Ocular surface alterations begin early in the course of Graves disease before the onset of overt TED.
Background. Graves’ ophthalmopathy is the most common extrathyroidal manifestation of Graves’ disease. The objective of this study was to investigate the clinical ophthalmological and MRI findings in newly diagnosed Graves’ ophthalmopathy. Methods. This study included 36 newly diagnosed Graves’ disease patients and 23 control participants. Patients and control participants underwent detailed ophthalmologic examination. In addition, all subjects underwent orbital MRI examination; and sizes, cross-sectional areas, and signal intensities of extraocular muscles were also measured. Results. Based on MRI measurements, the mean exophthalmos in the left eye was significantly higher in the patient group when compared to those of controls (2.04 ± 0.29 vs. 1.85 ± 0.15 cm, p = 0.003). The mean long diameter of inferior oblique muscle in both the right and left eyes were significantly shorter in patients when compared to those of controls ( p = 0.001, p = 0.002, resp.); however, the mean long diameter of superior oblique in the left eye was longer in patients than those of controls ( p = 0.001). Patients had significantly higher superior oblique muscle signal intensity than those of controls in the right eye ( p = 0.01). There was no significant difference for the other parameters between the patient and control groups. Conclusion. Our findings suggest that there is no obvious change in MRI examination despite clinical ophthalmological findings in patients with newly diagnosed Graves’ ophthalmopathy. Unnecessary MRI examination should be avoided in this patient group due to unsatisfactory cost-effectiveness.
Topikal anesteziklerin uzun süreli kullanımı, korneanın her katında doku hasarı ve inflamatuvar cevaba yol açan toksik keratopatiye neden olmaktadır. Klinik olarak enfeksiyöz keratitler ile benzerliği nedeniyle tanı ve tedavide gecikme görülmektedir. Ayırıcı tanının yapılması ciddi komplikasyonların önlenmesi açısından önem taşımaktadır. Bu yazıda topikal anesteziklerin kötüye kullanımına bağlı keratopati nedeniyle değerlendirilen iki hastanın in vivo konfokal mikroskopik bulguları rapor edilmektedir. (Turk J Ophthalmol 2015; 45: 37-39) Anah tar Ke li me ler: Topikal anestezik kötüye kullanımı, toksik keratopati, in vivo konfokal mikroskopi Prolonged use of topical anesthetic agents results in a toxic keratopathy with damage and inflammatory response in all corneal layers. The similarity of the clinical picture with infectious keratitis often leads to a delay in diagnosis and treatment. Consideration of topical anesthetic abuse in the differential diagnosis is crucial to prevent serious complications. In this paper, we report the in vivo confocal microscopic findings of two patients with toxic keratopathy secondary to topical anesthetic abuse.
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