scholarly journals Orbital Volumetry in Graves' Orbitopathy: Muscle and Fat Involvement in relation to Dysthyroid Optic Neuropathy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Moug Al-Bakri ◽  
Åse Krogh Rasmussen ◽  
Carsten Thomsen ◽  
Peter Bjerre Toft
Keyword(s):  
Optic Nerve ◽  
Optic Neuropathy ◽  
Ct Scans ◽  
Orbital Decompression ◽  
Orbital Fractures ◽  
Relative Significance ◽  
Dysthyroid Optic Neuropathy ◽  
Orbital Fat ◽  
Graves Orbitopathy ◽  
Fat Volume

Purpose. We wanted to investigate the relative significance of fat and muscle enlargement in the development of dysthyroid optic neuropathy (DON) in Graves’ orbitopathy (GO). Methods. Preoperative coronal CT scans of 13 patients with and without DON who subsequently underwent orbital decompression were retrospectively analyzed. Thirteen patients imaged for unilateral orbital fractures served as controls. Results. The retrobulbar muscle volume was 2.1 ± 0.5 cm3 (mean ± SD) in controls, 4.3 ± 1.5 cm3 in GO without DON, and 4.7 ± 1.7 cm3 in GO with DON. The retrobulbar fat volume was 5.4 ± 1.6 cm3 in controls, 8.7 ± 8.0 cm3 in GO without DON, and 9.4 ± 3.1 cm3 in GO with DON. The muscle and fat volumes were higher in patients with GO than in controls (P<0.001), but the volumes in orbits with and without DON were not significantly different. The volume of the optic nerve were similar in the 3 groups. The number of apical, coronal 2 mm thick slices with no fat was 2.9 ± 0.9 in normal orbits, it was 4.1 ± 1.0 in GO orbits without DON and 5.3 ± 0.8 in GO orbits with DON (P=0.007). Conclusion. Apical muscle enlargement may be more important than orbital fat enlargement in the development of DON. However, the fact that apical crowding and muscle enlargement also occur in orbits without DON suggests that other factors also play a role in the development of DON.

“Balanced” Orbital Decompression for Severe Graves' Orbitopathy: Technique with Treatment Algorithm

2003 ◽  
Vol 128 (2) ◽  
pp. 228-235 ◽  
Author(s):  
Kacker Ashutosh ◽  
Kazim Michael ◽  
Murphy Mark ◽  
Trokel Stephen ◽  
G. Close Lanny
Keyword(s):  
Optic Nerve ◽  
Optic Neuropathy ◽  
Treatment Algorithm ◽  
Orbital Decompression ◽  
Nerve Function ◽  
Muscle Involvement ◽  
Compressive Optic Neuropathy ◽  
Average Decrease ◽  
Graves Orbitopathy ◽  
Low Incidence

BACKGROUND: Graves' orbitopathy can produce proptosis, compressive optic neuropathy, and extraocular motility abnormalities; symptoms result from an increase in orbital volume due to expansion of intraorbital fat, with or without extraocular muscle involvement. STUDY DESIGN: We conducted a chart review of patients who underwent orbital decompression to treat Graves' orbitopathy. Twenty-two orbits (13 patients) underwent orbital bone decompression, of which 17 orbits (9 patients) underwent the combined medial and lateral “balanced” decompression. RESULTS: All patients had significant improvement with an average decrease in proptosis of 5.9 mm in the balanced decompression group. Restoration of normal optic nerve function was achieved in all patients with compressive optic neuropathy. Diplopia was noted in 4 patients (30.7%) preoperatively. Two patients had new postoperative diplopia (15.35%). CONCLUSION: In our experience, “balanced” decompression results in a reduction of proptosis and improved optic nerve function and has a low incidence of complications.

Subclinical dysthyroid optic neuropathy: tritan deficiency as an early sign of dysthyroid optic neuropathy

2020 ◽  
pp. bjophthalmol-2020-316433
Author(s):  
Aylin Garip-Kuebler ◽  
Kathrin Halfter ◽  
Lukas Reznicek ◽  
Annemarie Klingenstein ◽  
Siegfried Priglinger ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Neuropathy ◽  
Colour Vision ◽  
Definitive Diagnosis ◽  
Early Sign ◽  
Dysthyroid Optic Neuropathy ◽  
Graves Orbitopathy ◽  
The Mean ◽  
Pathological Sign ◽  
Optic Nerve Compression

