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J Ultrason 2018 ;18(75):349-354

Imperial College NHS Trust, Western Eye Hospital , London , UK.

Pathological processes within the orbits are a heterogeneous group of diseases of various etiologies, clinical pictures and therapy models. Due to poor access to the orbits in a clinical examination, imaging plays a significant role in both diagnosis and treatment monitoring in patients with an orbital pathology. One of such imaging modalities is ultrasonography. Read More

BMC Ophthalmol 2019 Jan 8;19(1). Epub 2019 Jan 8.

Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland.

Background: Thyroid-associated orbitopathy (TAO) constitutes an immune-mediated inflammation of the orbital tissues of unclear etiopathogenesis. TAO is most prevalent in hyperthyroid patients with Graves' disease (GD); however, severe cases of orbitopathy associated with Hashimoto's thyroiditis (HT) have rarely been described.

Case Presentation: Herewith we report an unusual case of a middle-aged clinically and biochemically euthyroid woman with a stable HT, who developed a severe unilateral left-sided TAO. Read More

Acta Clin Croat 2018 Jun;57(2):301-306

Department of Ophthalmology, Rijeka University Hospital Center, Rijeka, Croatia.

Thyroid-associated orbitopathy (TAO) is a common manifestation of Graves' disease. The aim of the study was to assess the six percent of patients with TAO that develop dysthyroid optic neuropathy (DON), which is the most serious complication of TAO. As DON can cause perma-nent damage, it is essential to detect DON early when visual loss is still reversible. Read More

Clin Physiol Funct Imaging 2019 Mar 16;39(2):135-142. Epub 2018 Oct 16.

Faculdade de Medicina, Pós-graduacão em Endocrinologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

It has been suggested that technetium-99m (99mTc)-anti-tumour necrosis factor alpha (TNF-α) scintigraphy (SCI) may be a useful diagnostic tool in Graves' ophthalmopathy (GO). This study evaluated whether orbit total radioactivity uptake on SCI could be used to predict corticosteroid therapy (CorT) responses in active-GO patients. A longitudinal study of patients with active GO defined by Clinical Active Score (CAS) >3/7 was done. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018 Aug;43(8):869-874

Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008, China.

Objective: To compare diagnostic value of 4 kinds of target-to-nontarget ratio (T/NT), and to choose a better one to assess thyroid associated ophthalmopathy (TAO) activity.
 Methods: The clinical data were collected for 29 newly-diagnosed patients (58 eyes) with TAO who underwent orbital 99mTc-DTPA single photon emission computed tomography/computed tomography (SPECT/CT) fusion images according to the clinical activity score (CAS). They were divided into an active group (18 cases, 36 eyes), an inactive group (11 cases, 22 eyes), and a control group (9 cases, 18 eyes). Read More

J Pediatr Ophthalmol Strabismus 2018 Nov 29;55(6):356-362. Epub 2018 Aug 29.

Purpose: To examine extraocular rectus muscle tendons in patients with Graves' ophthalmopathy using optical coherence tomography (OCT).

Methods: This was a cross-sectional observational study conducted with 55 healthy controls, 45 patients with clinically inactive Graves' ophthalmopathy, and 12 patients with clinically active Graves' ophthalmopathy. Scanning was performed at the 3- and 9-o'clock positions. Read More

Int J Ophthalmol 2018 18;11(8):1290-1295. Epub 2018 Aug 18.

Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

Aim: To report the long-term outcomes of a large cohort of upper lid retraction patients treated with subconjunctival triamcinolone acetonide injections.

Methods: This retrospective clinical study was conducted from 2009 to 2016. The documents of 97 patients (126 eyes) were reviewed. Read More

Endocr Pract 2018 Jul;24(7):658-667

Objective: It is uncertain whether there is an increased retinal vessel density in patients with thyroid-associated ophthalmology (TAO), or if ocular hemodynamic changes are associated with their vision. Many techniques have been applied to analyze ocular hemodynamic changes in TAO patients; however, they suffer from limitations. Optical coherence tomography angiography (OCTA) is more sensitive to hemodynamic changes. Read More

Acta Radiol Open 2018 Jun 25;7(6):2058460118780892. Epub 2018 Jun 25.

