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

Gonçalves, Arthur Lopes; Silva, L.N.; Gebrim, Eloísa Maria Mello Santiago; Monteiro, Mário Luiz Ribeiro

doi:10.3174/ajnr.a3029

Cited by 52 publications

(40 citation statements)

References 17 publications

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“…It is presumed to be an autoimmune inflammatory process that affects the orbital and periorbital tissues, predominantly the EOMs and retrobulbar fat. 28 The disease may involve the orbit before, during, or after the onset of hyperthyroidism and may occur less frequently in euthyroid or hypothyroid patients. The most common manifestations include dysthyroid optic neuropathy (DON), proptosis, diplopia, and orbital congestive signs.…”

Section: Thyroid Orbitopathymentioning

confidence: 99%

“…The most common manifestations include dysthyroid optic neuropathy (DON), proptosis, diplopia, and orbital congestive signs. 28 A serious complication of thyroid orbitopathy, dysthyroid optic neuropathy occurs in 3.4% of patients and is usually a result of optic nerve compression at the OA by enlarged EOMs. 28 MRI and CT imaging during the acute congestive phase of thyroid orbitopathy generally demonstrate markedly swollen retrobulbar orbital contents resulting in proptosis.…”

Section: Thyroid Orbitopathymentioning

confidence: 99%

“…28 A serious complication of thyroid orbitopathy, dysthyroid optic neuropathy occurs in 3.4% of patients and is usually a result of optic nerve compression at the OA by enlarged EOMs. 28 MRI and CT imaging during the acute congestive phase of thyroid orbitopathy generally demonstrate markedly swollen retrobulbar orbital contents resulting in proptosis. The coronal plane is especially valuable in depicting the enlargement of EOM bellies, resultant crowding at the OA, and optic nerve compression.…”

Section: Thyroid Orbitopathymentioning

confidence: 99%

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MRI in the Evaluation of Acute Visual Syndromes

Mukhi

Lincoln²

2015

Topics in Magnetic Resonance Imaging

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Acute visual symptom emergencies occur commonly and present a challenge to both clinical and radiologic facets. Although most patients with visual complaints routinely require clinical evaluation with direct ophthalmologic evaluation, imaging is rarely necessary. However, there are highly morbid conditions where the prompt recognition and management of an acute visual syndrome (AVS) requires an astute physician to probe further. Suspicious symptomatology including abrupt visual loss, diplopia, ophthalmoplegia, and proptosis/exophthalmos require further investigation with advanced imaging modalities such as magnetic resonance imaging and magnetic resonance angiography. This review will discuss a variety of AVSs including orbital apex syndrome, cavernous sinus thrombosis, cavernous carotid fistula, acute hypertensive encephalopathy (posterior reversible encephalopathy syndrome), optic neuritis, pituitary apoplexy including hemorrhage into an existing adenoma, and idiopathic intracranial hypertension. A discussion of each entity will focus on the clinical presentation, management and prognosis when necessary and finally, neuroimaging with emphasis on magnetic resonance imaging. The primary purpose of this review is to provide an organized approach to the differential diagnosis and typical imaging patterns for AVSs. We have provided a template for radiologists and specialists to assist in early intervention in order to decrease morbidity and provide value-based patient care through imaging.

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Section: Thyroid Orbitopathymentioning

confidence: 99%

Section: Thyroid Orbitopathymentioning

confidence: 99%

Section: Thyroid Orbitopathymentioning

confidence: 99%

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MRI in the Evaluation of Acute Visual Syndromes

Mukhi

Lincoln²

2015

Topics in Magnetic Resonance Imaging

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“…If the distance between interzygomatic line and anterior surface of the eyeball was >23 mm, proptosis was confirmed. 12,13 Visual acuity, proptosis, and size of the tumor before and 3 months after surgery were analyzed.…”

Section: Data Collectionmentioning

confidence: 99%

Combination of Surgery and Gamma Knife in the Management of En Plaque Meningioma

Mostafapour

Nikoobakht²,

Azar

et al. 2015

Neurosurgery Quarterly

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Objective: The aim of this study was to determine the results of using gamma knife in resection of en plaque meningioma after subtotal surgery resection.Materials and Methods: All patients with en plaque meningioma in spheno-orbital area, who were subject to this experiment in the Neurosurgery Clinic of Shahid Rajai Hospital (affiliated to Qazvin University of Medical Sciences, Qazvin, Iran), were operated for tumor resection. Gamma knife was used to resect the tumor tissue in patients who underwent subtotal surgery resection. Patients were followed up for recurrence.Results: Of the 22 patients with average age of 53.82 ± 11.03 years who participated in this study, 7 (31.82%) were male and 15 (68.18%) were female. Proptosis was the prevalent symptom with 77.28% prevalence. Tumor tissue was totally resected in 6 patients (26.1%), and the remaining patients were treated by gamma knife after undergoing subtotal resection. Visual acuity, tumor size, and the distance between the interzygomatic line and the interior surface of the eyeball had significant improvement after 3 months (P-value of changes of all 3 variables was <0.001). Recurrence in 6 patients (27.27%) was diagnosed on average 41.18 ± 5.77 months after follow-up, and it was significantly lower in patients treated using gamma knife (P-value <0.01). Recurrence was caused by involvement of orbital cavity and cavernous sinus (P-value < 0.01).Conclusions: Using gamma knife is useful in the treatment of en plaque meningioma patients after undergoing subtotal surgery resection. It also reduces the risk of tumor recurrence.

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“…Imaging data after damage to the orbit of the eye in trauma situations can be related to decline in visual function [21]. Orbital metrics of the eye such as Barrett Index have also been shown to be associated with dysthyroid optic neuropathy in patients with Graves’ orbitopathy [19–20]. …”

Section: Introductionmentioning

confidence: 99%

Structural-functional relationships between eye orbital imaging biomarkers and clinical visual assessments

et al. 2017

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Eye diseases and visual impairment affect millions of Americans and induce billions of dollars in annual economic burdens. Expounding upon existing knowledge of eye diseases could lead to improved treatment and disease prevention. This research investigated the relationship between structural metrics of the eye orbit and visual function measurements in a cohort of 470 patients from a retrospective study of ophthalmology records for patients (with thyroid eye disease, orbital inflammation, optic nerve edema, glaucoma, intrinsic optic nerve disease), clinical imaging, and visual function assessments. Orbital magnetic resonance imaging (MRI) and computed tomography (CT) images were retrieved and labeled in 3D using multi-atlas label fusion. Based on the 3D structures, both traditional radiology measures (e.g., Barrett index, volumetric crowding index, optic nerve length) and novel volumetric metrics were computed. Using stepwise regression, the associations between structural metrics and visual field scores (visual acuity, functional acuity, visual field, functional field, and functional vision) were assessed. Across all models, the explained variance was reasonable (R2 ~ 0.1–0.2) but highly significant (p < 0.001). Instead of analyzing a specific pathology, this study aimed to analyze data across a variety of pathologies. This approach yielded a general model for the connection between orbital structural imaging biomarkers and visual function.

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

Cited by 52 publications

References 17 publications

MRI in the Evaluation of Acute Visual Syndromes

MRI in the Evaluation of Acute Visual Syndromes

Combination of Surgery and Gamma Knife in the Management of En Plaque Meningioma

Structural-functional relationships between eye orbital imaging biomarkers and clinical visual assessments

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