Correlation between intraorbital structural alterations and diplopia in thyroid-associated ophthalmopathy: an...

Area of Science:

• Ophthalmology
• Endocrinology
• Radiology

Background:

• Thyroid-associated ophthalmopathy (TAO) is an autoimmune condition affecting the eye muscles and orbital tissues.
• Diplopia, or double vision, is a common and debilitating symptom in TAO patients.
• Understanding the structural basis of diplopia in TAO is crucial for effective management.

Purpose of the Study:

• To investigate the correlation between intraorbital tissue structures and diplopia in TAO patients using magnetic resonance imaging (MRI).
• To identify imaging biomarkers for predicting and understanding the development of diplopia in TAO.

Main Methods:

• Retrospective analysis of 228 TAO patients diagnosed between March 2021 and June 2024.
• Patients were categorized into diplopia (n=105) and non-diplopia (n=123) groups.
• Logistic regression and ROC curve analysis were used to evaluate imaging parameters and clinical factors.

Main Results:

• Increased thickness of the inferior, medial, and lateral rectus muscles, along with greater extraocular muscle volume (EMV), were identified as independent risk factors for diplopia (P<0.05).
• Higher thyroid-stimulating hormone receptor antibody (TRAb) levels were found to be an independent protective factor against diplopia (P<0.05).
• A combined predictive model using MRI parameters achieved an excellent area under the curve (AUC) of 0.986 for diplopia prediction.

Conclusions:

• MRI allows for quantitative assessment of intraorbital structural changes in TAO.
• MRI findings, when combined with clinical data, can aid in the early identification and intervention of diplopia in TAO patients.
• Specific MRI metrics can serve as valuable predictors of diplopia risk in TAO.