Department of Radiological Sciences, Sapienza University, Roma, Italy.

Background: Current magnetic resonance imaging (MRI) techniques for measuring extraocular muscle (EOM) volume enlargement are not ideally suited for routine follow-up of Graves' ophthalmopathy (GO) because the difficulty of segmenting the muscles at the tendon insertion complicates and lengthens the study protocol.

Purpose: To measure the EOM sampled volume (SV) and assess its correlation with proptosis.

Material And Methods: A total of 37 patients with newly diagnosed GO underwent 3-T MRI scanning with iterative decomposition of water and fat (IDEAL) sequences with and without contrast enhancement. Read More

Ophthalmic Plast Reconstr Surg 2018 Jul/Aug;34(4S Suppl 1):S52-S55

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Purpose: To review the clinical presentation, disease severity, and surgical interventions of children with thyroid eye disease (TED) at a single institution over a 7-year period.

Methods: Retrospective cohort study of children 0 to 18 years of age with a diagnosis of TED, seen at the Children's Hospital of Philadelphia from 2009 to 2016. Ophthalmic examination findings, neuroimaging study results, and ophthalmological management were recorded. Read More

Clin Imaging 2018 Sep - Oct;51:327-331. Epub 2018 Jun 23.

Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea.

Purpose: To evaluate the clinical feasibility of low-dose orbital CT with a knowledge-based iterative model reconstruction (IMR) algorithm for evaluating Graves' orbitopathy.

Methods: Low-dose orbital CT was performed with a CTDI of 4.4 mGy. Read More

Graefes Arch Clin Exp Ophthalmol 2018 Oct 29;256(10):2001-2008. Epub 2018 Jun 29.

Department of Ophthalmology, College of Medicine, Chung-Ang University Hospital, Chung-Ang University, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea.

Purpose: To assess the relationships between eyelid position and levator palpebrae superioris (LPS)-superior rectus (SR) complex and inferior rectus (IR) muscle volume in patients with Graves' orbitopathy (GO) with unilateral upper eyelid retraction.

Methods: This was a cross-sectional observational study of 48 patients with GO with unilateral upper eyelid retraction. To measure muscle volume, computerized tomography scans were performed, and 3D images were analyzed. Read More

Ophthalmic Plast Reconstr Surg 2018 Jul/Aug;34(4S Suppl 1):S34-S40

Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

Purpose: Thyroid eye disease (TED) is an autoimmune disorder causing inflammation, expansion, and fibrosis of orbital fat, muscle, and lacrimal gland. This article reviews the different methods of grading severity and activity of TED and focuses on the VISA Classification for disease evaluation and planning management.

Methods: Accurate evaluation of the clinical features of TED is essential for early diagnosis, identification of high-risk disease, planning medical and surgical intervention, and assessing response to therapy. Read More

Ophthalmic Plast Reconstr Surg 2019 Jan/Feb;35(1):22-24

Department of Diagnostic Imaging, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Purpose: To evaluate if parabulbar triamcinolone reduces orbital swelling in patients with Graves ophthalmopathy.

Methods: This is a prospective study of a series of patients with active and moderate Graves ophthalmopathy. Short tau inversion recovery magnetic resonance was used to evaluate the intensity of the extraocular rectus muscles and orbital fat, before and after the treatment with parabulbar triamcinolone. Read More

Ophthalmic Plast Reconstr Surg 2018 Jul/Aug;34(4S Suppl 1):S41-S51

Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.

Introduction: Thyroid eye disease (TED), is a term referring to the extrathyroidal manifestation of Grave's disease, a disorder which is currently the most common cause of hyperthyroidism and is characterised by underlying autoimmunity.The pathogenic course of the disease can be broadly classified into two stages, an early inflammatory and a late fibrotic stage. These stages are reflected in clinical severity and activity classifications, such as Clinical Activity Score and Class 0: No signs or symptoms, 1: Only signs, no symptoms (e. Read More

Ophthalmic Plast Reconstr Surg 2018 Jul/Aug;34(4S Suppl 1):S28-S33

Moorfields Eye Hospital, Adnexal Service, London, United Kingdom.

