eMedicine Specialties > Radiology > Head/Neck

Ophthalmopathy, Thyroid: Follow-up

Author: Michael T Yen, MD, Associate Professor of Ophthalmology, Department of Ophthalmology, Division of Ophthalmic Plastic, Lacrimal, and Orbital Surgery, Cullen Eye Institute, Baylor College of Medicine
Coauthor(s): Rudolph Lin, MD, Chief of Radiology, Department of Radiology, St. Elizabeth Hospital; Kimberly G Yen, MD, Assistant Professor of Ophthalmology, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine
Contributor Information and Disclosures

Updated: Mar 18, 2009

Intervention

Medicolegal Pitfalls

  • Failure to make the diagnosis in a timely manner (This may result in claims against the radiologist.)
  • Failure to perform orbital ultrasonography with particular attention to internal reflectivity, which may aid in differentiating between metastatic disease and thyroid ophthalmopathy
  • Failure to consider biopsy when findings are suggestive of metastatic disease

Special Concerns

  • Isolated metastasis to the extraocular muscle, which may cause enlargement of the extraocular muscle
 


More on Ophthalmopathy, Thyroid

Overview: Ophthalmopathy, Thyroid
Imaging: Ophthalmopathy, Thyroid
Follow-up: Ophthalmopathy, Thyroid
Multimedia: Ophthalmopathy, Thyroid
References
Further Reading
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References

  1. Kuriyan AE, Phipps RP, Feldon SE. The eye and thyroid disease. Curr Opin Ophthalmol. Nov 2008;19(6):499-506. [Medline].

  2. Kim N, Hatton MP. The role of genetics in Graves' disease and thyroid orbitopathy. Semin Ophthalmol. Jan-Feb 2008;23(1):67-72. [Medline].

  3. Khoo TK, Bahn RS. Pathogenesis of Graves' ophthalmopathy: the role of autoantibodies. Thyroid. Oct 2007;17(10):1013-8. [Medline].

  4. Mayer EJ, Fox DL, Herdman G, et al. Signal intensity, clinical activity and cross-sectional areas on MRI scans in thyroid eye disease. Eur J Radiol. Oct 2005;56(1):20-4.

  5. Taoka T, Sakamoto M, Nakagawa H, et al. Evaluation of extraocular muscles using dynamic contrast enhanced MRI in patients with chronic thyroid orbitopathy. J Comput Assist Tomogr. Jan-Feb 2005;29(1):115-20.

  6. Dodds NI, Atcha AW, Birchall D, Jackson A. Use of high-resolution MRI of the optic nerve in Graves' ophthalmopathy. Br J Radiol. Jan 5 2009;[Medline].

  7. Volpe NJ, Sbarbaro JA, Gendron Livingston K, et al. Occult thyroid eye disease in patients with unexplained ocular misalignment identified by standardized orbital echography. Am J Ophthalmol. Jul 2006;142(1):75-81.

  8. Kuo PH, Monchamp T, Deol P. Imaging of inflammation in Graves'' ophthalmopathy by positron emission tomography/computed tomography. Thyroid. Apr 2006;16(4):419-20.

  9. Stålberg P, Svensson A, Hessman O, Akerström G, Hellman P. Surgical treatment of Graves' disease: evidence-based approach. World J Surg. Jul 2008;32(7):1269-77. [Medline].

  10. Alp MN, Ozgen A, Can I, et al. Colour Doppler imaging of the orbital vasculature in Graves'' disease with computed tomographic correlation. Br J Ophthalmol. Sep 2000;84(9):1027-30. [Medline].

  11. Bartley GB, Fatourechi V, Kadrmas EF, et al. Clinical features of Graves'' ophthalmopathy in an incidence cohort. Am J Ophthalmol. Mar 1996;121(3):284-90. [Medline].

  12. Bartley GB, Fatourechi V, Kadrmas EF, et al. Long-term follow-up of Graves ophthalmopathy in an incidence cohort. Ophthalmology. Jun 1996;103(6):958-62. [Medline].

