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[甲状腺功能异常性眼病眼外肌增大的评估]

[Evaluation of extraocular muscle enlargement in dysthyroid ophthalmopathy].

作者信息

Murakami Y, Kanamoto T, Tsuboi T, Maeda T, Inoue Y

机构信息

Olympia Eye Hospital, Tokyo, Japan.

出版信息

Nippon Ganka Gakkai Zasshi. 2000 Jan;104(1):34-8.

Abstract

PURPOSE

To evaluate the extraocular muscle enlargement in dysthyroid opthalmopathy.

METHOD

Extraocular muscle enlargement was assessed by orbital computed tomography (CT) in 573 patients with dysthyroid ophthalmopathy in order to investigate the frequency and exact location of extraocular muscle enlargement and the clinical features of related ocular symptoms in patients with dysthyroid ophthalmopathy.

RESULTS AND CONCLUSION

187 patients (38% of the total) showed evidence of extraocular muscle enlargement on CT images, and this disorder were more frequent in male patients than in female patients. Extraocular muscle enlargement was also more frequently seen in older patients than in younger patients. Enlargement of a single muscle was found in 55% of the 187 patients, with the most frequently affected muscle being the inferior rectus muscle. When multiple muscles were enlarged, the inferior rectus muscle was the most frequently affected, followed by the medial rectus muscle. Of the clinical findings specific to dysthyroid ophthalmopathy examined in the present study, the incidence of exophthaomos, upper lid swelling, superior limbic keratoconjunctivitis, keratitis, diplopia, and dysthyroid optic neuropathy were significantly increased in patients with dysthyroid ophthalmopathy, indicating a close relationship between these findings and the underlying disease, but the incidence of upper lid retraction was not significantly increased.

摘要

目的

评估甲状腺功能异常性眼病患者的眼外肌增粗情况。

方法

对573例甲状腺功能异常性眼病患者进行眼眶计算机断层扫描(CT),以研究眼外肌增粗的频率、确切位置以及甲状腺功能异常性眼病患者相关眼部症状的临床特征。

结果与结论

187例患者(占总数的38%)CT图像显示有眼外肌增粗,这种情况在男性患者中比女性患者更常见。眼外肌增粗在老年患者中也比年轻患者更常见。在187例患者中,55%的患者发现单一肌肉增粗,最常受累的肌肉是下直肌。当多条肌肉增粗时,下直肌最常受累,其次是内直肌。在本研究中所检查的甲状腺功能异常性眼病特有的临床体征中,甲状腺功能异常性眼病患者眼球突出、上睑肿胀、上方角膜缘角结膜炎、角膜炎、复视和甲状腺功能异常性视神经病变的发生率显著增加,表明这些体征与潜在疾病密切相关,但上睑退缩的发生率没有显著增加。

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