Purpose: To describe a new classification system of thyroid eye disease (TED) based on the phenotypic features (clinical and radiologic) of the disease.

Methods: Clinical features, photographic, and orbital imaging of TED patients were considered in relation to their natural history and treatment response in the experience of the author. Phenotypically distinct categories of patients were identified and described. Read More

Ophthalmic Plast Reconstr Surg 2018 Jul/Aug;34(4S Suppl 1):S7-S12

Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, U.S.A.

Purpose: To review and summarize the clinical findings in thyroid eye disease (TED) related to the unique anatomical structures of the eyelids and orbit.

Methods: A PubMed search was performed searching for anatomical relationships between eyelid and orbital anatomy and the clinical findings of TED.

Results: The major clinical findings associated with TED are varied. Read More

Clin Radiol 2018 Aug 24;73(8):759.e11-759.e17. Epub 2018 May 24.

Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, People's Republic of China. Electronic address:

Aim: To investigate the accuracy of two semi-automatic segmentation measurements based on magnetic resonance imaging (MRI) three-dimensional (3D) Cube fast spin echo (FSE)-flex sequence in phantoms, and to evaluate the feasibility of determining the volumetric alterations of orbital fat (OF) and total extraocular muscles (TEM) in patients with thyroid-associated ophthalmopathy (TAO) by semi-automatic segmentation.

Materials And Methods: Forty-four fatty (n=22) and lean (n=22) phantoms were scanned by using Cube FSE-flex sequence with a 3 T MRI system. Their volumes were measured by manual segmentation (MS) and two semi-automatic segmentation algorithms (regional growing [RG], multi-dimensional threshold [MDT]). Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018 Apr;43(4):457-460

Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha 410008, China.

Objective: To evaluate the inflammatory activity in thyroid associated ophthalmopathy (TAO) by 99mTc-diethylene triamine pentaaceticacid (99mTc-DTPA) orbital single-photon emission computed tomography (SPECT)/CT.
 Methods: A total of 48 patients were enrolled from Xiangya Hospital of Central South University between October 2016 and March 2017. According to clinical active score (CAS), 93 eyes were divided into a TAO active group (n=72) and a TAO inactive group (n=21). Read More

Diagn Interv Imaging 2018 Jul - Aug;99(7-8):457-463. Epub 2018 Mar 21.

Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.

Purpose: The purpose of this study was to correlate diffusivity of extraocular muscles, measured by three-dimensional turbo field echo (3DTFE) magnetic resonance (MR) imaging using diffusion-sensitized driven-equilibrium preparation, with their size and activity in patients with Grave's ophthalmopathy.

Materials And Methods: Twenty-three patients with Grave's ophthalmopathy were included. There were 17 women and 6 men with a mean age of 55. Read More

Clin Endocrinol (Oxf) 2018 May 6;88(5):637-644. Epub 2018 Mar 6.

Department of Anatomy, Southern Medical University School of Basic Medical Science, Guangzhou, China.

Objective: Effective management of thyroid-associated ophthalmopathy (TAO) requires precise identification of the disease activity period as it is responsive to immunosuppressive treatment. Quantitative evaluations of orbital soft tissue are useful for analysing disease stages. We aimed to establish a method for orbital soft tissue volume calculation based on magnetic resonance imaging (MRI) data using 3D reconstruction technology. Read More

Indian J Radiol Imaging 2017 Oct-Dec;27(4):509-516

Nuclear Medicine Unit, Department of Clinical and Experimental Medicine, F. Magrassi, A. Lanzara, Seconda Università di Napoli, Napoli, Italy.

The somatostatin (SS) receptor scintigraphy (SRS), using octreotide radiolabelled with In (Ocreoscan©, OCT), is a consolidated diagnostic procedure in patients with neuroendocrine tumors (NET) because of an increased expression of somatostatin receptors (SS-R) on neoplastic cells. Uptake of SS analogues (SSA) can also be due to SS-R expression on nonmalignant cells when activated as lymphocytes, macrophages, fibroblasts, vascular cells. Because of this uptake, clinical indications can be found either in neoplasms not overexpressing SS-R, as nonsmall cell lung cancer, and in active benign diseases. Read More

BMC Ophthalmol 2018 Jan 12;18(1). Epub 2018 Jan 12.

Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei krt 98, Debrecen, 4032, Hungary.

Background: Immunoglobulin G4-related disease (IgG4-rd) is characterized by lymphoplasmacytic infiltration and tissue fibrosis. Orbital manifestations of IgG4-rd may include unilateral or bilateral proptosis, cicatricial extraocular muscle myopathy, orbital inflammation and pain which may mimic ophthalmic Graves' disease.

Case Presentation: A 25-year-old woman has been referred to the endocrinology clinic, 4 months after delivery, with suspected Graves' orbitopathy. Read More

Orbit 2018 Oct 10;37(5):325-330. Epub 2018 Jan 10.

c Eye Department , Central Middlesex Hospital , London , United Kingdom.

Aim: To examine the novel use of non-echo-planar diffusion weighted MRI (DWI) in depicting activity and treatment response in active Grave's orbitopathy (GO) by assessing, with inter-observer agreement, for a correlation between its apparent diffusion coefficients (ADCs) and conventional Short tau Inversion Recovery (STIR) MRI signal-intensity ratios (SIRs).

Method And Materials: A total of 23 actively inflamed muscles and 30 muscle response episodes were analysed in patients with active GO who underwent medical treatment. The MRI orbit scans included STIR sequences and non-echo-planar DWI were evaluated. Read More

Nucl Med Rev Cent East Eur 2018 10;21(1):54-58. Epub 2018 Jan 10.

University of Debrecen, Nagyerdei krt 98, 4032 Debrecen, Hungary.

The pathogenesis of Graves' orbitopathy (GO) is not completely understood. Coexistent hyperfunction of the thyroid gland is frequent; however, GO may also coexist with hypo- or euthyrodism. The course of GO is largely independent of thyroid function, although elevated serum TSH is known to negatively interfere with GO course. Read More

Orbit 2018 Aug 4;37(4):299-302. Epub 2018 Jan 4.

a The Rotterdam Eye Hospital , Rotterdam , the Netherlands.

A 55-year-old woman with concurrent active thyroid orbitopathy and B-cell lymphoma developed acute exacerbation of thyroid orbitopathy after receiving Rituximab, cyclophosphamide, hydroxydaunorubicin, Prednisone (R-CHOP) chemotherapy, presenting with subtotal loss of vision and severe eyelid edema. Intravenous methylprednisolone was fully effective within several hours. Further exacerbations of her orbitopathy were seen following every subsequent chemotherapeutic treatment, but responded well to oral prednisone. Read More

J Huazhong Univ Sci Technolog Med Sci 2017 Dec 21;37(6):938-942. Epub 2017 Dec 21.

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

The clinical application of orbital magnetic resonance (MR) T2-mapping imaging in detecting the disease activity of Graves' ophthalmopathy (GO), and the predictive values of therapy response to intravenous glucocorticoid (ivGC) were investigated. Approved by the local institutional review board (IRB), 106 consecutive patients with GO were included in this prospective study. All subjects were divided into two groups according to the patients' clinical activity score (CAS): the CAS positive group (CAS ≥3) or the CAS negative group (CAS <3). Read More

Sci Rep 2017 Dec 4;7(1):16874. Epub 2017 Dec 4.

Department of Ophthalmology, Shiga University of Medical Science, Otsu, Japan.

We quantitatively analyzed inflammation in orbital fat from cases of thyroid-associated ophthalmopathy (TAO) using short-tau inversion recovery (STIR) sequences from magnetic resonance imaging. The signal intensity ratios (SIRs) of orbital fat as well as the superior rectus (SR), inferior rectus (IR), lateral rectus (LR), medial rectus (MR), and superior oblique (SO) muscles on STIR images were measured in 70 eyes from 70 treatment-naive TAO patients (active TAO group, 19 patients; inactive TAO group, 51 patients) and 20 eyes from 20 controls. The mean SIR in the active TAO group was significantly higher than that in the inactive TAO group and controls (P < 0. Read More

Hell J Nucl Med 2017 Sep-Dec;20(3):227-231. Epub 2017 Nov 27.

