Abstract
Purpose :
Thyroid Eye Disease (TED) is currently considered primarily a disease of the orbit; however, there is a growing body of evidence to suggest that periorbital facial tissue, such as the buccal fat pad (BFP) can also be affected. In some cases, surgeons remove buccal fat during orbital decompression in order to improve cosmesis. We performed this retrospective cohort study in order to determine whether TED is associated with changes in BFP volume.
Methods :
Computed Topography (CT) scans and charts of adult patients with and without TED were collected from a database of patients who were seen at Stein Eye Institute. Inclusion criteria for the TED group included presence of TED and availability of adequate scans. The control group consisted of patients presenting for non-thyroid related reasons, who had CT scans done for other orbital pathologies. Exclusion criteria included history of orbitofacial trauma or facial surgery, poor quality scans, scans with a slice interval greater than 2mm, or scans without clear buccal fat pad limits. The collected patients were compiled in a spreadsheet in random order, and three independent, blinded observers then measured buccal fat pad volume, proptosis, and maximal skull width using Horos, a free, open-source medical image viewing software. The primary outcome was buccal fat pad volume, measured in cubic centimeters.
Results :
A total of 69 scans were included in our study, 29 TED patients and 40 controls. Our analysis consisted of an analysis of covariance that included TED diagnosis, age, and proptosis as covariates. The difference in BFP volume between TED patients and controls was 0.317cc (p-value = 0.374). In our study, TED was not associated with a statistically significant change in BFP when controlling for relevant patient factors like age and proptosis.
Conclusions :
We found that TED did not significantly impact BFP volume. These findings suggest that there may not be a compelling reason to extract buccal fat from these patients during orbital decompression surgery. However further analysis is needed to assess the impact of other factors such as sex and presence of comorbidities on the buccal fat pat volume in TED.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.