Calculated Computed Tomography Volumes of Lacrimal Glands and Comparison to Clinical Findings in Patients With Thyroid Eye Disease

Bingham, Chad M.; Harris, Mark; Realini, Tony; Nguyen, John; Hogg, Jeffery P.; Sivak-Callcott, Jennifer A.

doi:10.1097/iop.0000000000000015

Cited by 41 publications

(35 citation statements)

References 11 publications

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“…The control group orbital CT scans were performed between May 2013 and May 2014. As described by Bingham et al [ 12 ], CT scans were obtained using a 2-mm slice thickness orbit protocol on a Toshiba Aquilion 64-slice scanner (Toshiba Medical Systems, Otawara, Japan). As described by Bingham et al [ 13 ], an open source DICOM viewer (OsiriX, Geneva, Switzerland) was used to outline the lacrimal gland in consecutive axial slices and calculate the volume ( Fig.…”

Section: Methodsmentioning

confidence: 99%

“…Clinical notes that correlated most closely to the time of the CT scan were reviewed. Data were collected for abnormal motility, subjective tearing, corneal superficial punctate keratopathy (SPK), lagophthalmos and exophthalmometry [ 12 ]. The exclusion criteria for the TAO patients included non-Korean, age <20 years, previous orbital surgery, contralateral eye of a unilateral TAO patient (i.e., no symptoms to suspect TAO on one side and no extraocular muscle hypertrophy in CT scans).…”

Section: Methodsmentioning

confidence: 99%

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The Change of Lacrimal Gland Volume in Korean Patients with Thyroid-associated Ophthalmopathy

Huh

Kim

et al. 2016

Korean J Ophthalmol

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PurposeTo describe the change of lacrimal gland volumes in Korean patients with thyroid-associated ophthalmopathy (TAO) via computed tomography (CT).MethodsA retrospective review of CT images from 217 TAO patients and 135 control subjects was performed. The TAO patients were diagnosed between May 2005 and May 2014 and had a CT performed on initial presentation (330 orbital CT scans). These images were compared with 270 orbital CT scans from the control group, obtained between May 2013 and May 2014. An open source DICOM viewer was used to calculate the volume of the lacrimal gland.ResultsThe mean volume of the lacrimal gland in TAO patients was 0.816 cm3 in the right orbit (standard deviation [SD], 0.048) and 0.811 cm3 in the left orbit (SD, 0.051), with no significant difference between right and left (p = 0.192). However, significant differences were observed between TAO patients and healthy individuals (p < 0.001). There was no significant difference between mean lacrimal gland volumes of males (0.812 cm3; SD, 0.037) and females (0.816 cm3; SD, 0.029) (p = 0.513). There was a negative correlation between gland volume and age in TAO patients (Pearson r = -0.479, p = 0.00). The subjective tearing (right: r = 0.244, p = 0.018; left: r = 0.226, p = 0.024), corneal superficial punctate keratopathy (right: r = 0.192, p = 0.040; left: r = 0.206, p = 0.036), and exophthalmometry (right: r = 0.182, p = 0.032; left: r = 0.180, p = 0.046) correlated with lacrimal gland volume.ConclusionsThis study is the first to use CT images to calculate the lacrimal gland volume of Korean TAO patients. In TAO patients, the lacrimal gland volume was notably increased compared to control subjects. The lacrimal gland volume decreased with age, but there was no difference between gender and no difference between left and right. The lacrimal gland volume correlated with subjective tearing, corneal superficial punctate keratopathy and exophthalmometry.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The Change of Lacrimal Gland Volume in Korean Patients with Thyroid-associated Ophthalmopathy

Huh

Kim

et al. 2016

Korean J Ophthalmol

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“…Enlargement of the superior ophthalmic vein may also predict DON[28]. An anteriorly displaced or enlarged lacrimal gland may also be seen in the setting of TED and possibly DON[48–50]. …”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Dysthyroid optic neuropathy: update on pathogenesis, diagnosis, and management

Blandford

Zhang

Chundury

et al. 2017

Expert Review of Ophthalmology

102

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Introduction Dysthyroid optic neuropathy (DON) is a severe manifestation of thyroid eye disease (TED) that can result in permanent vision loss. Management is complex, multidisciplinary, and involves medical and/or surgical therapies. This review describes current concepts in the epidemiology, pathophysiology, diagnosis, and treatment of DON. Areas covered An extensive review of the literature was performed to detail current concepts on the diagnosis and management of DON. This includes utilization of various medical and surgical modalities for disease management. Expert commentary DON can result in permanent blindness and often requires the use of corticosteroids and surgical decompression. We favor the use of intravenous corticosteroids and a transcaruncular approach when surgical decompression is indicated. The use of orbital radiation for DON is often reserved for patients that are poor surgical candidates and/or patients with refractory disease.

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“…Few studies discuss the lacrimal gland involvement in thyroid eye disease. Computed to-mography and isotope study are used to assess lacrimal glands in patients with thyroid eye disease; however, they are associated with radiation exposure [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Assessment of lacrimal glands in thyroid eye disease with diffusion-weighted magnetic resonance imaging

Razek¹,

El-Hadidy²,

El-Metwaly³

et al. 2019

Pol J Radiol

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Purpose: To assess the lacrimal glands in patients with thyroid eye disease with diffusion-weighted magnetic resonance (MR) imaging. Material and methods: This study was carried out on 44 consecutive patients (17 males, 27 females, with mean age 36 years) with thyroid eye disease and 20 age-and sex-matched volunteers. They underwent diffusion-weighted MR imaging of the orbit. The apparent diffusion coefficient (ADC) values of the lacrimal glands were calculated and correlated with the clinical activity score (CAS). Results: The mean ADC of lacrimal glands in thyroid eye disease (1.73 × 10-3 mm 2 /s) was significantly higher (p = 0.001) than that of volunteers (1.52 × 10-3 mm 2 /s). The cutoff ADC value of lacrimal gland used for differentiation of thyroid eye disease from volunteers was 1.62 × 10-3 mm 2 /s with an area under the curve value of 0.95 and an accuracy of 96%. There was significant difference (p = 0.03) in the ADC of the lacrimal glands in patients with active (n = 24) and inactive (n = 20) disease. The cutoff ADC value of the lacrimal gland used to suspect active disease was 1.76 × 10-3 mm 2 /s with an area under the curve value of 0.80 and an accuracy of 82%. There was positive correlation between the ADC value of the lacrimal glands and CAS (r = 0.73, p = 0.001). Conclusions: The ADC of the lacrimal glands is a non-invasive imaging parameter that can be used for diagnosis of thyroid eye disease and to predict the active form of the disease.

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Calculated Computed Tomography Volumes of Lacrimal Glands and Comparison to Clinical Findings in Patients With Thyroid Eye Disease

Abstract: This study is the first to report the volume of the lacrimal gland calculated on CT scan for patients with TED. The lacrimal gland is larger in patients with TED and correlates with subjective tearing and exophthalmometry.

Cited by 41 publications

References 11 publications

The Change of Lacrimal Gland Volume in Korean Patients with Thyroid-associated Ophthalmopathy

The Change of Lacrimal Gland Volume in Korean Patients with Thyroid-associated Ophthalmopathy

Dysthyroid optic neuropathy: update on pathogenesis, diagnosis, and management

Assessment of lacrimal glands in thyroid eye disease with diffusion-weighted magnetic resonance imaging

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