Columbia University College of Physicians and Surgeons, New York, U.S.A.
Division of Oculoplastic and Orbital Surgery, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, U.S.A.
Ophthalmic Plast Reconstr Surg. 2019 May/Jun;35(3):262-265. doi: 10.1097/IOP.0000000000001224.
To compare extraocular muscle volumes in thyroid eye disease patients with and without compressive optic neuropathy.
A retrospective review of 44 orbital CT scans (28 orbits without compressive disease and 16 orbits with compressive optic neuropathy) was conducted. The extraocular muscle volumes, summated soft tissue volumes, and optic nerve volumes were calculated at a section in the posterior 1/3 of the orbit. The visual fields of the orbits with compressive optic neuropathy were analyzed.
The mean combined extraocular muscle/summated soft tissue volume ratio and the mean superior rectus-levator complex/summated soft tissue volume ratio were greater in those with compressive optic neuropathy than in those without compressive optic neuropathy (p = 0.02, 0.008, respectively). The ratio of the mean inferior, medial, or lateral rectus/summated soft tissue volume did not differ significantly between patients with or without compressive optic neuropathy (p values of 0.315, 0.615, and 0.254, respectively). Visual field analysis of the compressive optic neuropathy group demonstrated that 58% of the orbits with visual field defects had inferior field defects.
When measured at a section near the orbital apex, the mean combined muscle/summated soft tissue volume ratio and the mean superior rectus-levator complex/summated soft tissue volume ratio are greater in those with compressive disease than those without. This suggests that the specific enlargement of the superior rectus-levator complex makes a significant contribution to thyroid eye disease-compressive optic neuropathy and may explain the inferior visual field deficits classically found in this group of patients.
比较甲状腺眼病患者中伴与不伴压迫性视神经病变的眼外肌体积。
回顾性分析 44 例眼眶 CT 扫描（28 例无压迫性疾病，16 例压迫性视神经病变）。在眶后 1/3 处的一个节段计算眼外肌体积、总和软组织体积和视神经体积。分析压迫性视神经病变眼眶的视野。
压迫性视神经病变患者的总眼外肌/总和软组织体积比和总上直肌-提肌复合体/总和软组织体积比均大于无压迫性视神经病变患者（p = 0.02、0.008）。压迫性视神经病变患者的平均下直肌、内直肌或外直肌/总和软组织体积比无显著差异（p 值分别为 0.315、0.615 和 0.254）。压迫性视神经病变组的视野分析显示，58%的视野缺损眼眶存在下视野缺损。
在眶尖附近的节段测量时，压迫性疾病患者的总肌肉/总和软组织体积比和总上直肌-提肌复合体/总和软组织体积比大于无压迫性疾病患者。这表明上直肌-提肌复合体的特定增大对甲状腺眼病-压迫性视神经病变有重要贡献，这可能解释了该组患者典型的下视野缺损。
