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Lower Eyelid Contour in Graves Orbitopathy.

Denny Marcos Garcia1,2, Antonio Augusto Velasco Cruz1, Rodrigo Otávio Espírito Santo1

  • 1Department of Ophthalmology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.

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|June 13, 2019
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Summary

Graves orbitopathy alters lower eyelid shape, increasing curvature in both nasal and temporal regions. This geometric change is linked to eyelid retraction and lower eyelid position.

Keywords:
Bézier curvesGraves orbitopathycontour analysislower eyelidlower eyelid retraction

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Geometric Analysis

Background:

  • Graves orbitopathy is an autoimmune condition affecting the eye socket.
  • Eyelid abnormalities, including retraction, are common in Graves orbitopathy.
  • Quantitative analysis of lower eyelid contour changes is crucial for understanding disease impact.

Purpose of the Study:

  • To quantitatively analyze the lower eyelid contour in patients with Graves orbitopathy.
  • To compare the geometric features of lower eyelid contours between patients and healthy controls.

Main Methods:

  • Bézier curves were used to model lower eyelid contours from 41 Graves orbitopathy patients and 43 controls.
  • National Institute of Health (NIH) ImageJ and Matlab software were employed for contour analysis.
  • Curvature, contour peak, canthi position, and lacrimal punctum angles were measured and compared.

Main Results:

  • Increased curvature was observed in both temporal and nasal portions of the lower eyelid in Graves orbitopathy patients.
  • The degree of lower eyelid retraction (MRD2) correlated with temporal lid curvature.
  • The lower lacrimal punctum was significantly lowered, increasing the angle with the medial canthus.

Conclusions:

  • Increased lateral lower eyelid curvature in Graves disease is a geometric consequence of increased eyelid retraction (MRD2).
  • The nasal portion of the lower eyelid is also significantly affected, showing increased curvature due to retraction.