Kandasamy Sindhuja, Agrawal Sahil, Pushker Neelam, Meel Rachna, Bajaj Mandeep S, Thirumurthy Velpandian, Jyotsna Viveka P
Oculoplastics & Oncology Services, All India Institute of Medical Sciences, New Delhi, India.
Department of Ocular Pharmacology, Dr R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
J Ultrasound Med. 2023 Feb;42(2):399-408. doi: 10.1002/jum.16004. Epub 2022 May 12.
To study the thickness of levator palpebra superioris-Muller's muscle complex (LMC) on ultrasound biomicroscopy (UBM) and to correlate with the clinical response to botulinum toxin A (BTA) injection in patients with inactive-stage of thyroid-related upper eyelid retraction (UER). We also studied the correlation of clinical parameters, preinjection with postinjection values.
This was a prospective, interventional study. Patients with thyroid-related UER who underwent subconjunctival injection of BTA were recruited. Demographic data and clinical details were evaluated. UBM (50 MHz) was done to measure the thickness of LMC. Patient's satisfaction was graded at each follow-up. Follow-up was done at 1 week, 1 month, and 3 months' time intervals.
A total of 13 patients were recruited and 26 eyes were divided into two groups; group 1 included eyes with UER (n = 17), and group 2 included eyes without UER (n = 9). There was a statistically significant reduction in margin reflex distance 1 (MRD1) after BTA injection at 1-week, 1-month, and 3-months follow-up with maximum reduction at 1 month. The mean LMC thickness of 26 eyes was 0.96 mm which was found to be significantly more than normal controls. On comparison of mean LMC thickness with the amount of UER and reduction in MRD1, we did not find a significant difference.
Patients with TED have significantly thicker LMC on UBM than controls. Further studies are needed with a larger sample size on the correlation of UBM features of levator aponeurosis with response to BTA injection.
通过超声生物显微镜（UBM）研究甲状腺相关上睑退缩（UER）静止期患者提上睑肌-米勒肌复合体（LMC）的厚度，并将其与肉毒杆菌毒素A（BTA）注射的临床反应相关联。我们还研究了临床参数、注射前与注射后数值之间的相关性。
这是一项前瞻性干预性研究。招募接受BTA结膜下注射的甲状腺相关UER患者。评估人口统计学数据和临床细节。使用UBM（50 MHz）测量LMC的厚度。在每次随访时对患者满意度进行分级。随访时间间隔为1周、1个月和3个月。
共招募了13名患者，26只眼睛分为两组；第1组包括有UER的眼睛（n = 17），第2组包括无UER的眼睛（n = 9）。在1周、1个月和3个月随访时，BTA注射后边缘反射距离1（MRD1）有统计学意义的降低，在1个月时降低最大。26只眼睛的平均LMC厚度为0.96 mm，发现明显大于正常对照组。比较平均LMC厚度与UER量和MRD1降低情况，我们未发现显著差异。
甲状腺眼病患者的UBM显示LMC厚度明显厚于对照组。需要进一步进行更大样本量的研究，以探讨提上睑肌腱膜的UBM特征与BTA注射反应之间的相关性。
