Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Ophthalmic Plast Reconstr Surg. 2013 May-Jun;29(3):147-9. doi: 10.1097/IOP.0b013e3182831bd8.
To compare superior ophthalmic vein diameter and extraocular muscle index in patients with thyroid eye disease with or without optic neuropathy.
High-resolution CT scan images of 40 orbits of 20 patients with history of thyroid eye disease (with or without optic neuropathy), who underwent orbital decompression surgery from January 2007 to November 2009, were retrospectively reviewed. Superior ophthalmic vein diameter was measured in coronal and axial planes. Extraocular muscle index was calculated according to the method proposed by Barrett et al. The clinical diagnosis of optic neuropathy was based on characteristic signs that included afferent pupillary defect, decreased visual acuity, visual field defects, and dyschromatopsia. Orbits were divided in 2 groups based on presence or absence of optic neuropathy.
Superior ophthalmic vein diameter was significantly higher in orbits with concomitant optic neuropathy (mean 2.4 ± 0.4mm, p < 0.0001). Increased muscle index was also related to optic neuropathy (mean 57.9% ± 5.7%, p = 0.0002). Muscle index greater than 50% was present in all patients with dysthyroid optic neuropathy.
This study suggests that patients with thyroid eye disease with enlarged superior ophthalmic vein and increased extraocular muscle index are more likely to have concomitant optic neuropathy.
比较甲状腺眼病伴或不伴视神经病变患者的眼上静脉直径和眼外肌指数。
回顾性分析 2007 年 1 月至 2009 年 11 月间 20 例甲状腺眼病（伴或不伴视神经病变）患者的 40 例眼眶高分辨率 CT 扫描图像，所有患者均接受了眼眶减压手术。在冠状面和轴位测量眼上静脉直径。眼外肌指数根据 Barrett 等人提出的方法计算。视神经病变的临床诊断基于包括瞳孔传入缺陷、视力下降、视野缺损和色觉障碍等特征性体征。根据是否存在视神经病变将眼眶分为 2 组。
伴发视神经病变的眼眶眼上静脉直径明显增大（平均 2.4 ± 0.4mm，p < 0.0001）。肌肉指数增加也与视神经病变有关（平均 57.9% ± 5.7%，p = 0.0002）。所有甲状腺相关视神经病变患者的肌肉指数均大于 50%。
本研究提示，眼上静脉增大和眼外肌指数增加的甲状腺眼病患者更有可能伴发视神经病变。
