intraocular pressure (IOP) in patients with thyroid-associated ophthalmopathy (TAO).

Materials And Methods: We analyzed 33 patients with TAO (50 eyes) who presented with hypotropia in the primary position. There was significant eyeball movement restriction and inferior rectus muscle thickening was confirmed on computed tomography or magnetic resonance imaging. Read More

BMC Ophthalmol 2021 Jan 14;21(1):39. Epub 2021 Jan 14.

Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China.

Background: This study aimed to establish a deep learning system for detecting the active and inactive phases of thyroid-associated ophthalmopathy (TAO) using magnetic resonance imaging (MRI). This system could provide faster, more accurate, and more objective assessments across populations.

Methods: A total of 160 MRI images of patients with TAO, who visited the Ophthalmology Clinic of the Ninth People's Hospital, were retrospectively obtained for this study. Read More

Br J Radiol 2021 Feb 22;94(1118):20200884. Epub 2020 Dec 22.

Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Objective: To compare the two-point Dixon weighted imaging (WI) with conventional fat-sat WI in fat suppression (FS) quality and staging performance for patients with TAO.

Methods: We enrolled 37 thyroid-associated ophthalmopathy (TAO) patients and 15 healthy controls who underwent both coronal two-point Dixon and fat-sat WI. Qualitative (overall imaging quality, FS uniformity) and quantitative [signal intensity ratio of extraocular muscle (EOM-SIR)] parameters were assessed between the two-point Dixon WI and fat-sat WI. Read More

Sci Rep 2020 12 14;10(1):21875. Epub 2020 Dec 14.

Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA.

Radiologic orbital imaging provides important information in the diagnosis and management of orbital inflammation. However, the diagnostic value of orbital imaging is not well elucidated. This study aimed to investigate the diagnostic accuracy of orbital imaging to diagnose orbital inflammatory diseases and its ability to detect active inflammation. Read More

Tohoku J Exp Med 2020 12;252(4):321-327

Department of Endocrinology and Metabolism, National Hospital Organization Sendai Medical Center.

Dysthyroid optic neuropathy is a severe manifestation of Graves' ophthalmopathy that can result in permanent vision loss. We report a 37-year-old pregnant woman with Graves' ophthalmopathy which was deteriorated to dysthyroid optic neuropathy in the third trimester of pregnancy. Diplopia, bilateral eye lid retraction, lid edema and proptosis were observed in the 29th week of gestation. Read More

Int J Mol Sci 2020 Nov 30;21(23). Epub 2020 Nov 30.

School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK.

Depot specific expansion of orbital-adipose-tissue (OAT) in Graves' Orbitopathy (GO) is associated with lipid metabolism signaling defects. We hypothesize that the unique adipocyte biology of OAT facilitates its expansion in GO. A comprehensive comparison of OAT and white-adipose-tissue (WAT) was performed by light/electron-microscopy, lipidomic and transcriptional analysis using ex vivo WAT, healthy OAT (OAT-H) and OAT from GO (OAT-GO). Read More

Muscle Nerve 2021 05 27;63(5):631-639. Epub 2020 Nov 27.

Neuromuscular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Ocular myasthenia gravis (OMG) and thyroid eye disease are two autoimmune conditions that have several overlapping clinical features, and these coexist with a small but not insignificant frequency. Segregating these diagnoses is typically straightforward, but, when the two diseases co-occur in the same individual, making a diagnosis of OMG can be very challenging. In this review we address what is known about the coexistence of OMG and thyroid eye disease and we highlight the clinical features that are suggestive of overlapping conditions. Read More

Case Rep Ophthalmol Med 2020 1;2020:8829655. Epub 2020 Nov 1.

Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka, Japan.

Purpose: To report a case of isolated superior oblique muscle swelling causing acute vertical strabismus in Graves' disease.

Case: A 26-year-old woman with a 1-month history of misalignment of the right eye and diplopia was referred to us. Her visual acuity and intraocular pressures were normal in both eyes, but eye movement tests showed clear misalignment of her right eye. Read More

Sci Rep 2020 11 10;10(1):19445. Epub 2020 Nov 10.

Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

Using histogram analysis of T2 values to detect early involvement of extraocular muscles (EOMs) in patients with thyroid-associated ophthalmopathy (TAO). Five EOMs of each orbit were analyzed for 45 TAO patients and 22 healthy controls (HCs). Patients' EOMs were grouped into involved or normal-appearing EOMs (NAEOMs). Read More

Zhonghua Yan Ke Za Zhi 2020 Nov;56(11):824-831

Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, ChinaWang Yuhan is now working at Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China.

To analyze the characteristics of vessel density in the optic disc and macular area of patients with different phases of thyroid-associated ophthalmopathy (TAO) and their correlation with visual function. This case-control study was conducted at the Department of Ophthalmology of Peking Union Medical College Hospital between June 2019 and September 2019. TAO patients and healthy volunteers were included in the study. Read More

Int J Comput Assist Radiol Surg 2021 Feb 4;16(2):323-330. Epub 2020 Nov 4.

Department of Ophthalmology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Purpose: Thyroid-associated ophthalmopathy (TAO) might lead to blindness and orbital deformity. The early diagnosis and treatment are conducive to control disease progression, but currently, there is no effective screening method. The present study aimed to introduce an artificial intelligence (AI) model for screening and testing the model with TAO patients under clinical conditions. Read More

Int J Endocrinol 2020 22;2020:2575710. Epub 2020 Oct 22.

Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Background: Accurate staging of patients with thyroid-associated ophthalmopathy (TAO) is crucial for clinical decision. Full cognition of pathologic changes and staging TAO using conventional T2-weighted imaging is still limited.

Purpose: To investigate the feasibility of using T1 mapping to evaluate changes of extraocular muscles (EOMs) in TAO patients, as well as to compare T1 mapping and conventional T2-weighted imaging in staging TAO. Read More