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Brain Res 2022 Jun 20:147989. Epub 2022 Jun 20.

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing 100730, China. Electronic address:

Aim: To explore the morphological brain changes among active thyroid-associated ophthalmopathy (TAO) patients, inactive TAO patients and healthy controls and to investigate the neuropathological relationship of TAO using magnetic resonance imaging (MRI) data.

Methods: In this observational case-control study, we included 35 inactive TAO patients, 37 active TAO patients and 23 healthy controls. Voxel-based morphometry (VBM) analysis was conducted to evaluate the gray matter volume (GMV) changes among groups, and the correlations between GMV alterations and clinical parameters in active and inactive TAO groups were investigated. Read More

Cureus 2022 May 12;14(5):e24954. Epub 2022 May 12.

Department of Internal Medicine, King Saud University Medical City, Riyadh, SAU.

Graves' ophthalmopathy (GO) is commonly associated with hyperthyroidism secondary to Graves' disease (GD). Although rare, there have been case reports of it occurring in patients who are hypothyroid with underlying Hashimoto's thyroiditis (HT), as well as in euthyroid patients. Below, we describe a case of GO developing in a patient who has hypothyroidism secondary to HT successfully treated with high-dose steroids. Read More

Curr Eye Res 2022 May 23:1-7. Epub 2022 May 23.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China.

Purpose: To perform orbital magnetic resonance imaging (MRI) three-dimensional (3D) reconstruction based on volume rendering and analyse changes in soft tissues in dysthyroid optic neuropathy (DON) patients.

Methods: Using MRI 3D reconstruction based on volume rendering, orbital model parameters were compared with measurements made by observers. The fat volume (FV) and extraocular rectus muscle volume (EOMV) of subjects were calculated via MRI 3D reconstruction. Read More

Front Endocrinol (Lausanne) 2022 3;13:851143. Epub 2022 May 3.

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

Objective: To evaluate the microstructural changes of the orbital optic nerve in thyroid-associated ophthalmopathy (TAO) patients with or without dysthyroid optic neuropathy (DON) using diffusion tensor imaging (DTI) and investigate whether DTI can be used to detect DON.

Materials And Methods: 59 bilateral TAO patients with (n= 23) and without DON (non-DON, n= 36) who underwent pretreatment DTI were included and 118 orbits were analyzed. The clinical features of all patients were collected. Read More

Korean J Radiol 2022 Jun 26;23(6):664-673. Epub 2022 Apr 26.

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

Objective: To evaluate the performance of baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping of the extraocular muscles (EOMs) in the prediction of treatment response to intravenous glucocorticoid (IVGC) therapy for active and moderate-to-severe thyroid-associated ophthalmopathy (TAO) and to investigate the effect of fat-suppression (FS) in T2 mapping in this prediction.

Materials And Methods: A total of 79 patients clinically diagnosed with active, moderate-to-severe TAO (47 female, 32 male; mean age ± standard deviation, 46.1 ± 10 years), including 43 patients with a total of 86 orbits in the responsive group and 36 patients with a total of 72 orbits in the unresponsive group, were enrolled. Read More

Indian J Ophthalmol 2022 05;70(5):1736-1741

Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dong Cheng District, Beijing, China.

Purpose: To evaluate changes in the levator palpebrae superioris (LPS) muscle on 3.0 T magnetic resonance imaging (MRI) after triamcinolone acetonide injection for treating upper lid retraction (ULR) with Graves' ophthalmopathy (GO) and to explore the value of LPS muscle quantitative measurement for clinical treatment.

Methods: Patients with GO showing ULR were studied retrospectively and they underwent 3. Read More

Indian J Ophthalmol 2022 05;70(5):1446-1447

L V Prasad Eye Institute, Bhubaneswar, Odisha, India.

Int J Gen Med 2022 21;15:4273-4283. Epub 2022 Apr 21.

Department of Ophthalmology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, 330006, People's Republic of China.

Purpose: To explore the alterations in both local and remote brain connectivity in patients with thyroid-associated ophthalmopathy (TAO) and to investigate whether the alterations of local neural function could be used to distinguish patients with TAO from healthy controls (HCs) using support vector machine (SVM) classifier.

