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Ocular hypertension in patients with active thyroid-associated orbitopathy: a predictor of disease severity, particularly of extraocular muscle enlargement

  • Oculoplastics and Orbit
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Abstract

The purpose was to ascertain if any relation exists between the elevated intraocular pressure (IOP) in patients with thyroid-associated orbitopathy (TAO) in active stage and the severity of extraocular muscle involvement and the extent of exophthalmos.

Methods

A total of 96 eyes and orbits of 48 adult patients with active TAO were investigated. All patients underwent magnetic resonance imaging of the orbit and measurement of all extraocular recti muscles (EOM). The obtained data was divided into two groups according to the IOP value: normal IOP ≤ 21 mmHg; n = 47 and elevated IOP with IOP > 21 mmHg; n = 49, and analyszed.

Results

A significant difference was found in the short diameter of medial rectus and inferior rectus muscles and in the sum of short parameters of all EOM. All these parameters were significantly higher in the elevated IOP group. Motility restriction in at least one gaze direction was also significantly more frequent (p < 0.0001) in the elevated IOP group. A positive moderate correlation was found between IOP and the sum of short parameters of EOM (r = 0.496). No correlation was found between the IOP and exophthalmos values (r = 0.267). During the follow-up, the frequency of strabismus surgery and orbital decompression was significantly higher in the elevated IOP group (p = 0.003; p = 0.002).

Conclusion

Elevated IOP in the active TAO stage particularly correlates with extraocular muscle involvement. These patients are also more likely to require orbital decompression and strabismus surgery.

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Funding

This work was supported by the Ministry of Health of the Czech Republic–grant no. NU21J-01–00017 and DRO (FNOL, 00098892). All rights reserved.

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Authors and Affiliations

  1. Department of Ophthalmology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 6, 779 00, Olomouc, Czech Republic

    Marta Karhanová, Jana Kalitová, Petra Hübnerová, Petr Mlčák & Martin Šín

  2. Department of Radiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic

    Radim Kovář & Jakub Čivrný

  3. Department of Internal Medicine III–Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic

    Jan Schovánek & David Karásek

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  1. Marta Karhanová
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  2. Jana Kalitová
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  4. Jan Schovánek
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  7. Petra Hübnerová
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  8. Petr Mlčák
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  9. Martin Šín
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Correspondence to Marta Karhanová.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the University Hospital Olomouc and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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This article received support from the mentorship team. Further information can be found in the editorial https://link.springer.com/article/10.1007/s00417-019-04518-5

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Karhanová, M., Kalitová, J., Kovář, R. et al. Ocular hypertension in patients with active thyroid-associated orbitopathy: a predictor of disease severity, particularly of extraocular muscle enlargement. Graefes Arch Clin Exp Ophthalmol 260, 3977–3984 (2022). https://doi.org/10.1007/s00417-022-05760-0

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  • DOI: https://doi.org/10.1007/s00417-022-05760-0

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