scholarly journals Clinical and Radiological Findings in Patients with Newly Diagnosed Graves’ Ophthalmopathy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yakup Cevik ◽  
Hande Taylan Sekeroglu ◽  
Burce Ozgen ◽  
Kadriye Erkan Turan ◽  
Ali Sefik Sanac
Keyword(s):  
Patient Group ◽  
Oblique Muscle ◽  
Graves Disease ◽  
Newly Diagnosed ◽  
Mri Examination ◽  
Graves Ophthalmopathy ◽  
The Mean ◽  
The Right ◽  
And Control ◽  
Superior Oblique

Background. Graves’ ophthalmopathy is the most common extrathyroidal manifestation of Graves’ disease. The objective of this study was to investigate the clinical ophthalmological and MRI findings in newly diagnosed Graves’ ophthalmopathy. Methods. This study included 36 newly diagnosed Graves’ disease patients and 23 control participants. Patients and control participants underwent detailed ophthalmologic examination. In addition, all subjects underwent orbital MRI examination; and sizes, cross-sectional areas, and signal intensities of extraocular muscles were also measured. Results. Based on MRI measurements, the mean exophthalmos in the left eye was significantly higher in the patient group when compared to those of controls (2.04 ± 0.29 vs. 1.85 ± 0.15 cm, p  = 0.003). The mean long diameter of inferior oblique muscle in both the right and left eyes were significantly shorter in patients when compared to those of controls ( p  = 0.001, p  = 0.002, resp.); however, the mean long diameter of superior oblique in the left eye was longer in patients than those of controls ( p  = 0.001). Patients had significantly higher superior oblique muscle signal intensity than those of controls in the right eye ( p  = 0.01). There was no significant difference for the other parameters between the patient and control groups. Conclusion. Our findings suggest that there is no obvious change in MRI examination despite clinical ophthalmological findings in patients with newly diagnosed Graves’ ophthalmopathy. Unnecessary MRI examination should be avoided in this patient group due to unsatisfactory cost-effectiveness.

scholarly journals Isolated Superior Oblique Muscle Swelling Causing Acute Vertical Strabismus in Graves’ Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Keiichi Aomatsu ◽  
Shunji Kusaka
Keyword(s):  
Thyroid Stimulating Hormone ◽  
Oblique Muscle ◽  
Graves Disease ◽  
Related Factors ◽  
Muscle Involvement ◽  
Disease Case ◽  
The Right ◽  
Superior Oblique Muscle ◽  
Superior Oblique ◽  
Stimulating Hormone

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. Antibody tests for myasthenia gravis were negative. However, blood tests revealed abnormal levels of thyroid-related factors, such as decreased thyroid-stimulating hormone, elevated free T3 and T4, and elevated anti-thyroid-stimulating hormone receptor antibody. We performed magnetic resonance imaging (MRI), which showed slight enlargement of the left superior oblique muscle. The patient was eventually diagnosed with Graves’ disease with superior oblique muscle involvement and underwent a thyroidectomy. Three months postoperatively, her diplopia and abnormal eye movements had substantially resolved. Conclusion. Isolated superior oblique muscle involvement may be a presenting symptom of Graves’ disease. It should be taken into consideration that, in the early stages of thyroid-associated ophthalmopathy (TAO) in adults, only the superior oblique muscle may be enlarged.

scholarly journals A Clinical Investigation about Horizontal Heterophoria Among Newly Diagnosed Myopia Juveniles in Nanchong District of China

2019 ◽  
Author(s):  
Ying Li Yan ◽  
Long Li ◽  
Ying Wang ◽  
Peng Guan Zeng ◽  
Chun Yun Zou
Keyword(s):  
Prevention And Control ◽  
Statistical Difference ◽  
Clinical Investigation ◽  
Mean Deviation ◽  
Newly Diagnosed ◽  
School Students ◽  
High Prevalence ◽  
Prevention And Treatment ◽  
The Mean ◽  
And Control