Department of Endocrinology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.

Radioactive iodine in the treatment of Graves' disease has been associated with the development of de novo Graves' ophthalmopathy (GO). In this report, we describe five individuals who required extensive ophthalmic treatment for post-RAI de novo GO. Read More

Curr Eye Res 2018 03 22;43(3):289-292. Epub 2017 Nov 22.

a Department of Ophthalmology , University Hospital Dresden , Dresden , Germany.

Purpose: To investigate orbital biomechanical properties in patients with thyroid orbitopathy and in age- and gender-matched healthy subjects using the Corvis-ST (CST, Oculus Wetzlar, Germany).

Methods: The CST allows a non-contact tonometry with an ultra-high-speed Scheimpflug device to record the deformation of the cornea during an air pulse. Biomechanical response parameters (intraocular pressure (IOP), whole eye movement length (WEMl) and time (WEMt), deflection amplitude 2 mm ratio max, deflection amplitude max, stiffness parameter, and biomechanically corrected IOP were measured in 39 patients with thyroid orbitopathy (= group I) and in 33 age- and gender-matched healthy subjects (= group II) using the CST. Read More

Acta Clin Croat 2017 03;56(1):21-27

School of Medicine, University of Belgrade

The use of multidetector computed tomography (MDCT) is an integral part of contemporary diagnostics of Graves‘ orbitopathy. The aim of this study was to assess proptosis measurement by MDCT and to compare it to the current standard, Hertel exophthalmometry. A cross-sectional study was conducted at the Clinical Centre of Serbia and included 91 patients (19 male and 72 female) with verified Graves‘ orbitopathy. Read More

Int J Oral Maxillofac Surg 2018 Feb 31;47(2):167-174. Epub 2017 Oct 31.

Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.

Graves' orbitopathy, a condition seen in the autoimmune syndrome Graves' disease, affects the fatty tissue and muscles inside the orbit. Graves' orbitopathy is associated with increasing exophthalmos and sometimes leads to compressive dysthyroid optic neuropathy, resulting in progressive vision loss. Dysthyroid compressive optic neuropathy, functional problems, and cosmetic problems are the main indications for surgical decompression of the orbit, especially if conservative treatment has not led to a reduction in symptoms. Read More

Orbit 2018 Jun 23;37(3):230-234. Epub 2017 Oct 23.

a Department of Ophthalmology , University of California Los Angeles , Los Angeles , California , USA.

Introduction: Double vision after decompression surgery for Thyroid Eye Disease (TED) is well described in the literature and the incidence ranges from 0 to 64%. The Mechanisms for new onset diplopia after orbital decompression are poorly understood. Common theories include: Fibrosis of muscles, displacement of the muscle cone, and reactivation of the TED. Read More

Clin Exp Immunol 2018 03 17;191(3):255-267. Epub 2017 Nov 17.

Molecular Ophthalmology, Departments of Ophthalmology University Hospital Essen, Germany.

Experimental models of Graves' hyperthyroid disease accompanied by Graves' orbitopathy (GO) can be induced efficiently in susceptible inbred strains of mice by immunization by electroporation of heterologous human TSH receptor (TSHR) A-subunit plasmid. In this study, we report on the development of a bona fide murine model of autoimmune Graves' disease induced with homologous mouse TSHR A-subunit plasmid. Autoimmune thyroid disease in the self-antigen model was accompanied by GO and characterized by histopathology of hyperplastic glands with large thyroid follicular cells. Read More

Orbit 2018 Jun 20;37(3):175-178. Epub 2017 Oct 20.

a UPMC Eye Center, Eye and Ear Institute , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.

Superior ophthalmic vein thrombosis is a rare, life- and sight-threatening complication of both infectious and inflammatory orbital disease as well as hypercoagulable state. Only one case of superior ophthalmic vein thrombosis due to thyroid eye disease has been reported in the literature. This article describes the diagnosis and management of a case of superior ophthalmic vein thrombosis due to Graves' orbitopathy. Read More

Nan Fang Yi Ke Da Xue Xue Bao 2017 Sep;37(9):1248-1251

Department of Endocrinology and Metabolism, Third Affiliated Hospital, Southern Medical University, Guangzhou 510630, China.E-mail:

Objective: To establish a new method for rapid and quantitative measurement of orbital fat volume based on magnetic resonance imaging (MRI) data.

