Park Kristen, Li Joy, Wen Joyce, Li Shirley, Lee Jonathan, Danesh Kayla, Malkoff Nicolas, Gokoffski Kimberly, Lerner Alexander, Patel Vishal, Zhang-Nunes Sandy, Chang Jessica
Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, USA.
University of Southern California (USC) Roski Eye Institute, Keck School Medicine, University of Southern California, Los Angeles, USA.
Cureus. 2024 Jul 4;16(7):e63843. doi: 10.7759/cureus.63843. eCollection 2024 Jul.
It is commonly taught that thyroid eye disease (TED) causes enlargement of the extraocular muscles (EOMs) in the following descending order: inferior rectus (IR), medial rectus (MR), superior rectus (SR), lateral rectus (LR), superior oblique (SO) and inferior oblique (IO). However, with recent literature challenging this notion, we aimed to compare EOM volumes in our cohort of TED patients. Methods: We conducted a retrospective, non-randomized case-control study. Twenty-eight orbits from 28 unique patients with TED who had high-resolution CT scans were compared to 31 normal orbits, all from a single academic institution. Orbital soft tissues were manually segmented using ITK-SNAP 3.8.0 (http://itksnap.org), and soft tissue volumes of the control and TED orbits were compared using independent-sample t-tests.
Of the TED orbits, 54% of SR/levator palpebrae superioris complex volumes (SRC) and 50% of IR volumes were greater than two standard deviations above the normal orbit average. Compared to controls, the mean SRC volume in TED subjects was 2.3 times enlarged, followed by the IR (2.1 times), SO (1.8 times), MR (1.7 times), LR (1.6 times), IO (1.6 times), and orbital fat (1.4 times) ( < 0.01 for all). Conclusions: Our findings suggest that contrary to previous teaching, the SRC may be the most severely affected in TED.
通常认为甲状腺眼病（TED）会导致眼外肌（EOMs）按以下降序增大：下直肌（IR）、内直肌（MR）、上直肌（SR）、外直肌（LR）、上斜肌（SO）和下斜肌（IO）。然而，随着近期文献对这一观点提出质疑，我们旨在比较我们队列中TED患者的眼外肌体积。方法：我们进行了一项回顾性、非随机病例对照研究。将来自28例接受高分辨率CT扫描的TED患者的28个眼眶与来自同一学术机构的31个正常眼眶进行比较。使用ITK-SNAP 3.8.0（http://itksnap.org）手动分割眼眶软组织，并使用独立样本t检验比较对照组和TED眼眶的软组织体积。结果：在TED眼眶中，54%的上直肌/上睑提肌复合体体积（SRC）和50%的下直肌体积比正常眼眶平均值高出两个标准差以上。与对照组相比，TED受试者的平均SRC体积增大了2.3倍，其次是下直肌（2.1倍）、上斜肌（1.8倍）、内直肌（1.7倍）、外直肌（1.6倍）、下斜肌（1.6倍）和眼眶脂肪（1.4倍）（所有P<0.01）。结论：我们的研究结果表明，与先前的观点相反，SRC在TED中可能受影响最严重。
