Endocrinology, Department of Clinical Sciences and Community Health, Graves' Orbitopathy Center, Università degli Studi di Milano, Fondazione Cà Granda, IRCCS Milan, Italy.
Ophthalmology. 2013 May;120(5):1092-8. doi: 10.1016/j.ophtha.2012.10.041. Epub 2013 Feb 8.
To define a method of quantifying axial proptosis in patients with Graves' orbitopathy (GO) and to validate a score that correlates with the orbital involvement and helps determine the degree of proptosis correction for elective orbital decompression.
Retrospective, case series.
The study included 50 patients (group A) and 29 control subjects who underwent orbital computed tomography (CT). The method was then validated in another group of 21 patients with GO (group B).
The orbital area (OA) was measured manually on the central axial section of the CT scan at a level where the lens is visualized. The OA intersects the projection of the globe and delimitates the chord of an arch (globe chord [OC]). The area of the circular sector under the chord (CA) represents the portion of the globe within the orbit.
A CA-to-OA ratio was calculated to reduce the error due to variability of the measurements and to perform correlations with some of the clinical parameters of GO.
Measurement error was low (<2%). We did not observe significant differences in the mean OA of patients with GO (783.6 ± 12.1 mm(2)) and controls (758.5 ± 20.4 mm(2); P = not significant). The OC value in patients with GO was 130.2 ± 11.5 mm(2), significantly lower than in controls (281.8 ± 9.7 mm(2); P<0.0001). The CA-to-OA ratio also was lower in patients with GO than in controls (0.16 ± 0.01 vs. 0.38 ± 0.01; P<0.0001). A significant correlation was found in patients with GO between the CA-to-OA ratio and proptosis (P<0.001), lid fissure (P = 0.004), and intraocular pressure (P<0.001). In group B, the CA-to-OA ratio was 0.18 ± 0.02, significantly different from that of controls (P<0.0001) and inversely correlated with proptosis (P<0.0001) and lid fissure (P<0.045).
By measuring the CA-to-OA ratio, we were able to quantify the degree of axial proptosis in patients with GO. The significant correlation of CA/OA with some orbital parameters confirms that this parameter also may be used as a measure of orbital involvement in GO.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
定义一种量化格雷夫斯眼病（GO）患者眼球突出度的方法，并验证一种与眼眶受累相关的评分，以帮助确定选择性眼眶减压术的眼球突出度矫正程度。
回顾性病例系列。
该研究纳入了 50 名患者（A 组）和 29 名接受眼眶计算机断层扫描（CT）的对照受试者。然后，该方法在另 21 名 GO 患者（B 组）中得到验证。
在 CT 扫描的中央轴向截面，在可观察晶状体的水平手动测量眼眶面积（OA）。OA 与眼球的投影相交，并限定了拱的弦（眼球弦[OC]）。在弦下的圆形扇区的面积（CA）代表眼眶内的眼球部分。
计算 CA/OA 比值以减少因测量差异引起的误差，并与 GO 的一些临床参数进行相关性分析。
测量误差较小（<2%）。我们没有观察到 GO 患者（783.6±12.1mm²）和对照组（758.5±20.4mm²；P=无显著性差异）的平均 OA 存在显著差异。GO 患者的 OC 值为 130.2±11.5mm²，明显低于对照组（281.8±9.7mm²；P<0.0001）。GO 患者的 CA/OA 比值也低于对照组（0.16±0.01 对 0.38±0.01；P<0.0001）。GO 患者中 CA/OA 比值与突眼（P<0.001）、睑裂（P=0.004）和眼内压（P<0.001）之间存在显著相关性。在 B 组中，CA/OA 比值为 0.18±0.02，与对照组有显著差异（P<0.0001），并与突眼（P<0.0001）和睑裂（P<0.045）呈负相关。
通过测量 CA/OA 比值，我们能够量化 GO 患者的轴向突眼程度。CA/OA 与一些眼眶参数的显著相关性证实，该参数也可作为 GO 眼眶受累的衡量标准。
作者没有与本文讨论的任何材料有关的专有或商业利益。