Abstract Background: To establish the prevalence and distribution of heterophoria in low myopia juveniles and and provide evidence of myopia prevention and treatment. Methods: Near and distant heterophoria were administered to the patients who were diagnosed of low myopia at their first visit in clinic. Tthe Von Graefe method was performed to test near, distant horizontal heterophoria types and degrees. Statistical analysis was performed with SPSS17.0 software. Results: A total of 150 students were participated in this study. Distant and near phoria was detected in 92.67% and 96.00% of the students respectively. exophoria was more common than esophoria(diantant:79.33% vs 13.33%; near:86.67% vs 9.33%, P<0.05), and the mean deviation of diantant and near heterophoria was -1.97△ and -3.91△. There was a statistical difference between the near and distant heterophoria (P<0.05). Conclusions: Most myopia juveniles have different extents of exophoria. Due to the high prevalence of heterophoria in myopia, in the process of refraction, attention should be paid to the examination of binocular visual function parameters such as heterophoria, which is conducive to the issuance of suitable optical correction prescriptions and the reasonable measures for myopia prevention and control. Keywords: Heterophoria, myopia, juvenile school students

Asymmetric superior oblique split Z-tendon lengthening for face turn in bilateral asymmetric superior oblique overaction and exotropia

2020 ◽  
pp. 112067211989798
Author(s):  
Massimiliano Serafino ◽  
Matteo Scaramuzzi ◽  
Claudia Specchia ◽  
Francesco Bonsignore ◽  
Paolo Nucci
Keyword(s):  
Oblique Muscle ◽  
Intermittent Exotropia ◽  
Left Turn ◽  
Vertical Deviation ◽  
Tendon Lengthening ◽  
The Face ◽  
The Right ◽  
Clinical Records ◽  
Superior Oblique Muscle ◽  
Superior Oblique

Introduction: The aim was to evaluate the effectiveness of the procedure of the superior oblique split Z-tendon lengthening to collapse A pattern and treat face turn in a cohort of patients with both incomitant intermittent exotropia and a vertical deviation associated with a bilateral asymmetric superior oblique overaction. Methods: We retrospectively reviewed the clinical records of patients with facial turn associated with intermittent exotropia and bilateral asymmetric superior oblique overaction, who underwent superior oblique muscle split tendon lengthening and concurrent horizontal surgery between 2009 and 2017. Results: A total of eight patients met the inclusion criteria. The preoperative average face turn was 26.8° (range, 20°–5°), and it significantly improved to 5.4° (range, 2°–8°) ( p < 0.05). All the patients showed an improvement in the face turn with neutralization of the vertical deviation. The vertical deviation in the right gaze for the patient with a right turn and the left gaze in patients with left turn improved significantly (values of p < 0.05). Conclusion: The superior oblique split Z-tendon lengthening was an effective procedure to collapse the A pattern and the treatment of the face turn in a cohort of patients with both incomitant intermittent exotropia and a vertical deviation associated with a bilateral asymmetric superior oblique muscle overaction with less complications, and less varying results.

Location of the middle cranial fossa dural plate in patients with chronic otitis media

2014 ◽  
Vol 128 (1) ◽  
pp. 60-63 ◽  
Author(s):  
S Genc ◽  
M G Genc ◽  
I B Arslan ◽  
A Selcuk
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Middle Cranial Fossa ◽  
Control Group ◽  
Adjacent Structures ◽  
Cranial Fossa ◽  
The Mean ◽  
Bone Scans ◽  
The Right ◽  
And Control

AbstractAim:This study aimed to determine whether or not the middle cranial fossa dural plate is located lower (i.e. more caudally) in patients with chronic otitis media, relative to adjacent structures.Methods:The authors retrospectively investigated computed tomography temporal bone scans of 267 ears of 206 patients who had undergone surgery with a diagnosis of chronic otitis media, together with scans of 222 ears of 111 patients without chronic otitis media. The depth of the middle cranial fossa dural plates was recorded.Results:The mean depth of the middle cranial fossa dural plate was 4.59 mm in the study group and 2.71 mm in the control group (p < 0.001). The middle cranial fossa dural plate was located lower in the right ear in both the study and control groups.Conclusion:The middle cranial fossa dural plate was located lower in patients with chronic otitis media, and in the right ears of both patients and controls. Surgeons should take this low location into consideration, and take extra care, during relevant surgery on patients with chronic otitis media.

