Endocrine orbitopathy: Patients with exophthalmus and patients with optic compression – is there a difference between the cts pictures?

Introduction Patients with endocrine orbitopathy suffer from two main symptoms, namely exophthalmos and compression of the optic nerve (dysthyroid optic neuropathy = DON). Reasons for this are not certain. The intent of the study is to detect possible CT-morphological differences in the two collectives.

Methods The retro-perspective study included 40 patients (70 orbitae) with endocrine orbitopathy who received balanced orbital decompression between 08/2011 and 12/2018. There is a classification in patients with a Hertel-index of  <  20mm and with optic neuritis (DON) (Group 1) and in patients with a Hertel-index > 20mm (exophthalmos) but without DON (Group 2). The following clinical parameters were recorded: Hertel-index, visual acuity as well as double images pre- and postoperative. In addition, we were recording a CT-morphologically status with the length of the orbita and the level of hyperplasia of the eye muscles.

Result In comparing the two groups, there was a significant difference in hyperplasia of the eye muscles in patients with DON compared to those without (M. rectus med. P-vale = 0,0003; M. rectus sup. P-vale  <  0,0001). There was no significant variation in orbital length in the compared groups (Group 1: 31,70mm, group 2: 31,93mm).

Discussion There was a high correlation of hyperplasia shown and DON. There is a causal connection between the compression of the optical nerve. Regarding the examined orbital length there was no significant evidence of correlation between the decrease of vision and the orbital length. Post surgically, there is a registered, suffiecient improvement of the main symptoms in both groups.

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Artikel online veröffentlicht:
10. Juni 2020