scholarly journals Orbital Fat Herniation Through the Superior Orbital Fissure in Thyroid Eye Disease

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Karen M. Wai ◽  
Natalie Wolkow ◽  
Suzanne K. Freitag
Keyword(s):  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Superior Orbital Fissure ◽  
Orbital Fat ◽  
Fat Herniation

Orbital fat expansion in thyroid eye disease is related to age

2019 ◽  
Vol 30 (5) ◽  
pp. 1004-1007 ◽  
Author(s):  
Shoaib Ugradar ◽  
Daniel B Rootman
Keyword(s):  
Standard Deviation ◽  
Muscle Volume ◽  
Thyroid Eye Disease ◽  
Secondary Outcome ◽  
Eye Disease ◽  
Decompression Surgery ◽  
Analysis Tool ◽  
Orbital Fat ◽  
Orbital Volume ◽  
Fat Volume

Purpose: To objectively measure the differential expansion of orbital fat and muscle volume in patients with thyroid eye disease. Methods: In this retrospective study, eligible participants were adults with clinical evidence of thyroid eye disease and high-resolution computed tomography scans of their orbits. Patients with a history of decompression surgery and/or medical or other conditions that could alter the orbital anatomy were excluded. Three dimensional reconstructions of the orbits allowed the calculation of the fat volume, muscle volume and bony orbital volume using the MIMICS imaging analysis tool. Both orbits from each patient were included without bias through the use of the generalized estimating equation. The primary outcome was the measurement of fat volume. Secondary outcome measures included the correlation of the muscle volume, bony orbital volume and exophthalmometry with age. Results: Fifty patients with thyroid eye disease who were included contributed 100 orbits. The sample included 29 females (age 57, standard deviation = 14.8) and 21 males (age 52, standard deviation = 18.14). Mean (standard deviation) exophthalmometry measurement was 21.58 (4.01). Fat volume and exophthalmometry were negatively correlated with age (p = 0.00001 and p = 0.00001, respectively). Muscle volume (p = 0.985) and bony orbital volume (p = 0.484) did not correlate with age. Conclusion: Older patients with thyroid eye disease have less expansion of fat volume compared with younger patients. There are no associations between age and the bony orbital volume or muscle volume. These results support the growing body of evidence which suggests that the pathophysiology of TED is different in older patient.

Orbital Fat Decompression for Thyroid Eye Disease

2015 ◽  
Vol 31 (3) ◽  
pp. 215-218 ◽  
Author(s):  
Marta Calsina Prat ◽  
Alexandra L. Braunstein ◽  
Lora R. Dagi Glass ◽  
Michael Kazim
Keyword(s):  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Orbital Fat

Teprotumumab reduces extraocular muscle and orbital fat volume in thyroid eye disease

2020 ◽  
pp. bjophthalmol-2020-317806
Author(s):  
Amy Patel Jain ◽  
Norman Gellada ◽  
Shoaib Ugradar ◽  
Ada Kumar ◽  
George Kahaly ◽  
...  
Keyword(s):  
Human Monoclonal Antibody ◽  
Clinical Manifestations ◽  
Post Treatment ◽  
Thyroid Eye Disease ◽  
Phase Iii ◽  
Eye Disease ◽  
Control Group ◽  
Orbital Fat ◽  
Orbital Imaging ◽  
Fat Volume

PurposeThyroid eye disease (TED) is a progressive, debilitating and potentially vision-threatening autoimmune disease. Teprotumumab, a novel human monoclonal antibody, has been shown to reverse the clinical manifestations of TED. Patients receiving teprotumumab have been shown in two multicenter, randomized placebo-controlled trials to have decreased proptosis, diplopia and inflammation after 24 weeks of treatment. This study aims to analyse volumetric and inflammatory changes on orbital imaging prior to and after teprotumumab treatment from one of these trials.DesignRetrospective review.SubjectsSix patients enrolled in the phase III teprotumumab clinical trial (OPTIC, NCT03298867) with active TED who received 24 weeks of teprotumumab and had pre- and post-treatment orbital imaging (CT or MRI). Additionally, 12 non-TED patients (24 orbits) were analysed as a comparative control group.Methods3D volumetric calculations of the extraocular muscles (EOMs), orbital fat, and bony orbit were measured using previously validated image processing software. 3D volumetric results and changes in EOM inflammation were compared with clinical measurements of TED.ResultsTotal EOM volume within each orbit was markedly reduced post-teprotumumab in all patients (n=six patients, 12/12 orbits, p<0.02). There was no statistical difference in post-treatment EOM volume when compared to non-TED controls. Total orbital fat volume was also reduced in 11 of 12 studied orbits (n=six patients, p=0.04). Overall EOM inflammation based on MRI signal intensity ratio was reduced in 8/8 orbits (n=four patients, p<0.01).ConclusionOrbital imaging demonstrated decreased EOM volumes and orbital fat tissue volumes after teprotumumab treatment.

Recurring thyroid eye disease: a diagnostic dilemma

2015 ◽  
Author(s):  
Pauline McAleer ◽  
Emma Turtle ◽  
Jan Kerr ◽  
Karen Adamson
Keyword(s):  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Diagnostic Dilemma

Early low dose rituximab for active thyroid eye disease: an effective and well tolerated treatment

2018 ◽  
Author(s):  
Elizabeth Insull ◽  
Helen Turner ◽  
Joel David ◽  
Jonathan Norris
Keyword(s):  
Low Dose ◽  
Thyroid Eye Disease ◽  
Eye Disease
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