Proteomic Analysis of Waldenstrom Macroglobulinemia (WM) Using Nanoscale Protein Micorarray Techniques.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 504-504
Author(s):  
Yazan Alsayed ◽  
Michael Timm ◽  
Alexey Leontovich ◽  
Daniel Santos ◽  
Allen Ho ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Mtor Inhibitors ◽  
Pi3k Pathway ◽  
Protein Quantification ◽  
Minimal Amount ◽  
Newly Diagnosed ◽  
Apoptosis Protein ◽  
The Mean ◽  
And Control ◽  
Control Samples

Abstract The objective of this study was to determine the molecular alterations that occur at the protein level in patients with WM in order to identify novel targets of therapy, determine new markers of prognosis, and begin to delineate the pathogenesis of WM. Five bone marrow samples were obtained after informed consent from patients with symptomatic WM. Two bone marrow samples were obtained from age-matched controls and were pooled. All samples were purified with anti-CD19+ beads with over 90% purity. Protein quantification was performed and 1ug of protein was obtained for each sample and control. The nanoscale protein micorarray technique (BD Clontech, CA) was used to measure changes in the patterns of protein expression between WM samples and control lymphocytes. This is a new technique that detects differences in protein abundance between the tumor and control samples by hybridizing fluorescently labeled (Cy3 and Cy5) protein mixtures onto slides spotted with 512 monoclonal antibodies against human polypeptides. It requires minimal amount of protein. Two microarray slides were used for each experiment and a control experiment of control versus control was performed for normalization of the data. The slides were scanned using the Axon GenePix 4000B scanner. Two ratios were generated from the spot images for each protein target. The mean of the ratios of Cy5/Cy3 of both slides were analyzed using Clontech software and used to calculate an Internally Normalized Ratio (INR = ÷Ratio1/Ratio2, ratios 1 and 2 correspond to slides 1 and 2) for each spot on the array. The INR values were input into GeneSpring 6.0 software (Silicon Genetics, Redwood City CA). The data was normalized to the mean INR of the control samples. Proteins whose expression fold change relative to control was greater than 1.3 fold were determined. All samples were of symptomatic WM. There were 3 females and 2 males. The median age was 61 years (range, 47–83). Four patients were newly diagnosed and one had received prior rituximab, CHOP ad thalidomide therapy. Clustering analysis did not demonstrate a difference between newly diagnosed and treated samples. There were 72 proteins up or downregulated by 1.3 fold in all WM samples as compared to control. These included proteins in the PI3K pathway such as VHR, PTP1B, PI3K (p110alpha) and Rb2. Protein kinases such as PKCi, PKCbeta, PKC gamma, PKC delta, PLCgamma were all upregulated in WM samples. Other proteins included the B-cell specific activator protein PAX-5, the ubiquitin protein UBCH6, the STAT kinase STAT4, the GTPase Rho A-binding kinase ROK alpha, and the apoptosis protein SMAC/DIABLO. We demonstrate that several isoforms of the PKC family of proteins are upregulated in WM. PKC proteins regulate apoptosis, proliferation and migration in many cancer cells. These proteins may be useful targets of therapy in future clinical trials in WM. Other inhibitors that may be useful in WM include ubiqutin/proteosome inhibitors such as bortezomib and PI3K pathway inhibitors such AKT or mTOR inhibitors. Our results also confirm the presence of PAX-5 in WM consistent with previous cytogenetic studies. Supported in part by an ASH scholar award and Research Fund for Waldenstrom.

Clinical and pathological significance of sibling Graves' disease

1980 ◽  
Vol 94 (4) ◽  
pp. 498-502 ◽  
Author(s):  
Toshio Tanaka ◽  
Shoichi Katayama ◽  
Kanji Kuma ◽  
Hajime Tamai ◽  
Fumio Matsuzuka ◽  
...  
Keyword(s):  
Subtotal Thyroidectomy ◽  
Graves Disease ◽  
Lymphoid Follicles ◽  
Mean Values ◽  
Significant Difference ◽  
Thyroid Glands ◽  
History Of ◽  
The Mean ◽  
And Control ◽  
Age And Sex

Abstract. The clinical picture and serum antithyroid antibodies in 16 pairs of siblings with Graves' disease were compared with an age and sex matched group of 32 patients with Graves' disease who did not have a family history of any thyroid disease (control patients). There was a significant difference in frequency and mean titres of antibodies to thyroglobulin between sibling patients. (positive 76.0%) and control patients (positive 40.0%), but not in microsomal antibodies (sibling; positive 92.0%, control; 92.0%). There were no significant differences in the mean values of 24 h 131I-thyroidal uptake, serum T3U, serum T4 and T3 concentrations before treatment between the two groups. Lymphoid follicles and degeneration of the epithelia were more often found in the thyroid glands of sibling patients than in those of the control patients, when 32 (16 sibling, 16 control) thyroid glands from the same groups in the clinical study, including antibody series, were examined pathologically after subtotal thyroidectomy for Graves' disease. Moreover, there was a strong tendency to increased lymphocyte and plasma cell infiltration in the thyroid glands of sibling patients with Graves' disease. The findings might indicate that Graves' disease is closely related to Hashimoto's thyroiditis, especially in sibling patients with Graves' disease.