Methods: We collected MRI data from normalized mold and patients with the diagnosis of thyroid-associated ophthalmopathy (TAO). The cross-sectional areas of the orbital fat on each MR image slice were measured to calculate the fat volume on each slice and then the total orbital fat volume. Read More

J Comput Assist Tomogr 2018 Mar/Apr;42(2):293-298

Objective: The aim of this study was to determine whether the optic nerve is affected by thyroid eye disease (TED) before the development of dysthyroid optic neuropathy with diffusion-tensor imaging (DTI).

Methods: Twenty TED patients and 20 controls were included. The mean, axial, and radial diffusivities and fractional anisotropy (FA) value were measured at the optic nerves in DTI. Read More

Graefes Arch Clin Exp Ophthalmol 2017 Dec 1;255(12):2467-2471. Epub 2017 Sep 1.

Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan.

Purpose: To examine Bell's phenomenon in patients with unilateral thyroid-associated inferior rectus myopathy and changes in this phenomenon after inferior rectus muscle recession.

Methods: This prospective interventional study included 12 patients who underwent inferior rectus muscle recession with or without nasal transposition. Bell's phenomenon was examined before and 3 months after surgery. Read More

Saudi J Ophthalmol 2017 Jul-Sep;31(3):156-161. Epub 2017 Jun 14.

Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Orbital decompression is an effective and invaluable procedure for addressing some of the chronic manifestations of Graves' Ophthalmopathy (GO) such as exophthalmos and orbital congestion. Fat-removal orbital decompression (FROD) started to gain popularity after its introduction in the late 20th century. Among the therapeutic armamentarium of techniques and approaches available for orbital decompression, FROD has proven its efficacy and safety in addition to its ability to reduce proptosis in a relatively predictable manner. Read More

Orbit 2017 Dec 16;36(6):462-464. Epub 2017 Aug 16.

c Oculoplastic and Orbital Surgery Service , Wills Eye Hospital , Philadelphia , Pennsylvania , USA.

This is a retrospective case description of a single female patient found to have concomitant bilateral silent sinus syndrome, bilateral thyroid eye disease, unilateral dacryoadenitis, and idiopathic orbital inflammation that presented as progressive unilateral right-sided proptosis. The spectrum of inflammatory orbital diseases can make discerning between different entities challenging, but more unique in this case was the simultaneous presentation with bilateral silent sinus syndrome, a rare entity in its own right. Identifying each of these concurrent disease processes is important to establishing a multidisciplinary treatment approach to address all the patient's orbital and peri-orbital pathology. Read More

J Pak Med Assoc 2017 Jul;67(7):1104-1106

Aga Khan University Hospital, Karachi, Pakistan.

Graves ophthalmopathy (GO) usually occurs in a close temporal relationship with hyperthyroidism. It is rare in patients with normal thyroid function (euthyroid GO) and in patients with hypothyroid forms of thyroid autoimmune diseases (hypothyroid GO). We report a 52-years old man presenting in our endocrine clinic with diagnosed primary hypothyroidism 3 months back during evaluation for glaucoma. Read More

Chin Med J (Engl) 2017 08;130(15):1884-1885

Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China.

Curr Opin Ophthalmol 2017 Sep;28(5):505-513

aJohns Hopkins University, Baltimore, Maryland, USA bKing Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

Purpose Of Review: To report the most recent therapeutic advances of thyroid eye disease (TED) and offer general recommendations for management of TED.

Recent Findings: Treatment of Graves ophthalmopathy is traditionally based on the use of high doses of corticosteroids and/or radiotherapy (RT) to decrease the activity of the disease, with the subsequent proptosis, strabismus and eyelid deformites treated with different surgical procedures. In recent years, the evidence that oxidative stress plays a relevant role in exacerbating TED severity has encouraged the use of antioxydative agents such as selenium, which has shown a capacity in limiting the disease progression. Read More

Zhonghua Yan Ke Za Zhi 2017 Jun;53(6):430-435

Department of Ophthalmology, Tianjin First Center Hospital, Tianjin 300192, China.

