Color Doppler imaging of the superior ophthalmic vein in different clinical forms of Graves’ orbitopathy

Monteiro, Mário Luiz Ribeiro; Neto, Hélio Angotti; Benabou, Joseph Elias; Betinjane, Alberto Jorge

doi:10.1007/s10384-008-0594-y

Cited by 35 publications

(32 citation statements)

References 17 publications

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“…The evaluation of the venous flow can also be useful. Monteiro et al (66) reported that patients with congestive orbitopathy and predominantly myogenic fibrotic GO experience a significant reduction in the SOV flow, matching reports from other authors (81) and supporting the idea that orbital congestion due to extraocular muscle enlargement can reduce orbital venous drainage. Because DON is known to be related to orbital apex crowding, the existence of severe venous stasis in the orbits possibly reflects a stage in its development.…”

Section: Introductionsupporting

confidence: 55%

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Imaging studies for diagnosing Graves’ orbitopathy and dysthyroid optic neuropathy

Gonçalves¹,

Gebrim²,

Monteiro³

2012

Clinics

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Although the diagnosis of Graves' orbitopathy is primarily made clinically based on laboratory tests indicative of thyroid dysfunction and autoimmunity, imaging studies, such as computed tomography, magnetic resonance imaging, ultrasound and color Doppler imaging, play an important role both in the diagnosis and follow-up after clinical or surgical treatment of the disease. Imaging studies can be used to evaluate morphological abnormalities of the orbital structures during the diagnostic workup when a differential diagnosis versus other orbital diseases is needed. Imaging may also be useful to distinguish the inflammatory early stage from the inactive stage of the disease. Finally, imaging studies can be of great help in identifying patients prone to develop dysthyroid optic neuropathy and therefore enabling the timely diagnosis and treatment of the condition, avoiding permanent visual loss. In this paper, we review the imaging modalities that aid in the diagnosis and management of Graves' orbitopathy, with special emphasis on the diagnosis of optic nerve dysfunction in this condition.

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Section: Introductionsupporting

confidence: 55%

“…Several studies have compared the orbital blood flow in GO patients and control subjects (25),(64),(65), as well as in patients with different clinical forms of GO (66). Benning et al (64) found that the flow velocity in the right ophthalmic artery was much greater in subjects with clinically active GO than control subjects.…”

Section: Introductionmentioning

confidence: 99%

Imaging studies for diagnosing Graves’ orbitopathy and dysthyroid optic neuropathy

Gonçalves¹,

Gebrim²,

Monteiro³

2012

Clinics

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show abstract

“…Congestion of the superior orbital vein plays an important role in the inflammatory phase, as demonstrated by computed tomography (19,20,21) and color Doppler imaging studies (22,23,24,25). It has been suggested that in GO the success of the immunosuppressive treatment is the result of the effect not only on the autoimmune process but also on the reduction of orbital venous congestion.…”

Section: Chronic Congestive Gomentioning

confidence: 99%

THERAPY OF ENDOCRINE DISEASE: Endocrine dilemma: management of Graves’ orbitopathy

Campi

Vannucchi

Salvi

2016

European Journal of Endocrinology

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Management of Graves' orbitopathy (GO) must be based on the correct assessment of activity and severity of the disease. Activity is usually assessed with the Clinical Activity Score, whereas severity is classified according to a European Group On Graves' Orbitopathy (EUGOGO) consensus statement as mild, moderate-to-severe, and sight-threatening. Myopathic and chronic congestive forms are uncommon clinical presentations of GO. Restoration and maintenance of stable euthyroidism are recommended in the presence of GO. In moderate-to-severe disease, steroids have been widely employed and have shown to possess an anti-inflammatory activity, but about 20 -30% of patients are not responsive and present recurrence. Some novel immunosuppressors have already been employed in clinical studies and have shown interesting results, although the lack of randomized and controlled trials suggests caution for their use in clinical practice. Potential targets for therapy in GO are the thyroid-stimulating hormone and the insulin-like growth factor 1 receptor on the fibroblasts, inflammatory cytokines, B and T cells, and the PIK3/mTORC1 signaling cascades for adipogenesis. A recent open study has shown that tocilizumab, an anti-sIL-6R antibody, inactivates GO. Consistent reports on the efficacy of rituximab have recently been challenged by randomized controlled trials. As the main goal of treatment is the well-being of the patient, the therapeutic strategy should be addressed to better suit the patient needs, more than improving one or more biological parameters. The increasing availability of new therapies will expand the therapeutic options for GO patients and allow the clinician to really personalize the treatment to better suit the patients' personal needs.

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“…1 The enlargement of the extraocular muscles is responsible for most of the debilitating manifestations of the disease, including proptosis, diplopia, congestive signs, and DON. [2][3][4][5] DON is a serious complication of GO occurring in 3.4% of patients, 6 almost always as a result of optic nerve compression at the orbital apex by enlarged extraocular muscles. The diagnosis of DON rests mainly on clinical findings such as decreased VA, abnormal VFs, altered color and brightness perception, delayed visual evoked potentials, afferent pupillary defects, and edema or atrophy of the optic nerve head.…”

mentioning

confidence: 99%

Quantification of Orbital Apex Crowding for Screening of Dysthyroid Optic Neuropathy Using Multidetector CT

Gonçalves¹,

Silva

Gebrim

et al. 2012

AJNR Am J Neuroradiol

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Color Doppler imaging of the superior ophthalmic vein in different clinical forms of Graves’ orbitopathy

Abstract: SOV was significantly reduced in orbits with congestive GO or with myogenic fibrotic GO, but not in orbits with fibrotic lipogenic orbitopathy. SOV congestion may be a contributing pathogenic factor in both congestive and fibrotic myogenic Graves' orbitopathy.

Cited by 35 publications

References 17 publications

Imaging studies for diagnosing Graves’ orbitopathy and dysthyroid optic neuropathy

Imaging studies for diagnosing Graves’ orbitopathy and dysthyroid optic neuropathy

THERAPY OF ENDOCRINE DISEASE: Endocrine dilemma: management of Graves’ orbitopathy

Quantification of Orbital Apex Crowding for Screening of Dysthyroid Optic Neuropathy Using Multidetector CT

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