  13. Byrne SF, Gendron EK, Glaser JS, et al. Diameter of normal extraocular recti muscles with echography. Am J Ophthalmol. Dec 15 1991;112(6):706-13. [Medline].

  14. Day RM, Carroll FD. Corticosteroids in the treatment of optic nerve involvement associated with thyroid dysfunction. Arch Ophthalmol. Mar 1968;79(3):279-82. [Medline].

  15. Forrester JV, Sutherland GR, McDougall IR. Dysthyroid ophthalmopathy: orbital evaluation with B-scan ultrasonography. J Clin Endocrinol Metab. Aug 1977;45(2):221-4. [Medline].

  16. Gerding MN, van der Zant FM, van Royen EA, et al. Octreotide-scintigraphy is a disease-activity parameter in Graves'' ophthalmopathy. Clin Endocrinol (Oxf). Mar 1999;50(3):373-9. [Medline].

  17. Hall R, Kirkham K, Doniach D, el-Kabir D. Ophthalmic Graves'' disease. Diagnosis and pathogenesis. Lancet. Feb 21 1970;1(7643):375-8. [Medline].

  18. Kahaly GJ. Imaging in thyroid-associated orbitopathy. Eur J Endocrinol. (Aug) 2001;145(2):107-18.

  19. Nunery WR. Ophthalmic Grave's disease: a dual theory of pathogenesis. Ophthalmol Clin North Am. 1991;4:73-87.

  20. Ozgen A, Alp MN, Ariyurek M, et al. Quantitative CT of the orbit in Graves'' disease. Br J Radiol. Aug 1999;72(860):757-62. [Medline].

  21. Scott IU, Siatkowski MR. Thyroid eye disease. Semin Ophthalmol. Jun 1999;14(2):52-61. [Medline].

  22. Shammas HJ, Minckler DS, Ogden C. Ultrasound in early thyroid orbitopathy. Arch Ophthalmol. Feb 1980;98(2):277-9. [Medline].

  23. Trokel SL, Jakobiec FA. Correlation of CT scanning and pathologic features of ophthalmic Graves'' disease. Ophthalmology. Jun 1981;88(6):553-64. [Medline].

  24. Weetman AP. Graves' disease. N Engl J Med. Oct 26 2000;343(17):1236-48. [Medline].

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Keywords

thyroid ophthalmopathy, thyroid eye disease, Graves disease, Graves' disease, Graves ophthalmopathy, thyrotoxic ophthalmopathy, thyrotoxic exophthalmos, thyroid-associated ophthalmopathy, endocrine exophthalmos

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Contributor Information and Disclosures

Author

Michael T Yen, MD, Associate Professor of Ophthalmology, Department of Ophthalmology, Division of Ophthalmic Plastic, Lacrimal, and Orbital Surgery, Cullen Eye Institute, Baylor College of Medicine
Michael T Yen, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Plastic and Reconstructive Surgery, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Coauthor(s)

Rudolph Lin, MD, Chief of Radiology, Department of Radiology, St. Elizabeth Hospital
Rudolph Lin, MD is a member of the following medical societies: American College of Radiology, American Medical Association, American Roentgen Ray Society, and Radiological Society of North America
Disclosure: Nothing to disclose.

Kimberly G Yen, MD, Assistant Professor of Ophthalmology, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine
Kimberly G Yen, MD is a member of the following medical societies: Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

David S Levey, MD, PhD, Orthopedic/Spine MRI TeleRadiologist, Radsource, LLC
David S Levey, MD, PhD is a member of the following medical societies: American Roentgen Ray Society, Radiological Society of North America, and Texas Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

C Douglas Phillips, MD, Professor, Departments of Radiology, Neurosurgery, and Otolaryngology, University of Virginia Health Sciences Center
C Douglas Phillips, MD is a member of the following medical societies: American College of Radiology, American Medical Association, American Society of Head and Neck Radiology, American Society of Neuroradiology, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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