Graves ophthalmopathy (GO) is the most common extrathyroidal manifestation of Graves disease. It is important to identify the acute inflammation phase at an early stage to improve GO clinical outcomes. The lacrimal gland (LG) involvement in patients with GO has been considered as a potential cause of the associated GO symptoms [1-3] and different studies found that the LG measurements were significantly higher in patients with GO than healthy controls [4-6]. However, no data are available about the difference in LC volume between patients with...

Thirty-two consecutive Caucasian patients (10M, 22F, mean age 49.5, IR 30-68 yrs), affected by GO were enrolled and grouped in group A (n=16 with inactive GO, CAS<3) and B (n=16 with active GO, CAS≥3) according to their GO activity. All patients underwent to a clinical, biochemical and morphological thyroid assessment, a complete ocular evaluation and an orbital MRI examination. Lacrimal glands herniation has been evaluated on axial MRI sequences by drawing a line between the right and left ventral zygomatic border (interzygomatic line). This line...

No significant difference was found for the hormonal parameters and thyroid ultrasound-derived parameters between the two groups. TRAb levels resulted slightly higher, although not significantly, in group B [2.76 (0-40) vs. 1.74 (0-13.8) UI/L; p=0.073)]. The LC herniation measurement MRI-evaluated was significantly higher in the group B for both right [10.1 (7.3-17) vs. 7 (0-13.4) mm; p=0.004)] and left [8.5 (6.6-13) vs. 5.8 (0-12) mm; p=0.026)] eye than group A. A linear correlation was found between TRAb levels and LC herniation (Rho 0.462, p=0.009) in...

The measurement of the lacrimal gland herniation seems to be a good marker of the activity of GO as evidenced by the significant difference between the two groups of patients. The correlation between TRAb levels and the degree of lacrimal gland herniation may suggest a more relevant role of the lacrimal gland involvement in the pathogenesis of GO. Future studies in a larger group of patient with different degree of GO activity will confirm these preliminary data.

Cesare Gagliardo1, Stefano Radellini2, Giorgia Falanga1, Raffaella Morreale Bubella2, Maria Vadalà3, Pierina Richiusa2, Alessandro Ciresi2, Giuseppe La Tona1, Carla Giordano2 Section of Radiology, Department of Biopathology and Medical Biotechnologies, DIBIMED, University of Palermo, Italy Section of Endocrinology, Metabolic and Genetic Diseases, DIBIMIS, University of Palermo, Italy Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section, University of Palermo, Italy Corresponding author: Dr Cesare Gagliardo Address: Sezione di Scienze Radiologiche Dipartimento di Biopatologia e Biotecnologie Mediche Università degli Studi di Palermo Via del Vespro, 127 90127...

[1] Chang TC, Huang KM, Chang TJ and Lin SL: Correlation of orbital computed tomography and antibodies in patients with hyperthyroid Graves' disease. Clin Endocrinol (Oxf) 32: 551 558, 1990. [2] Eckstein AK, Finkenrath A, Heiligenhaus A, Renzing Köhler K, Esser J, Krüger C, Quadbeck B, Steuhl KP and Gieseler RK: Dry eye syndrome in thyroid associated ophthalmopathy: Lacrimal expression of TSH receptor suggests involvement of TSHR specific autoantibodies. Acta Ophthalmol Scand 82: 291 297, 2004. [3] Jacobson DH and Gorman CA: Endocrine ophthalmopathy: Current...