Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia College of Physicians and Surgeons, New York, New York, USA.
Ophthalmic Plast Reconstr Surg. 2011 Mar-Apr;27(2):102-10. doi: 10.1097/IOP.0b013e3181e9a063.
Evaluate the relationship between extraocular muscle (EOM) size, measured by computed tomography, and ocular motility in thyroid eye disease (TED).
This case series is based on a retrospective review of the records of 54 patients (108 orbits) with TED. Main outcome measures included EOM size and degree of motility restriction. The average diameter of each rectus muscle was compared with published norms. Four subpopulations based on Age (< 40 or ≥ 40 years) and State of thyroid eye disease (active or stable) were studied. Versions were measured by the corneal light reflex method. The trend of muscle diameter versus motility restriction was evaluated.
The average EOM diameter was greater than the norm in the study cohort and 4 subpopulations. The average diameter was largest in the Older and Active TED subpopulations. The inferior rectus and medial rectus were most frequently restricted in the study cohort and 4 subpopulations. The medial rectus had the strongest trend between increasing diameter and motility restriction, followed by the inferior rectus and the superior muscle group (comprised of the superior rectus and levator palpebrae superioris). However, there was a general lack of strong correlation between the diameter of the rectus muscles and their respective motility, especially in the Younger subpopulation.
EOM diameters are larger and have more restricted motility in the Older and Active TED subpopulations. Contrary to prior publications, the correlation between EOM diameters and motility was weak, especially in the Younger subpopulation. These findings suggest that the pathophysiology of EOM enlargement is different based upon the age of the patient and the activity of the orbitopathy.
评估甲状腺眼病（TED）患者的眼外肌（EOM）大小（通过计算机断层扫描测量）与眼球运动之间的关系。
本病例系列研究基于对 54 例（108 只眼）TED 患者的记录进行的回顾性分析。主要观察指标包括 EOM 大小和运动受限程度。将每条直肌的平均直径与已发表的正常值进行比较。根据年龄（<40 岁或≥40 岁）和甲状腺眼病状态（活动或稳定）将患者分为 4 个亚组进行研究。通过角膜光反射法测量斜视度。评估了肌肉直径与运动受限之间的趋势关系。
研究队列和 4 个亚组的 EOM 平均直径均大于正常值。在年龄较大和活动期 TED 亚组中，平均直径最大。在研究队列和 4 个亚组中，下直肌和内直肌最常受限。内直肌的直径与运动受限之间的趋势最强，其次是下直肌和上直肌组（包括上直肌和上睑提肌）。然而，直肌直径与其各自运动之间的相关性通常较弱，尤其是在年轻亚组中。
在年龄较大和活动期 TED 亚组中，EOM 直径较大且运动受限更明显。与之前的文献报道相反，EOM 直径与运动之间的相关性较弱，尤其是在年轻亚组中。这些发现表明，EOM 增大的病理生理学机制因患者年龄和眼眶病变的活动度而异。
