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[Thyroid ophthalmopathy: clinical and tomographic study]

J Ampudia1, E Guardia, P Castrillo

  • 1Servicio de Endocrinología, Hospital de la Santa Creu i Sant Pau, Barcelona.

Medicina Clinica
|March 27, 1993
PubMed
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Hertel exophthalmometer (HE) measurements of exophthalmos in thyroidal ophthalmopathy were higher than computed tomography (CT) but well-correlated. Medial rectus muscle enlargement on CT was common but not linked to disease duration or severity.

Area of Science:

  • Ophthalmology
  • Radiology
  • Endocrinology

Background:

  • Thyroidal ophthalmopathy, often Graves' disease, causes exophthalmos and extraocular muscle changes.
  • Accurate exophthalmos measurement and understanding muscle involvement are crucial for patient management.

Purpose of the Study:

  • Compare exophthalmos measurements using Hertel exophthalmometer (HE) versus computed tomography (CT).
  • Evaluate extraocular muscle width on CT and its correlation with the clinical course of thyroidal ophthalmopathy.

Main Methods:

  • Reviewed 118 orbits from 59 patients with thyroidal ophthalmopathy (Graves' disease or Hashimoto's thyroiditis).
  • Measured exophthalmos using HE and CT; analyzed medial rectus (MR) muscle width on CT using coronal and mid-axial scans.
  • Assessed MR width using the Hallin and Feldon technique.

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Main Results:

  • HE exophthalmos measurements (22.5-23.2 mm) were significantly higher than CT measurements (20.8-20.9 mm) (p < 0.00001), with good correlation (r = 0.72-0.65).
  • Mean MR width on mid-axial CT scans was 4.1-4.2 mm.
  • Medial rectus was the most frequently enlarged extraocular muscle on coronal CT scans, followed by superior, inferior, and lateral rectus.

Conclusions:

  • HE provides a reliable, albeit higher, measurement of exophthalmos compared to CT in thyroidal ophthalmopathy.
  • Medial rectus muscle enlargement is a common finding in CT imaging but does not correlate with disease duration or severity.