Materials And Methods: In total, 21 patients with TAO and 21 well-matched HCs were enrolled in our study and underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning. We employed regional homogeneity (ReHo) algorithm to evaluate local neural function and selected significantly altered brain regions as seed areas for subsequent study of the remote functional connectivity (FC). Read More

Sci Rep 2022 04 15;12(1):6259. Epub 2022 Apr 15.

Department of Neuroradiology, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany.

Goal of the study was to evaluate bony orbit remodeling and extraocular muscle (EOM) volume in thyroid eye disease (TED) and their role as predicting factors for development of dysthyroid optic neuropathy (DON). Orbital computed tomography of 92 patients with TED with (76 orbits) or without DON (98 orbits) were retrospectively evaluated. Orbits (n = 40) of subjects without TED served as controls. Read More

Eur J Radiol 2022 Jun 6;151:110295. Epub 2022 Apr 6.

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

Purpose: To investigate the feasibility of using magnetization transfer (MT) magnetic resonance imaging for evaluating patients with thyroid-associated ophthalmopathy (TAO), and determine its added value for differentiating active from inactive TAO and predicting clinical activity score (CAS), compared with conventional fat-saturated T2-weighted and diffusion-weighted imaging.

Methods: Orbital MT, fat-saturated T2-weighted, and diffusion-weighted imaging of 60 prospectively enrolled consecutive patients with TAO was analyzed. Simplified histogram parameters (mean, max, min) of magnetization transfer ratio (MTR), signal intensity ratio (SIR), and apparent diffusion coefficient (ADC) at extraocular muscles were calculated for each orbit and compared between the active and inactive groups. Read More

Biomed Res Int 2022 16;2022:9115270. Epub 2022 Mar 16.

Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.

Background: Laser speckle flowgraphy (LSFG) can be used to estimate optic nerve blood flow. This study used LSFG to evaluate optic nerve microcirculation in patients with thyroid eye disease (TED).

Methods: This was a retrospective review of patients with active TED who underwent LSFG between October 2020 and June 2021. Read More

Acta Radiol 2022 Mar 15:2841851221082419. Epub 2022 Mar 15.

Beijing Friendship Hospital, 26455Capital Medical University, Beijing, PR China.

Background: It is difficult to detect optic nerve changes in patients with thyroid-associated ophthalmopathy (TAO) before the development of optic neuropathy.

Purpose: To detect changes in the intraorbital segment of the optic nerve in patients with TAO using diffusion tensor imaging (DTI) and determine any correlations with disease severity.

Material And Methods: A total of 74 participants (17 normal, 22 mild, and 35 moderate-severe TAO) were organized to be given 3-T DTI to measure fractional anisotropy (FA) and mean diffusivity (MD) for the orbital segments of their optic nerves. Read More

PLoS One 2022 11;17(3):e0265324. Epub 2022 Mar 11.

Department of Ophthalmology, Leipzig University, Leipzig, Germany.

Purpose: This study aimed at evaluating the orbital anatomy of patients concerning the relevance of orbital anatomy in the etiology of EO (endocrine orbitopathy) and exophthalmos utilizing a novel approach regarding three-dimensional measurements. Furthermore, sexual dimorphism in orbital anatomy was analyzed.

Methods: Orbital anatomy of 123 Caucasian patients (52 with EO, 71 without EO) was examined using computed tomographic data and FAT software for 3-D cephalometry. Read More

Biomed Res Int 2022 27;2022:4808194. Epub 2022 Feb 27.

Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

Purpose: To demonstrate the changes in the retinal nerve fiber layer (RNFL) after orbital decompression for thyroid eye disease (TED).

Methods: We retrospectively enrolled 52 surgical TED patients, 30 nonsurgical TED patients, and 30 control subjects. Five surgical TED eyes with disc edema were excluded. Read More

Cureus 2022 Jan 28;14(1):e21695. Epub 2022 Jan 28.

Internal Medicine, Howard University, Washington, DC, USA.