scholarly journals Serum Immunogllobulin G Levels in Graves’ disease Patients at Various Stages of Antithyroid Therapy

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
N Kousar ◽  
M Tayyab ◽  
A Ditta ◽  
F Kamal ◽  
SN Chaudhary
Keyword(s):  
Drug Therapy ◽  
Therapy Group ◽  
Antithyroid Drug ◽  
Graves Disease ◽  
Newly Diagnosed ◽  
Antithyroid Drug Therapy ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Normal Controls

Thirty six patients with Graves’ disease (GD), diagnosed on the basis of clinical examination and appropriate laboratory tests were classified into three groups (A-C): Group A: twelve newly diagnosed Graves’ disease patients; Group B: twelve hyperthyroid Graves’ disease patients on Antithyroid drug therapy and Group C: twelve Graves’ disease patients who had been rendered cuthyroid with Antithyroid drug (ATD) therapy, Serum lgG was determined  by radial immunodiffusion method using commercially available kits (The Binding Site UK). The mean lgG in newly diagnosed patients with GD (Group A) was 18.78±1.81. It was 22.75 ± 1.89 in hyperthyroid GD patients on drug therapy (Group B), 14.3±0.8 in GD patients who were rendered euthyroid with drug therapy (Group C) and 11.85±0.72 in normal controls. The lgG level of group A patients were not significantly different from those of Group B. However, the levels of lgG and lgA were significantly low in group C Graves’ disease patients as compared to group A patients. A significant reduction in lgG LEVEL IN Graves’ disease patients who were rendered cuthyroid after Antithyroid drug therapy as compared to newly diagnosed Graves’ disease patients indicate the immunosuppressive effect of Antithyroid drug therapy.

scholarly journals Corticosteroids in Moderate-To-Severe Graves’ Ophthalmopathy: Oral or Intravenous Therapy?

2019 ◽  
Vol 16 (1) ◽  
pp. 155 ◽  
Author(s):  
Laura Penta ◽  
Giulia Muzi ◽  
Marta Cofini ◽  
Alberto Leonardi ◽  
Lucia Lanciotti ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Anterior Segment ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Free Triiodothyronine ◽  
Upper Eyelid ◽  
Conjunctival Hyperaemia ◽  
Graves Ophthalmopathy ◽  
Antibody Positivity ◽  
The Right

Background: Ophthalmopathy is a rare extra-thyroid manifestation of Graves’ disease, in paediatrics. Intravenous corticosteroids are the main treatment of moderate-to-severe Graves’ orbitopathy. In this paper, we describe a moderate-to-severe active Graves’ ophthalmopathy in a child and the response to oral therapy with prednisone. Case presentation: A nine-year-old male child suffering for a few months, from palpitations, tremors, and paresthesia was hospitalized in our Pediatric Clinic. At admission, the thyroid function laboratory tests showed hyperthyroidism with elevated free thyroxine (FT4) and free triiodothyronine (FT3) levels and suppressed thyroid-stimulating hormone (TSH) levels. These findings, combined with the clinical conditions—an ophthalmologic evaluation (that showed the presence of exophthalmos without lagophthalmos and visual acuity deficiency), thyroid ultrasound, and TSH receptor antibody positivity—led to a diagnosis of Graves’ disease. Therefore, methimazole was administered at a dose of 0.4 mg/kg/day. After 4 months, thyroid function was clearly improved, with normal FT3 and FT4 values and increasing TSH values, without adverse effects. Nevertheless, an eye examination showed ophthalmopathy with signs of activity, an increase in the exophthalmos of the right eye with palpebral retraction, soft tissue involvement (succulent and oedematous eyelids, caruncle and conjunctival hyperaemia and oedema) and keratopathy, resulting from exposure. We began steroid therapy with oral administration of prednisone (1 mg/kg/day) for four weeks, followed by gradual tapering. After one week of therapy with prednisone, an eye assessment showed reduced retraction of the upper eyelid of the right eye, improvement of right eye exophthalmometry and reduction of conjunctival hyperaemia. After four weeks of therapy with prednisone, an eye assessment showed reduction of the right palpebral retraction without conjunctival hyperaemia and no other signs of inflammation of the anterior segment; after twelve weeks, an eye assessment showed a notable decrease in the right palpebral retraction and the absence of keratitis, despite persisting moderate conjunctival hyperaemia. No adverse event associated with steroid use was observed during the treatment period and no problem in compliance was reported. Conclusion: Prednisone seems a better choice than intravenous corticosteroids, for treating moderate-to-severe and active Graves’ ophthalmopathy, keeping in mind the importance of quality of life in pediatric patients.

