The Clinical Features and the Change of Extraocular Muscle at the First Visit in Hyperthyroidism Patients

ABSTRACT

PURPOSE: To investigate of the orbital manifestations and the changes in extraocular muscles of hyperthyroidism patients at the first visit to out-patient clinic. METHODS: We reviewed the orbital manifestation and extraocular muscle hypertrophy of the patient with the hyperthyroidism who are transfered from internal medicine to ophthalmology. We used the NOSPECS system to classify the patients and checked the orbital CT, schirmer test, visual field exam, and the Hertel's exophthalmometer for evaluation of ocular symptoms. RESULTS: Mean age of the group was 34.62 +/- 9.89 years. They were 5 males and 11 females. According to NOSPECS system, the change of eyelid and ptoptosis was 1.56 and 1.31, the change of extraocular muscle and the degree of corneal involvement was 0.56, sight loss due to optic nerve involvement was 0.25 in ophthalmic index. The thickness of the extraocular muscles measured by CT scan showed 4.40mm in the superior muscle group, 3.90mm in the inferior rectus muscle, 3.42mm in the medial rectus muscle, 3.40mm in the lateral rectus muscle. CONCLUSION: According to NOSPECS system, the ophthalmic index was 4.18. Especially, the changes of eyelid were remarkable(1.56) among the signs. The hypertrophy of superior muscle group(superior rectus and levator palpebral muscle) and inferior rectus muscle were eminent, measured by CT scan.