To explore the feasibility of the semi-quantitative rectus extraocular muscle (EOM) parameters of dynamic contrast-enhanced magetic resonance imaging (DCE-MRI) in assessing the clinical course of thyroid associated ophthalmopathy (TAO). It was a retrospective case series study. A total of 136 cases of TAO were recruited from March 2011 to October 2012 in the Tianjin the first center hospital including 63 males and 72 females, aged 24. Read More

Zhonghua Yan Ke Za Zhi 2017 Jun;53(6):424-429

Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Myopia Key Laboratory of Health Ministry, Shanghai 200031, China.

To analyze the change of globe position after different orbital decompression in thyroid-associated ophthalmopathy (TAO). It was a retrosective case series study. Twenty-nine TAO patients (33 eyes) underwent orbital decompression were collected between October 2014 and December 2016 at Eye & ENT Hospital of Fudan University. Read More

Zhonghua Yan Ke Za Zhi 2017 Jun;53(6):416-423

Institute of orbital diseases, the General Hospital of the Armed Police Force, Beijing 100039, China.

To evaluate the effectiveness of maximal orbital decompression in treatment for severe dysthyroid optic neuropathy (DON) of thyroid associated ophthalmopathy (TAO) and predictive factors of this therapy. The group consisted of 21 patients (30 eyes) with DON. The diagnosis was based on the following criteria: Deterioration of best corrected visual acuity (VA≤0. Read More

Trans Am Ophthalmol Soc 2016 Aug 24;114:T9. Epub 2017 May 24.

Department of Ophthalmology, California Pacific Medical Center (Dr Silkiss or and Department of Psychology, University of York (Dr Wade or

Purpose: To evaluate whether patients with Graves' dysthyroid ophthalmopathy (GDO) have changes in brain anatomy that can be assessed by neuroimaging as compared to age-matched controls.

Methods: We examined 10 female, euthyroid patients with GDO and 14 age and gender matched controls using high-resolution structural MRI scanning. An automatic cortical segmentation algorithm was used to estimate the thickness of each subject's gray matter across the brain. Read More

Isr Med Assoc J 2017 05;19(5):277-281

Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Thyroid-associated ophthalmopathy (TAO) is an inflammatory disease that affects the thyroid gland and the eye orbit. Of patients with TAO, 3%-5% have severe sight-threatening disease due to optic neuropathy Optical coherence tomography (OCT), the non-invasive imaging technology that yields high-resolution cross-sectional images of the retina, provides qualitative and quantitative data on the retina.

Objectives: To apply this technique to quantitatively assess retinal nerve fiber layer (RNFL) and macular ring thicknesses in healthy subjects and in patients with TAO to determine their relationship to the severity of the orbital disease. Read More

Front Med 2017 Sep 13;11(3):359-364. Epub 2017 May 13.

Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.

Thyroid-associated orbitopathy (TAO) is an inflammatory autoimmune disorder. The most serious complication of TAO is dysthyroid optic neuropathy (DON), which can lead to permanent vision loss because of volume expansion in the orbital apex. Orbital radiation therapy (ORT) is an anti-inflammatory treatment used in the treatment of active TAO. Read More

Invest Ophthalmol Vis Sci 2017 05;58(5):2527-2533

Orbit and Oculofacial Service, Department of Ophthalmology, National University Hospital, Singapore.

Purpose: To radiologically examine for the presence of bony remodeling of the orbit in thyroid eye disease (TED).

Methods: Computed tomography (CT) scans of 248 orbits of 124 patients with TED and 185 orbits of 138 controls were retrospectively reviewed, and the following parameters measured: the angle of the inferomedial orbital strut (AIOS), the angle of the medial wall (AMW), and the diameters of the extraocular muscles. The association of TED with the AIOS or AMW was analyzed with linear regression models, and the correlations between the AMW or AIOS measurements with the extraocular muscle measurements were determined. Read More