Predicting dysthyroid optic neuropathy using computed tomography volumetric analyses of orbital structures

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGONCALVES, Allan C. Pieroni
dc.contributor.authorSILVA, Lucas Nunes
dc.contributor.authorGEBRIM, Eloisa M. M. S.
dc.contributor.authorMATAYOSHI, Suzana
dc.contributor.authorMONTEIRO, Mario Luiz Ribeiro
dc.date.accessioned2013-07-30T15:14:13Z
dc.date.available2013-07-30T15:14:13Z
dc.date.issued2012
dc.description.abstractOBJECTIVE: To evaluate the ability of orbital apex crowding volume measurements calculated with multidetector-computed tomography to detect dysthyroid optic neuropathy. METHODS: Ninety-three patients with Graves' orbitopathy were studied prospectively. All of the patients underwent a complete neuro-ophthalmic examination and computed tomography scanning. Volumetric measurements were calculated from axial and coronal contiguous sections using a dedicated workstation. Orbital fat and muscle volume were estimated on the basis of their attenuation values (in Hounsfield units) using measurements from the anterior orbital rim to the optic foramen. Two indexes of orbital muscle crowding were calculated: i) the volumetric crowding index, which is the ratio between soft tissue (mainly extraocular muscles) and orbital fat volume and is based on axial scans of the entire orbit; and ii) the volumetric orbital apex crowding index, which is the ratio between the extraocular muscles and orbital fat volume and is based on coronal scans of the orbital apex. Two groups of orbits (with and without dysthyroid optic neuropathy) were compared. RESULTS: One hundred and two orbits of 61 patients with Graves' orbitopathy met the inclusion criteria and were analyzed. Forty-one orbits were diagnosed with Graves' orbitopathy, and 61 orbits did not have optic neuropathy. The two groups of orbits differed significantly with regard to both of the volumetric indexes (p<0.001). Although both indexes had good discrimination ability, the volumetric orbital apex crowding index yielded the best results with 92% sensitivity, 86% specificity, 81%/94% positive/negative predictive value and 88% accuracy at a cutoff of 4.14. CONCLUSION: This study found that the orbital volumetric crowding index was a more effective predictor of dysthyroid optic neuropathy than previously described computed tomography indexes were.
dc.description.indexMEDLINE
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo FAPESP Sao Paulo, Brazil [12/50392-0]
dc.description.sponsorshipConselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) Brasilia, Brazil [306487/2011-0]
dc.identifier.citationCLINICS, v.67, n.8, p.891-896, 2012
dc.identifier.doi10.6061/clinics/2012(08)06
dc.identifier.issn1807-5932
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/906
dc.language.isoeng
dc.publisherHOSPITAL CLINICAS, UNIV SAO PAULO
dc.relation.ispartofClinics
dc.rightsopenAccess
dc.rights.holderCopyright HOSPITAL CLINICAS, UNIV SAO PAULO
dc.subjectDysthyroid optic neuropathy
dc.subjectMultidetector computed tomography
dc.subjectGraves' orbitopathy
dc.subjectVolume CT
dc.subject.otherfrequency-doubling perimetry
dc.subject.otherthyroid-related orbitopathy
dc.subject.othergraves ophthalmopathy
dc.subject.otherextraocular-muscle
dc.subject.othernerve compression
dc.subject.othereye disease
dc.subject.otherct
dc.subject.otherfat
dc.subject.otherdecompression
dc.subject.otherrisk
dc.subject.wosMedicine, General & Internal
dc.titlePredicting dysthyroid optic neuropathy using computed tomography volumetric analyses of orbital structures
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.citation.scopus31
hcfmusp.contributor.author-fmusphcALLAN CHRISTIAN PIERONI GONCALVES
hcfmusp.contributor.author-fmusphcLUCAS NUNES DA SILVA
hcfmusp.contributor.author-fmusphcELOISA MARIA MELLO SANTIAGO GEBRIM
hcfmusp.contributor.author-fmusphcSUZANA MATAYOSHI
hcfmusp.contributor.author-fmusphcMARIO LUIZ RIBEIRO MONTEIRO
hcfmusp.description.beginpage891
hcfmusp.description.endpage896
hcfmusp.description.issue8
hcfmusp.description.volume67
hcfmusp.lim.ref2012
hcfmusp.origemWOS
hcfmusp.origem.pubmed22948455
hcfmusp.origem.scieloSCIELO:S1807-59322012000800006
hcfmusp.origem.scopus2-s2.0-84866309693
hcfmusp.origem.wosWOS:000308409100006
hcfmusp.publisher.citySAO PAULO
hcfmusp.publisher.countryBRAZIL
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hcfmusp.remissive.sponsorshipCNPq
hcfmusp.remissive.sponsorshipFAPESP
hcfmusp.scopus.lastupdate2024-05-17
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