TY - JOUR
T1 - Natural Course of Mild Graves Orbitopathy
T2 - Increase of Orbital Fat But Decrease of Muscle Volume With Increased Muscle Fatty Degeneration During a 4-Year Follow-Up
AU - Potgieser, Peter W
AU - de Win, Maartje M M L
AU - Wiersinga, Wilmar M
AU - Mourits, Maarten P
PY - 2019
Y1 - 2019
N2 - PURPOSE: To describe the natural course of orbital fat volume and extraocular muscle volume in mild Graves orbitopathy during a 4-year follow-up. To describe fatty changes within the extraocular muscles. PATIENTS: Twenty-five patients with mild Graves orbitopathy, who did not require any therapeutic intervention other than supportive therapy, were followed for 4 years. METHODS: CT scans were performed in all patients at baseline and follow-up. A validated technique using Mimics (Materialise) was used to calculate fat and muscle volumes. Outcomes were compared with previously collected data. The amount of intramuscular fat was assessed on CT scans in a semi-quantitative way by two blinded observers according to a four-point scale. RESULTS: After a median follow-up of 4.3 years, the median fat to orbital volume ratio increased with 0.08 from 0.57 to 0.65 (p = 0.000), whereas the median muscle volume to orbital volume ratio decreased with 0.03 from 0.17 to 0.14 (p = 0.000). In this control group in patients between 49 and 54 years old, the changes were 0.01 and -0.002, respectively. The Clinical Activity Score decreased to zero (p = 0.000), and the median eyelid aperture decreased from 12 to 10 mm (p = 0.007). A significant increase of intramuscular fat was found in patients with Graves orbitopathy. CONCLUSIONS: The natural course of mild Graves orbitopathy, as observed over 4 years, is characterized by an increase of orbital fat volume, a decrease in muscle volume, and an increased intramuscular fatty degeneration.
AB - PURPOSE: To describe the natural course of orbital fat volume and extraocular muscle volume in mild Graves orbitopathy during a 4-year follow-up. To describe fatty changes within the extraocular muscles. PATIENTS: Twenty-five patients with mild Graves orbitopathy, who did not require any therapeutic intervention other than supportive therapy, were followed for 4 years. METHODS: CT scans were performed in all patients at baseline and follow-up. A validated technique using Mimics (Materialise) was used to calculate fat and muscle volumes. Outcomes were compared with previously collected data. The amount of intramuscular fat was assessed on CT scans in a semi-quantitative way by two blinded observers according to a four-point scale. RESULTS: After a median follow-up of 4.3 years, the median fat to orbital volume ratio increased with 0.08 from 0.57 to 0.65 (p = 0.000), whereas the median muscle volume to orbital volume ratio decreased with 0.03 from 0.17 to 0.14 (p = 0.000). In this control group in patients between 49 and 54 years old, the changes were 0.01 and -0.002, respectively. The Clinical Activity Score decreased to zero (p = 0.000), and the median eyelid aperture decreased from 12 to 10 mm (p = 0.007). A significant increase of intramuscular fat was found in patients with Graves orbitopathy. CONCLUSIONS: The natural course of mild Graves orbitopathy, as observed over 4 years, is characterized by an increase of orbital fat volume, a decrease in muscle volume, and an increased intramuscular fatty degeneration.
KW - Adipose Tissue/pathology
KW - Adult
KW - Female
KW - Follow-Up Studies
KW - Graves Ophthalmopathy/pathology
KW - Humans
KW - Male
KW - Middle Aged
KW - Oculomotor Muscles/pathology
KW - Orbit/pathology
KW - Tomography, X-Ray Computed
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85072058376&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30882587
U2 - https://doi.org/10.1097/IOP.0000000000001319
DO - https://doi.org/10.1097/IOP.0000000000001319
M3 - Article
C2 - 30882587
SN - 0740-9303
VL - 35
SP - 456
EP - 460
JO - Ophthalmic plastic and reconstructive surgery
JF - Ophthalmic plastic and reconstructive surgery
IS - 5
ER -