PurposeThe aim of this research was to investigate the subclinical findings of dysthyroid optic neuropathy (DON) and to look for early indicators for optic nerve compression in patients with Graves’ orbitopathy.Patients and MethodsIn this observational, retrospective study, the medical charts of 24 patients (32 eyes) with a diagnosis of DON between 2008 and 2019 were included. Our goal was to identify potential pathological signs in patients with DON prior to the definitive diagnosis of DON.ResultsWe discovered that the earliest pathological sign in the subclinical cases was tritan deficiency obtained with a standardised colour vision test by Arden. In all cases but one, regardless of the visual field (VF) defects, the tritan values were pathological (based on a threshold of ≥8%) in the subclinical phase. The mean tritan value was 19.12% (range 6.9–80.8%) at the time of the subclinical phase and 32.16% (range 6.3–100.0%) at the time of the diagnosis of DON. The sensitivity of the colour vision test was 20% for protan and 96.67% for tritan in the subclinical phase. At the time of the definitive diagnosis of DON, the sensitivity of protan was 48.15% compared to 96.30% for tritan.ConclusionWe found that changes in vision affecting the blue-yellow (tritan) colours resulting from the compression of optic nerve, even in affected patients with normal VF tests, are a reliable early sign of DON.

scholarly journals Imaging studies for diagnosing Graves' orbitopathy and dysthyroid optic neuropathy

Clinics ◽  
2012 ◽  
Vol 67 (11) ◽  
pp. 1327-1334 ◽  
Author(s):  
ACP Gonçalves ◽  
EM Gebrim ◽  
ML Monteiro
Keyword(s):  
Optic Neuropathy ◽  
Imaging Studies ◽  
Dysthyroid Optic Neuropathy ◽  
Graves Orbitopathy

scholarly journals Comparison of 2-wall versus 3-wall orbital decompression against dysthyroid optic neuropathy in visual function

Medicine ◽  
2021 ◽  
Vol 100 (8) ◽  
pp. e24513
Author(s):  
Sheng-Nan Cheng ◽  
Yue-Qi Yu ◽  
Ya-Yan You ◽  
Jin Chen ◽  
Xiao-Huan Pi ◽  
...  
Keyword(s):  
Optic Neuropathy ◽  
Visual Function ◽  
Orbital Decompression ◽  
Dysthyroid Optic Neuropathy

scholarly journals Preoperative clinical factors and visual outcomes following orbital decompression with dysthyroid optic neuropathy

2020 ◽  
Author(s):  
Mizuki Tagami ◽  
Shigeru Honda ◽  
Atsushi Azumi
Keyword(s):  
Visual Acuity ◽  
Optic Neuropathy ◽  
Japanese Patients ◽  
Decompression Surgery ◽  
Orbital Decompression ◽  
Clinical Factors ◽  
Dysthyroid Optic Neuropathy ◽  
Visual Outcomes ◽  
Additional Surgery ◽  
Case Series Study

Abstract Purpose: To investigate preoperative clinical factors and visual outcomes of Japanese patients with dysthyroid optic neuropathy (DON) after urgent orbital decompression. Methods: This retrospective, observational case series study investigated 44 patients who exhibited several preoperative clinical factors that might be associated with the need for urgent orbital decompression due to DON. Additionally, the visual acuity of DON patients was compared between the patients preoperatively and at 1 and 6 months postoperatively. Results: All 44 patients received steroid and with or without radiation therapy, with 27 patients able to avoid undergoing urgent surgery. However, the remaining 17 patients required urgent orbital decompression following a lack of response to the therapy. None of the patients who initially avoided surgery required additional surgery for DON. Factors significantly associated with the need for urgent orbital decompression surgery included: female gender, older age, long disease duration, unilateral significant DON, history of resistance to pulsed steroid therapy, unstable thyroid function, high TRAb(Thyrotrophin receptor antibody )value, poor visual acuity, presence of central diplopia, and presence of corneal problems ( P <0.05 each). The results also showed that postoperative visual outcomes of surgery for DON were acceptable. Conclusion: This study revealed several preoperative clinical factors for DON that appear to be associated with the need for urgent orbital decompression surgery in Japanese patients.

Efficacy of transethmoidal orbital decompression in patients with dysthyroid optic neuropathy

2020 ◽  
Vol 85 (6) ◽  
pp. 52
Author(s):  
Y.O. Grusha ◽  
P.A. Kochetkov ◽  
D.S. Ismailova ◽  
V.M. Svistushkin ◽  
N.V. Zhorzholadze ◽  
...  
Keyword(s):  
Optic Neuropathy ◽  
Orbital Decompression ◽  
Dysthyroid Optic Neuropathy
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