scholarly journals Isolated pathetick nerve paresis by compression from a dolichoectatic basilar artery: case report

2007 ◽  
Vol 65 (1) ◽  
pp. 176-178 ◽  
Author(s):  
Péricles Maranhão-Filho ◽  
Antonio Aversa Dutra do Souto ◽  
Jânio Nogueira
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Basilar Artery ◽  
Head Position ◽  
Oblique Muscle ◽  
Ophthalmic Examination ◽  
Nerve Paresis ◽  
The Right ◽  
Superior Oblique Muscle ◽  
Superior Oblique

The article describes a woman with 53 year-old that has presented diplopia when looking down and adopted a tilted head position in order to read for the last six months. The neuro-ophthalmic examination shows isolated right superior oblique muscle paresis. The magnetic resonance and the angioresonance show the dolicoectatic basilar artery compressing the right ventral lateral brainstem.

scholarly journals Optic Nerve Sheath Diameter and Retinal Artery Resistive Index Measurements with Bedside Ophthalmic Ultrasound in Pediatric Patients with Pseudotumor Cerebri Syndrome

2020 ◽  
Vol 09 (03) ◽  
pp. 181-187 ◽  
Author(s):  
Nagehan Aslan ◽  
Dincer Yildizdas ◽  
Neslihan Ozcan ◽  
Ozden Ozgur Horoz ◽  
Gulen Gul Mert ◽  
...  
Keyword(s):  
Patient Group ◽  
Resistive Index ◽  
Pseudotumor Cerebri ◽  
Optic Nerve Sheath Diameter ◽  
Control Group ◽  
Opening Pressure ◽  
Retinal Artery ◽  
The Mean ◽  
The Right

AbstractPseudotumor cerebri syndrome (PTCS) is characterized by raised intracranial pressure (ICP) with no neuroradiological abnormalities. Ocular ultrasound has been in use to measure optic nerve sheath diameter (ONSD), and retinal artery Doppler indices have been used for indirect assessment of ICP by pediatric intensivists. Here, we aimed to evaluate the correlation of the lumbar puncture (LP) opening pressure with the ultrasonographic ONSD and retinal resistive index (RRI) measures in patients with PTCS. And we wanted to find an answer to the following question: Can ultrasonographic ONSD measures serve as a follow-up tool in patients with PTCS? A prospective, single-center, case–control study was performed by pediatric intensive care and pediatric neurology departments. A total of 7 patients with PTCS were evaluated as patient group and 15 healthy children were evaluated as control group. The mean age of patient group was 138.8 ± 43.7 months. The mean right ONSD was 6.7 ± 0.5 mm and the mean left ONSD was 6.7 ± 0.6 mm. The mean right RRI value was 0.73 ± 0.03 and the mean left RRI was 0.73 ± 0.09. For the patient group, ONSD and RRI values of both eyes were statistically significant higher values than for the control group. The mean LP opening pressure was 56.57 ± 16.36 cmH2O. We detected strong, positive, and statistically significant correlations between the LP opening pressure and ONSD baseline measures for both the right eye (r = 0.882, p = 0.009) and the left eye (r = 0.649, p = 0.004). There was no correlation between opening pressure in LP and RRI measurements. We detected a statistically significant decrease in the right ONSD and left ONSD values and visual analog scale scores at the third-month follow-up. Our study results demonstrate that ultrasonographic ONSD measurements can be used as a noninvasive tool for assessment of the ICP at first admission and can be used as a follow-up tool in PTSC patients.

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