Abstract
Purpose
Graves’ orbitopathy (GO) is an extraocular eye disease with symptoms ranging from minor discomfort from dry eyes to strabismus and visual loss. One of the hallmarks of active GO is visible hyperemia at the insertion of the extraocular muscles. The aim of the present study was to evaluate the use of enhanced-depth imaging spectral domain anterior segment optical coherence tomography (EDI SD AS-OCT) for detecting pathological changes in horizontal recti muscles of patients with GO.
Methods
Prospective cross sectional study of 27 eyes. Only women were included. EDI AS-OCT was used to measure the thickness of the tendons of the horizontal recti muscles in a predefined area in patients with GO and healthy controls.
Results
EDI AS-OCT was able to image the tendons of the horizontal recti muscles in both healthy controls and patients suffering from GO. The mean thickness of the medial rectus muscle (MR) tendon was 256.4 μm [±17.13 μm standard deviation (SD)] in the GO group and, therefore, significantly thicker (p = 0.046) than in the healthy group which had a mean thickness of 214.7 μm (±5.516 μm SD). There was no significant difference in the mean thickness of the tendon of the lateral recti muscles (LRs) between these groups.
Conclusion
This is the first report showing that EDI AS-OCT is suitable to detect swelling at the insertion site of the MR muscle in GO. MR tendon thickness may be a useful parameter to monitor activity in these patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Piantanida E, Tanda ML, Lai A, Sassi L, Bartalena L (2013) Prevalence and natural history of Graves’ orbitopathy in the XXI century. J Endocrinol Invest 36:444–449
Verity DH, Rose GE (2013) Acute thyroid eye disease (TED): principles of medical and surgical management. Eye (Lond) 27:308–319
Eckstein A, Esser J (2011) Graves’ orbitopathy. Klin Monbl Augenheilkd 228:432–438
Daubner D, Spieth S, Engellandt K, von Kummer R (2012) Diagnosis and differential diagnosis of Graves’ orbitopathy in MRI. Radiologe 52:550–559
Johnson KT, Wittig A, Loesch C, Esser J, Sauerwein W, Eckstein AK (2010) A retrospective study on the efficacy of total absorbed orbital doses of 12, 16 and 20 Gy combined with systemic steroid treatment in patients with Graves’ orbitopathy. Graefe’s archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle. Ophthalmologie 248:103–109
Bartalena L, Baldeschi L, Dickinson A, Eckstein A, Kendall-Taylor P, Marcocci C, Mourits M, Perros P, Boboridis K, Boschi A, Curro N, Daumerie C, Kahaly GJ, Krassas GE, Lane CM, Lazarus JH, Marino M, Nardi M, Neoh C, Orgiazzi J, Pearce S, Pinchera A, Pitz S, Salvi M, Sivelli P, Stahl M, von Arx G, Wiersinga WM (2008) Consensus statement of the European Group on Graves’ orbitopathy (EUGOGO) on management of GO. Eur J Endocrinol 158:273–285
Mourits MP, Prummel MF, Wiersinga WM, Koornneef L (1997) Clinical activity score as a guide in the management of patients with Graves’ ophthalmopathy. Clin Endocrinol (Oxf) 47:9–14
Kvetny J, Puhakka KB, Rohl L (2006) Magnetic resonance imaging determination of extraocular eye muscle volume in patients with thyroid-associated ophthalmopathy and proptosis. Acta Ophthalmol Scand 84:419–423
Nishida Y, Tian S, Isberg B, Hayashi O, Tallstedt L, Lennerstrand G (2002) Significance of orbital fatty tissue for exophthalmos in thyroid-associated ophthalmopathy. Graefe’s archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle. Ophthalmologie 240:515–520
Campi I, Vannucchi GM, Minetti AM, Dazzi D, Avignone S, Covelli D, Curro N, Ratiglia R, Guastella C, Pignataro L, Beck-Peccoz P, Salvi M (2013) A quantitative method for assessing the degree of axial proptosis in relation to orbital tissue involvement in Graves’ orbitopathy. Ophthalmology 120:1092–1098
Wang J, Abou Shousha M, Perez VL, Karp CL, Yoo SH, Shen M, Cui L, Hurmeric V, Du C, Zhu D, Chen Q, Li M (2011) Ultra-high resolution optical coherence tomography for imaging the anterior segment of the eye. Ophthalmic Surg Lasers Imaging 42(Suppl):S15–27
Nolan WP, See JL, Chew PT, Friedman DS, Smith SD, Radhakrishnan S, Zheng C, Foster PJ, Aung T (2007) Detection of primary angle closure using anterior segment optical coherence tomography in Asian eyes. Ophthalmology 114:33–39
Sayegh RR, Pineda R 2nd (2012) Practical applications of anterior segment optical coherence tomography imaging following corneal surgery. Semin Ophthalmol 27:125–132
Ramos JL, Li Y, Huang D (2009) Clinical and research applications of anterior segment optical coherence tomography - a review. Clin Exp Ophthalmol 37:81–89
Liu X, Wang F, Xiao Y, Ye X, Hou L (2011) Measurement of the limbus-insertion distance in adult strabismus patients with anterior segment optical coherence tomography. Invest Ophthalmol Vis Sci 52:8370–8373
Trokel SL, Jakobiec FA (1981) Correlation of CT scanning and pathologic features of ophthalmic Graves’ disease. Ophthalmology 88:553–564
Conflict of interest
The authors acknowledge the use of the facilities and scientific and technical assistance of the Department for Clinical Research (DCR) of the University of Bern. These studies were supported by grants from the Inselspital Bern and the OPOS Foundation. Dr. Zinkernagel has served as a speaker for and has received funding from Heidelberg Engineering GMbH, Germany
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Häner, N.U., Dysli, M., Abegg, M. et al. Enhanced-depth optical coherence tomography for imaging horizontal rectus muscles in Graves’ orbitopathy. Graefes Arch Clin Exp Ophthalmol 253, 1569–1573 (2015). https://doi.org/10.1007/s00417-015-3060-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-015-3060-9