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Rundle's Curve: A Useful Construct That Does Not Fit All.
Antonio A V Cruz1, Juliana A Guimarães, Denny M Garcia
1Department of Ophthalmology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil.
Ophthalmic Plastic and Reconstructive Surgery
|December 6, 2023
Summary
Graves orbitopathy (GO) natural history data, including Rundle's original work, were analyzed. Most GO progression data do not follow the biphasic pattern Rundle described.
Area of Science:
- Ophthalmology
- Endocrinology
- Medical History
Background:
- Graves orbitopathy (GO) is an autoimmune condition affecting the eyes.
- Understanding the natural history of GO is crucial for patient management.
- Rundle's early work provided foundational observations on GO progression.
Purpose of the Study:
- To re-evaluate Rundle's original data on Graves orbitopathy.
- To analyze subsequent English literature on GO's natural history.
- To assess the validity of Rundle's proposed biphasic progression model.
Main Methods:
- Qualitative and quantitative analysis of Rundle's publications (1945-1957).
- Fitting serial measurements of proptosis and supraduction with various mathematical functions.
- Systematic review and analysis of subsequent English literature on GO natural history.
Main Results:
- Rundle's data on proptosis and supraduction measurements showed good fits with linear, parabolic, and exponential functions.
- Subsequent quantitative data on these variables also demonstrated good fits with various functions.
- The biphasic (dynamic and static) pattern described by Rundle was not consistently observed in his data or later studies.
Conclusions:
- Rundle's observations on ocular changes in GO are valuable but lack pathophysiological detail.
- The commonly cited 'Rundle's curve' may not accurately represent the natural history of GO for most patients.
- Further research is needed to refine models of GO progression, incorporating inflammatory and cicatricial phases.
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