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Spontaneous orbital decompression in thyroid eye disease: new measurement methods and its influential factors

  • Oculoplastics and Orbit
  • Published:
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Abstract

Purpose

To evaluate spontaneous decompression of the medial orbital wall and orbital floor in thyroid eye disease using new measurement methods and to analyze the influential factors.

Methods

This retrospective study included 86 patients (172 sides). Regarding evaluation of spontaneous medial orbital decompression, an anteroposterior line was drawn between the posterior lacrimal crest and the junction between the ethmoid bone and corpus ossis sphenoidalis. The bulged and/or dented areas from that line were measured. Regarding evaluation of spontaneous orbital floor decompression, the length of the perpendicular distance from a line that was drawn between the inferior orbital rim and the orbital process of palatal bone to the tip of the superior bulge of the orbital floor was measured.

Results

Multivariate linear regression analysis revealed that the maximum cross-sectional areas of the superior rectus/levator palpebrae superioris complex (P = 0.020) and medial rectus muscle (P = 0.028) were influential factors for spontaneous decompression of medial orbital wall (adjusted r2 = 0.090; P < 0.001), whereas the number of cycles of steroid pulse therapy (P = 0.002) and the maximum cross-sectional area of the inferior rectus muscle (P = 0.007) were the ones for that of the orbital floor (adjusted r2 = 0.096; P < 0.001).

Conclusion

We believe that the identification of multiple influential factors of spontaneous decompression of the medial orbital wall and orbital floor will be helpful for better understanding and planned management of thyroid eye disease patients undergoing orbital decompression surgery.

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Data availability

All data are included in this report.

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Authors and Affiliations

  1. Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan

    Aric Vaidya, Patricia Ann L. Lee, Hirohiko Kakizaki & Yasuhiro Takahashi

  2. Department of Ophthalmology, Osaka University, Suita, Osaka, Japan

    Yoshiyuki Kitaguchi

Authors
  1. Aric Vaidya
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  2. Patricia Ann L. Lee
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  3. Yoshiyuki Kitaguchi
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  4. Hirohiko Kakizaki
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  5. Yasuhiro Takahashi
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Contributions

All authors qualify for authorship based on contributions to the conception and design (YT), acquisition of data (YT), statistical analysis (YK and YT), literature search (AV and YT), and interpretation of data (all authors). All authors contributed to drafting the article and revising it critically for important intellectual content and final approval of the version to be published. No one contributed to the work who did not meet our authorship criteria.

Corresponding author

Correspondence to Yasuhiro Takahashi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was approved by the Institutional Review Board (IRB) of our institution (Aichi Medical University Hospital, approval No. 2019-175) and followed the tenets of the 1964 Declaration of Helsinki.

Consent to participate

The IRB granted a waiver of informed consent for this study on the basis of the ethical guidelines for medical and health research involving human subjects established by the Japanese Ministry of Education, Culture, Sports, Science, and Technology and the Ministry of Health, Labour, and Welfare. The waiver was granted because the study was a retrospective review and not an interventional study and because it was difficult to obtain consent from patients who had been treated several years prior to this study. Nevertheless, at the request of the IRB, an outline of the study was published on the website of our institution and this was made available for public viewing. This public posting also gave patients an opportunity to decline participation, although no refusal was made known to us. Personal identifiers were removed from the records prior to data analysis.

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Vaidya, A., Lee, P.A.L., Kitaguchi, Y. et al. Spontaneous orbital decompression in thyroid eye disease: new measurement methods and its influential factors. Graefes Arch Clin Exp Ophthalmol 258, 2321–2329 (2020). https://doi.org/10.1007/s00417-020-04762-0

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  • DOI: https://doi.org/10.1007/s00417-020-04762-0

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