CORRELATION OF ORBITAL COMPUTED-TOMOGRAPHY AND ANTIBODIES IN PATIENTS WITH HYPERTHYROID GRAVES-DISEASE

The purpose of this study was to elucidate the incidence of orbital changes in computed tomography, and the relationships of orbital changes with eye‐muscle antibody (EMAb), thyrotrophin‐binding inhibitor immunoglobulin (TBII), antithyroglobulin antibody (TgAb) and anti‐thyroid microsomal antibody (MsAb), in 55 consecutive patients with hyperthyroid Graves'disease. EMAb was demonstrated by an immunoperoxidase technique. The results showed that the prevalence of orbital fat increase, extraocular muscle enlargement, lacrimal gland enlargement and optic nerve swelling were 54.5, 41.8, 21.8 and 16.5% respectively. There were 32.7% of patients without any orbital changes. The patients with extraocular muscle enlargement, lacrimal gland enlargement and optic nerve swelling had higher titres of EMAb than the patients without these orbital changes. The patients with lacrimal gland enlargement had a lower TBII index than those without. There was no difference in TgAb or MsAb between the patients with extraocular muscle enlargement, lacrimal gland enlargement, optic nerve swelling or orbital fat increase and those patients without these orbital changes. The patients with extraocular muscle enlargement, optic nerve swelling and orbital fat increase had a higher degree of exophthalmos than the patients without these orbital changes. EMAb was negatively correlated with TBII. However, there was no correlation between EMAb and TgAb or MsAb. The degree of exophthalmos was positively correlated with EMAb and negatively correlated with age. There was no correlation between exophthalmos and TBII, TgAb or MsAb. In conclusion, although the pathogenesis of orbital changes and hyperthyroidism is different, a close link between these two entities is suggested by the high incidence of orbital changes in hyperthyroid Graves'disease. Extraocular muscle enlargement is related to EMAb. Although not related to TBII or definitely related to EMAb, increased orbital fat also plays a role in exophthalmos. Copyright © 1990, Wiley Blackwell. All rights reserved