Abstract
Purpose :
Diagnostic guidelines for thyroid eye disease (TED) have been developed using a mostly Caucasian population. Studies of TED presentation among Asian patients found lower lid retraction in 60% of cases and proposed adding lower lid retraction to TED diagnostic criteria1. While these studies demonstrate clinical differences in other populations, there have been few studies on the presentation of TED in Black populations. We performed a retrospective analysis of radiological images and reports to further characterize how TED presents in Black patients.
Methods :
Retrospective analysis of radiological images and reports of Black patients with TED at Kings County Hospital and SUNY Downstate Medical Center in Brooklyn, NY and its affiliated clinics from January 1, 2010-July 31, 2021. Specific measures include extraocular muscle (EOM) enlargement, bilateral involvement, proptosis, and orbital apex crowding.
Results :
Review of radiologic reports (N=18) EOM enlargement in 16/18 (88%) patients, proptosis in 12/18 (66%) and orbital apex crowding in 4/18 (22%). Direct review of available radiologic images was performed in nine patients. Of these 9/9 (100%) had EOM enlargement and 9/9 (100%) had bilateral involvement. 9/9 (100%) of patients had enlargement of the inferior and medial rectus. The superior rectus was enlarged in 5/9 (56%) patients and the lateral rectus was enlarged in 3/9 (33%) patients. Proptosis was seen in 5/9 (55%) patients and orbital apex crowding was seen in 3/9 (33%) patients.
Conclusions :
This analysis identified several radiological features of TED in Black patients. The EOM enlargement found in this sample is similar to the results in the current literature2. This study contributes to the growing body of research in TED, more studies with larger sample sizes are needed to further elucidate TED manifestations in other races and amend diagnostic criteria.
1 Lim SL, Lim AKE, Mumtaz M, Hussein E, Wan Bebakar WM, Khir AS. Prevalence, risk factors, and clinical features of thyroid-associated ophthalmopathy in multiethnic Malaysian patients with graves' disease.Thyroid : official journal of the American Thyroid Association. https://pubmed.ncbi.nlm.nih.gov/19012471/. Published December 2008
2 Dagi LR, Zoumalan CI, Konrad H, Trokel SL, Kazim M. Correlation between extraocular muscle size and motility restriction in thyroid eye disease. Ophthalmic plastic and reconstructive surgery. https://pubmed.ncbi.nlm.nih.gov/21383547/. Published 2011.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.