Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 11-12, Pages: 694-698
https://doi.org/10.2298/SARH1212694J
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Clinical evaluation of Graves ophthalmopathy
Janićijević-Petrović Mirjana A. (Klinika za oftalmologiju, Klinički centar, Kragujevac)
Šarenac Tatjana (Klinika za oftalmologiju, Klinički centar, Kragujevac)
Srećković Sunčica (Klinika za oftalmologiju, Klinički centar, Kragujevac)
Janićijević Katarina (Medicinski fakultet, Kragujevac)
Petrović Marko (Medicinski fakultet, Kragujevac)
Vulović Dejan (Medicinski fakultet, Kragujevac)
Introduction. Graves ophthalmopathy is an autoimmune disease, which is the
consequence of thyroid dysfunction. Ocular manifestations occur in 50% of
patients with Graves disease. The changes occur due to the inflammatory cell
infiltration of retrobulbar fat tissue and extraocular muscles.
Ultrasonography of eye orbit provides important information about the
condition of retrobulbar adipose tissue and the thickness of extraocular
muscles. Objective. The aim of our study was to show the clinical
significance of orbital ultrasonography in the diagnostics and follow-up of
patients with Graves disease. Methods. The authors examined 154 patients with
Graves ophthalmopathy at the Clinic of Ophthalmology of the Clinical Centre
in Kragujevac during the period 2008–2010. Ophthalmological examination
included visual acuity testing (Snellen chart), biomicroscopy and applanation
tonometry, direct and indirect ophthalmoscopy, dry eye testing and
exophthalmometry (Hertel). Orbital ultrasonography examination and
extraorbital muscle measurement was done by ultrasound B-scan. Results. The
disease was more frequent in women (79.87%) aged from 36–45 years. Most
patients had hyperthyreoidism (54.55%). In relation to the duration of the
disease, the most frequent clinical signs were bilateral ptosis, conjunctival
chemosis and periorbital edema. According to our data the highest number of
patients had enlarged medial straight muscle. Conclusion. Graves
ophthalmopathy is the most frequent sign of thyroid disease. By orbital
ultrasonography we detected extended echogram and measured the thickness of
the extraocular muscle. Computerized tomography and magnetic resonance scan
were utilized for cases of insufficiently manifested clinical signs of the
disease. The advantages of ultrasonography lie in easy handling, patients’
comfort, short time of examination and possibilities of repetition.
Keywords: Graves ophthalmopathy, ultrasonography, extraocular muscles