Abstract
Purpose:
In untreated Graves' disease patients with bilateral upper eyelid retraction, we investigated relationship to thyroid function, thyroid antibody, levator muscle, and extraocular muscle compared with patients without upper eyelid retraction.
Methods:
Newly diagnosed Graves' disease patients were included in this study, who were underwent MRI examination before medical treatment. We distinguished patients with bilateral upper eyelid retraction (UER positive group, n = 49) and without eyelid retraction (UER negative group, n = 96) from all patients. Thyroid function (FT3, FT4, and TSH), thyroid antibody (TBII, TSAb, TgAb, and TPOAb), and cross-section area of extraocular muscle and levator muscle on MRI, which were evaluated in both groups.
Results:
Thyroid function was no significant difference between both groups. In UER positive group, TSAb (p < 0.0001) and TBII (p = 0.0415) were significantly high level compared with UER negative group. The extraocular muscle of UER positive group , such as inferior (p = 0.0067), medial (p = 0.0139), superior (p = 0.0087), and lateral rectus muscle (p = 0.0014), was significantly enlarged than UER negative group. In UER positive group, moreover, exophthalmos was more observed compared with UER negative group (margin 1.5 mm).
Conclusions:
In untreated Graves’ disease patients, existence of bilateral eyelid retraction may already develop the enlargement of levator and extraocular muscle. It was considered that complete examination on MRI was necessary in these cases
Keywords: 526 eyelid •
631 orbit •
432 autoimmune disease