Recurrent falls are a common cause of morbidity in the elderly population, as more than one-third of individuals aged 65 years or older experience falls each year. Falls remain a multifactorial phenomenon that can potentially result in devastating debilitation and hence require proper medical attention and management. In an elderly patient presenting with recurrent falls, the workup for differential diagnoses remains wide with various causes such as postural hypotension, syncope, seizures, arrhythmia, medication-induced, and cognitive impairment. Read More

Front Hum Neurosci 2021 4;15:805945. Epub 2022 Feb 4.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Objective: We aim to investigate the feasibility of using diffusion tensor imaging (DTI) to evaluate changes in extraocular muscles (EOMs) and lacrimal gland (LG) in patients with thyroid-associated ophthalmopathy (TAO) and to evaluate disease severity.

Materials And Methods: A total of 74 participants, including 17 healthy controls (HCs), 22 patients with mild TAO, and 35 patients with moderate-severe TAO, underwent 3-Tesla DTI to measure fractional anisotropy (FA) and mean diffusivity (MD) of the EOMs and LG. Ophthalmological examinations, including visual acuity, exophthalmos, intraocular pressure, and fundoscopy, were performed. Read More

BMC Ophthalmol 2022 Feb 10;22(1):66. Epub 2022 Feb 10.

Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Background: Studies on the factors related to lacrimal gland prolapse (LGP) in patients with thyroid-associated ophthalmopathy (TAO) are limited. This study aimed to assess the factors associated with LGP on magnetic resonance imaging (MRI) and its relation to TAO activity .

Methods: Thirty-six patients (72 orbits) with inactive TAO (43 orbits, Clinical Activity Score [CAS] < 3) or active TAO (29 orbits, CAS ≥3) were investigated retrospectively. Read More

J Magn Reson Imaging 2022 Jan 29. Epub 2022 Jan 29.

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

Background: MR imaging has been applied to determine therapeutic response to glucocorticoid (GC) before treatment in thyroid-associated ophthalmopathy (TAO), while the performance was still poor.

Purpose: To investigate the value of T -weighted imaging (T WI)-derived radiomics for pretreatment determination of therapeutic response to GC in TAO patients, and compare its diagnostic performance with that of semiquantitative parameters.

Study Type: Retrospective. Read More

Endocr Pract 2022 May 25;28(5):502-508. Epub 2022 Jan 25.

Thyroid Section, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Objective: Graves' disease (GD) is caused by the stimulation of thyrotropin receptors by autoantibodies. We compared the diagnostic accuracy of the thyroid-stimulating immunoglobulin (TSI) bioassay and thyrotropin-binding inhibitory immunoglobulin (TBII) assay in differentiating GD from other causes of thyrotoxicosis.

Methods: We retrospectively evaluated 493 patients with thyrotoxicosis who were tested with the third-generation TSI and TBII assays simultaneously. Read More

Rev Endocr Metab Disord 2022 06 23;23(3):541-567. Epub 2022 Jan 23.

Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 301B Cyberport 4, 100 Cyberport Road, Pokfulam, Hong Kong SAR.

Thyroid Eye Disease (TED) is an autoimmune disease that affects the extraocular muscles and periorbital fat. It most commonly occurs with Graves' Disease (GD) as an extrathyroidal manifestation, hence, it is also sometimes used interchangeably with Graves' Ophthalmopathy (GO). Well-known autoimmune markers for GD include thyroid stimulating hormone (TSH) receptor antibodies (TSH-R-Ab) which contribute to hyperthyroidism and ocular signs. Read More

Endocrine 2022 04 18;76(1):243-244. Epub 2022 Jan 18.

Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, PR China.

Orbit 2022 Feb 4;41(1):89-96. Epub 2022 Jan 4.

Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, Kallam Anji Reddy Campus, Lv Prasad Eye Institute, Hyderabad, India.

Purpose: To report the differences in choroidal vascularity index (CVI) in thyroid eye disease (TED) and normals and its discriminatory value for differentiating various stages of TED.

Methods: Prospective, cross-sectional, non-interventional imaging study. Ninety-four eyes of 54 patients were included and divided into 5 groups - normal controls (C), inactive TED (I), active TED (A), non-inflammatory active TED (NIA) and systemic hyperthyroid disorder but no TED (SYS). Read More

IEEE J Biomed Health Inform 2022 Jun 3;26(6):2606-2614. Epub 2022 Jun 3.

