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Asymmetric proptosis in thyroid eye disease.

Khizar Rana1,2, Devanshu Garg3,4, Lee Shien S Yong3,4

  • 1Department of Ophthalmology and Visual Sciences, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia. khizar.rana@adelaide.edu.au.

International Ophthalmology
|April 27, 2024
PubMed
Summary

Asymmetric thyroid eye disease (TED) affects one-third of patients and is linked to larger eye muscle volumes. This suggests muscle enlargement contributes to the asymmetry in proptosis.

Keywords:
AsymmetryOrbitThyroid eye disease

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Area of Science:

  • Ophthalmology
  • Endocrinology

Background:

  • Thyroid eye disease (TED) can manifest with asymmetry in orbital presentation.
  • Understanding the prevalence and associations of asymmetric TED is crucial for diagnosis and management.

Purpose of the Study:

  • To determine the prevalence of asymmetric TED in an Australian cohort.
  • To investigate clinical, biochemical, and radiological factors associated with asymmetric TED.

Main Methods:

  • Retrospective analysis of 86 patients with TED, utilizing Hertel exophthalmometry and orbital CT scans.
  • Asymmetry defined as ≥3 mm difference in globe protrusion.
  • Extraocular muscle volumes quantified via CT scan segmentation.

Main Results:

  • 33% of patients exhibited asymmetric TED.
  • No significant differences in demographics, thyroid status, or disease activity between asymmetric and non-asymmetric groups.
  • Significantly greater extraocular muscle volumes were found in the asymmetric orbit.

Conclusions:

  • Asymmetric TED is common and associated with increased extraocular muscle volumes.
  • Muscle enlargement is a potential contributor to asymmetric proptosis in TED.
  • TED should be considered in the differential diagnosis of asymmetric orbital inflammatory conditions.