Orbital Echography Can Pick Up Thyroid Eye Disease

In those with unexplained ocular misalignment, thyroid eye disease may be frequent cause

MONDAY, July 31 (HealthDay News) -- Orbital echography can pick up thyroid eye disease among patients with unexplained ocular misalignment who present in an occult fashion, according to a study in the July issue of the American Journal of Ophthalmology.

Nicholas J. Volpe, M.D., of the University of Pennsylvania School of Medicine in Philadelphia, and colleagues conducted a retrospective, observational study of 78 patients who presented with chronic ocular misalignment that suggested thyroid eye disease because of a history of systemic thyroid disease.

The investigators found that 55 percent of patients with unexplained ocular misalignment were likely to have thyroid eye disease, although clinical findings were not sufficient enough to make this call. Of patients confirmed to have thyroid eye disease by echography, 20 percent presented without findings that are typically associated with thyroid eye disease, such as lid retraction, lid lag and exophthalmos. Forty percent had no lid retraction or exophthalmos, and 70 percent had no lid retraction.

Although computed tomography scan and magnetic resonance imaging of the orbit are important in ruling out other causes of double vision, "the expedient diagnosis of thyroid eye disease by echography not only identifies a condition with systemic implications, but may also significantly reduce the need for further costly evaluation," the authors conclude.

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