Identifying position errors for Graves' ophthalmopathy (GO) patients using electronic portal imaging device (EPID) transmission fluence maps is helpful in monitoring treatment. However, most of the existing models only extract features from dose difference maps computed from EPID images, which do not fully characterize all information of the positional errors. In addition, the position error has a three-dimensional spatial nature, which has never been explored in previous work. Read More

Front Neurosci 2021 6;15:799916. Epub 2021 Dec 6.

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

Thyroid-associated ophthalmopathy (TAO) is a debilitating and sight-threatening autoimmune disease that severely impairs patients' quality of life. Besides the most common ophthalmic manifestations, the emotional and psychiatric disturbances are also usually observed in clinical settings. This study was to investigate the interhemispheric functional connectivity alterations in TAO patients using resting-state functional magnetic resonance imaging (rs-fMRI). Read More

Int J Emerg Med 2021 Dec 18;14(1):74. Epub 2021 Dec 18.

Department of Emergency Medicine, Kirk Kerkorian School of Medicine at UNLV, 901 Rancho Lane, Ste 135, Las Vegas, NV, 89106, USA.

Background: Spontaneous globe subluxation (SGS) is an atraumatic anterior dislocation of the eyeball. It is exceedingly rare. Understanding SGS predisposing factors may help uncover its etiology and undertake vision-saving management. Read More

Cureus 2021 Oct 24;13(10):e19015. Epub 2021 Oct 24.

Internal Medicine, Texas Tech University Health Sciences Center, Odessa, USA.

Thyroid eye disease (TED), also known as Graves' orbitopathy or ophthalmopathy (GO) or Graves' eye disease, is an autoimmune condition of the retroocular tissues associated with Graves' disease. In isolated GO, the patient can present without thyroid hormone dysfunction or systemic symptoms of Graves' disease, in which case it is called euthyroid Graves' ophthalmopathy (EGO). It is very rare for this condition to have negative thyroid-stimulating hormone receptor (TSHR) autoantibodies, and we present such a rare case of a young female, who had progressive bilateral vision loss, intermittent left-sided retroocular headache, and severe bilateral proptosis. Read More

Thyroid 2022 03 11;32(3):283-293. Epub 2022 Jan 11.

Molecular Ophthalmology, Department of Ophthalmology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.

Graves' orbitopathy (GO) is an autoimmune-driven manifestation of Graves' disease (GD) where pathogenic autoantibodies to the thyrotropin receptor (TSHR) activate orbital fibroblasts/preadipocytes in the orbital tissue to induce inflammation and extracellular matrix deposition. Since there are significant limitations to study immunological and proinflammatory mediator expression in early and during disease progression in GO patients, we used our experimental mouse model to elucidate early pathogenic processes. We have developed a robust mouse model of GD/GO induced by electroporation immunization of plasmid encoding human TSHR A-subunit, comprising multiple injections over a course of 15 weeks to fully recapitulate the orbital pathology. Read More

Neuroreport 2021 12;32(18):1416-1422

Department of Ophthalmology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, Jiangxi.

Objectives: Previous studies demonstrated that thyroid-associated ophthalmopathy (TAO) patients were accompanied by cognitive decline. However, The exact neural mechanisms of cognitive decline in TAO patients remain unclear. Our study aimed to investigate the spontaneous brain activity alterations using amplitude of low-frequency fluctuation (ALFF) method and their relationships with clinical features in TAO patients. Read More

BMC Endocr Disord 2021 Nov 13;21(1):226. Epub 2021 Nov 13.

Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, NO.1, Friendship road, Yuzhong District, Chongqing, 400016, China.

Objective: Quantitatively staging TAO using MRI remains limited. Our study aims to identify the cut-off signal intensity value for staging TAO using STIR sequence scan.

Methods: Between June 2018 and July 2020, a number of 51 patients with TAO (102 eyes) and 19 volunteer controls (38 eyes) were recruited. Read More

Zhonghua Yan Ke Za Zhi 2021 Nov;57(11):830-836

Department of Ophthalmology, the Second Hospital of Dalian Medical University, Dalian 116027, China.

To explore the application value of Tc-diethylenetriaminepentaacetic acid (DTPA) orbital single photon emission computed tomography/computed tomography (SPECT/CT) in staging evaluation of thyroid associated ophthalmopathy (TAO). A case-control study. A total of 40 patients with binocular TAO were recruited from May 2019 to December 2019 in the Second Hospital of Dalian Medical University. Read More