Suplement
do nr. 1/2003
|
|
|
|
|
|
|
|
|
Zmiany oczne u pacjentów z chorob± Gravesa
przebiegaj±c± z eutyreoz±
Ocular changes in patients with euthyroid Graves' disease
Jadwiga Janik1, Helena Jastrzębska2,
Małgorzata Gietka-Czernel2, Stefan Zgliczyński2, Barbara Rożniatowska3,
Jerzy Elbanowski4
1Poradnia Okulistyczna i 2Klinika Endokrynologii
Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Kierownik: prof. dr hab. med. Stefan Zgliczyński
3Zakład Radiologii i Pracownia Tomografii Komputerowej
Szpitala Bielańskiego w Warszawie
Kierownik: lek. med. Krzysztof Lerch
4Zakład Informatyki Centrum Medycznego
Kształcenia Podyplomowego w Warszawie
Kierownik: dr med. Włodzimierz Borkowski |
|
|
|
|
|
|
|
| Summary: |
Purpose: Evaluation of ocular changes in patients with
euthyroid Graves' disease. Material and methods: The study involved 15 patients (30
eyes) with Graves' disease which was not accompanied by hyperthyroidism. The mean
patients' age was 49,27?8,17 years (aged 39 to 66 years); 10 woman and 5 men. Fifteen
normal subjects (30 eyes), mean age 48,73?7,83, served as controls. In all complete
ophthalmological examination, exophthalmometry, tonometry and computed static perimetry
(Octopus 1-2-3 Interzeag, G1X program) were performed. All orbits were CT scanned in both
axial and direct coronal planes with the use of ELSCINT SPRINT 2000. Ocular changes were
classified according to the NOSPECS system. Results: Antithyroglobulin and/or
antimicrosomal antibodes and goitre were present in all patients with euthyroid Graves'
disease. Ocular changes in these patients were classified according to the NOSPECS system
as: 2a and b, 3a, 4a and b, 6a; no class 5 changes were found. Proptosis in this group was
clearly asymmetric (statistically significant, p<0,0001) with mean value of 18,07?2,02.
Intraocular pressure did not differ significantly between the patients with euthyroid
Graves' disease and the normal subjects (p=0,597). Enlargement of extraocular muscles
was found in 11 (36,7%) orbits with euthyroid Graves' disease. In 8 (72,7%) of these 11
affected orbits, the muscle enlargement was unilateral. The inferior rectus muscle was
most frequently affected - 7 cases (23,3%) and the lateral rectus was the least
frequently affected muscle - 1 case (3,3%). Conclusions: 1. An association was observed
between ocular changes and the presence of antithyroglobulin and/or antimicrosomal
antibodies and goitre. 2. The changes in soft tissue were mild or moderate; no large
proptosis or corneal damage were found. 3. The most frequent finding was asymmetry of
ocular change, especially seen in proptosis and extraocular muscles. |
|
|
| Key words: |
euthyroid Graves' disease, ocular changes, extraocular
muscles (CT). |
|
|
|
|
|
|
|
|
