Changes in horizontal strabismus after inferior rectus muscle recession with or without nasal transposition in thyroid eye disease: A retrospective, observational study

Abstract Background To investigate the incidence of absent Bell’s phenomenon (BP) and the relationship between absent BP and inferior rectus muscle hypertrophy and other clinical features in patients with thyroid eye disease (TED). Methods A total of 104 patients who were first diagnosed with TED between January and December 2014 were included. Inferior rectus muscle area and associations with clinical features of TED and thyroid function test including thyroid specific antibodies were compared between patients with TED with and without BP. The volume of the inferior rectus muscle was calculated by adding up all the cross-sectional areas measured on sagittal CT images. Results Among the 104 patients, 14 had absent BP (13.5%), 12 with bilateral and two with unilateral. There was no significant difference in thyroid function test, presence of TSIs, exophthalmos, or volume of inferior rectus muscle measured in CT scans (P > 0.05). Incidence of diplopia, elevation limitation, and upper eyelid retraction were risk factors of absent BP in TED patients (by logistic regression analysis, P < 0.05). Conclusions Inferior rectus muscle hypertrophy was not the cause of absent BP in TED patients. Fibrosis and tightening of the inferior rectus muscle, lower eyelid, and surrounding orbital tissues, rather than inferior rectus muscle hypertrophy, might be related to absent BP in TED patients.

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Simulation of Inferior Rectus Muscle Behavior in Patients with Hypertrophic Thyroid Eye Disease Using Computational Biomechanics

Transactions of the Korean Society of Mechanical Engineers B ◽

10.3795/ksme-b.2021.45.8.409 ◽

2021 ◽

Vol 45 (8) ◽

pp. 409-417

Author(s):

Byeong-Cheol Jeong ◽

Jungyul Park ◽

Chi-Seung Lee ◽

Dongman Ryu

Keyword(s):

Rectus Muscle ◽

Thyroid Eye Disease ◽

Eye Disease ◽

Inferior Rectus ◽

Computational Biomechanics ◽

Inferior Rectus Muscle

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Predictors of the Dose-Effect Relationship regarding Unilateral Inferior Rectus Muscle Recession in Patients with Thyroid Eye Disease

International Journal of Endocrinology ◽

10.1155/2015/703671 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Yasuhiro Takahashi ◽

Hirohiko Kakizaki

Keyword(s):

Multiple Regression ◽

Smoking Status ◽

Rectus Muscle ◽

Dose Effect ◽

Eye Disease ◽

Inferior Rectus ◽

Orbital Radiotherapy ◽

Effect Relationship ◽

History Of ◽

Inferior Rectus Muscle

Purpose. To evaluate whether inferior rectus muscle (IRM) thickness, the degree of adipose change in the IRM, smoking status, and the previous history of orbital radiotherapy can predict the dose-effect relationship regarding unilateral IRM recession in thyroid eye disease (TED).Methods. Twenty-five patients were retrospectively reviewed. We calculated the largest IRM cross-sectional area and evaluated the degree of adipose change in the IRM using magnetic resonance imaging. The degree of adipose change and smoking status were classified using grading scales (0–3); previous orbital radiotherapy was graded as 0 when a history was not available and 1 when it was available. The correlation between the dose-effect relationship and the hypothesized predictive factors was evaluated using stepwise multiple regression analysis.Results. The multiple regression model, with the exception of the history of the previous orbital radiotherapy, estimated a significant dose-effect relationship for the parameters evaluated (YDOSE-EFFECT= 0.013XIRM AREA − 0.222XADIPOSE − 0.102XSMOKING+ 1.694;r= 0.668; adjustedr2= 0.367;P= 0.005).Conclusions. The dose-effect relationship regarding unilateral IRM recession in TED could be predicted using IRM thickness, degree of intramuscular adipose change, and smoking status but could not be predicted using the previous orbital radiotherapy history.

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Primary Infratarsal Lower Eyelid Retractor Lysis to Prevent Eyelid Retraction After Inferior Rectus Muscle Recession

American Journal of Ophthalmology ◽

10.1016/s0002-9394(14)72059-8 ◽

1996 ◽

Vol 122 (3) ◽

pp. 331-339 ◽

Cited By ~ 25

Author(s):

DALE R. MEYER ◽

JOHN W. SIMON ◽

MARY KANSORA

Keyword(s):

Rectus Muscle ◽

Lower Eyelid ◽

Eyelid Retraction ◽

Inferior Rectus ◽

Inferior Rectus Muscle ◽

Inferior Rectus Muscle Recession

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Bilateral inferior rectus muscle recession for correction of hypotropia in dysthyroid ophthalmopathy

Journal of American Association for Pediatric Ophthalmology and Strabismus ◽

10.1016/s1091-8531(99)70061-3 ◽

1999 ◽

Vol 3 (3) ◽

pp. 157-159 ◽

Cited By ~ 11

Author(s):

Oscar A. Cruz ◽

Bradley V. Davitt

Keyword(s):

Rectus Muscle ◽

Inferior Rectus ◽

Inferior Rectus Muscle ◽

Inferior Rectus Muscle Recession ◽

Dysthyroid Ophthalmopathy

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Correlation between Thyroid-stimulating Antibody Level Change and Extraocular Muscle Thickness Change in Thyroid Eye Disease

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.10.1315 ◽

2021 ◽

Vol 62 (10) ◽

pp. 1315-1323

Author(s):

Jeeyoung Kwak ◽

Dong Cheol Lee

Keyword(s):

Extraocular Muscle ◽

Rectus Muscle ◽

Muscle Thickness ◽

Lateral Rectus ◽

Eye Disease ◽

Inferior Rectus ◽

Lateral Rectus Muscle ◽

Experimental Group ◽

Inferior Rectus Muscle

Purpose: To investigate the changes in extraocular muscle thicknesses by variations in the thyroid stimulating antibody (TSAb) level in patients with thyroid eye disease (TED).Methods: A total of 67 TED patients were enrolled. They were divided into two groups: an experimental group with clinically significant elevated TSAb levels (≥140 IU/L) and a control group (TSAb <140 IU/L). All of the lateral, medial, superior, and inferior rectus muscle thicknesses were measured with the aid of anterior segment optical coherence tomography (OCT). The average thicknesses for both eyes were recorded for each patient based on the values measured at the ends of the muscles (which become vertically thinner from the points of tendon attachment). We measured changes in TSAb levels and extraocular muscle thicknesses after two follow-up periods and sought correlations among these parameters.Results: At the initial visits, the inferior rectus muscle thickness was positively correlated with the TSAb level in the experimental group (p = 0.045, r = 0.478). None of the medial, superior, or lateral rectus muscle thicknesses were so correlated. On follow-up, the variation in TSAb level correlated negatively with changes in lateral rectus muscle thickness (p = 0.038, r = -0.357). The superior rectus muscle thickness tended to be negatively correlated with the TSAb level, but statistical significance was not attained (p = 0.146, r = -0.669). The thicknesses of the inferior and superior rectus muscles did not change over time.Conclusions: In TED patients, TSAb variations seem to reflect the extent of periorbital tissue edema, thus correlating negatively with especially lateral rectus muscle thickness changes.

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