Eye Hospital Herzog-Carl-Theodor, Munich, Germany.
Acta Ophthalmol. 2012 Dec;90(8):713-20. doi: 10.1111/j.1755-3768.2011.02216.x. Epub 2011 Jul 29.
To establish whether or not the dynamics of saccadic eye movements are significantly changed in patients with different stages of thyroid-associated ophthalmopathy (TAO) and, subsequently, if analysis of saccades could serve as an additional diagnostic tool for early detection of inflammatory activity in TAO.
Thirty-seven patients with TAO and 10 age- and gender-matched control subjects were investigated. The patients were divided into four groups according to the stage of the disease: (i) early mild disease (n = 10), (ii) early severe disease (n = 11), (iii) long-standing restrictive disease (n = 10) and (iv) proven auto-immune hyperthyroidism without any signs of TAO (n = 6). Horizontal and vertical saccades with amplitudes of 10°, 20°, 30° and 40° were recorded binocularly using the induction scleral search coil technique. The two main sequence constants V(max) and C were calculated for each eye. Repeated measurement analysis of variance was carried out to test for differences between different gaze directions, eyes and groups.
In horizontal saccades, significant differences were found between groups but not between abduction and adduction. In vertical saccades, differences between groups and the interaction between groups and up- and down-gaze saccades were significant. Compared with the control group, analysis of the main sequence curves revealed larger differences in patients of group 3 and 4 than in those of group 1 and 2. Whereas in the control group down-gaze saccades were faster than up-gaze saccades, the opposite behaviour was found in all patient groups. The largest differences were detected among those patients who had no signs of TAO (group 4).
In this study, significant saccade differences were detected in all patients with TAO. In contrast to our earlier studies where evaluation of multiple individual saccade parameters did not reveal significant differences, analysis of the main sequence constants and mathematical reconstruction of the main sequence curves turned out to be a sensitive technique for reliable detection of subtle ocular motility changes. Significant differences were detected even in patients with auto-immune thyroiditis where no clinical signs of TAO were apparent.
确定不同阶段甲状腺相关眼病（TAO）患者的眼球扫视运动动力学是否发生显著变化，以及分析扫视运动是否可作为早期检测 TAO 炎症活动的附加诊断工具。
研究了 37 例 TAO 患者和 10 名年龄和性别匹配的对照者。根据疾病阶段将患者分为 4 组：（i）早期轻度疾病（n=10），（ii）早期重度疾病（n=11），（iii）长期限制性疾病（n=10）和（iv）已确诊自身免疫性甲状腺功能亢进但无任何 TAO 迹象的患者（n=6）。使用诱导性巩膜搜索线圈技术，双眼记录水平和垂直扫视，扫视幅度为 10°、20°、30°和 40°。为每只眼计算两个主要序列常数 V(max)和 C。进行重复测量方差分析以检验不同注视方向、眼和组之间的差异。
在水平扫视中，组间存在显著差异，但外展和内收之间没有差异。在垂直扫视中，组间差异以及组间与上、下扫视之间的相互作用具有显著性。与对照组相比，第 3 组和第 4 组患者的主序列曲线分析显示出比第 1 组和第 2 组更大的差异。而在对照组中，下视扫视比上视扫视更快，而在所有患者组中则表现出相反的行为。在那些没有 TAO 迹象的患者（第 4 组）中，检测到的差异最大。
在这项研究中，所有 TAO 患者均检测到明显的扫视差异。与我们之前的研究不同，评估多个单独的扫视参数并未发现显著差异，而主要序列常数的分析和主序列曲线的数学重建结果表明，这是一种可靠检测微妙眼球运动变化的敏感技术。即使在自身免疫性甲状腺炎患者中，也检测到了明显的差异，这些患者没有明显的 TAO 临床症状。
