Phenotypes of endocrine ophthalmopathy: clinical manifestation and tomographic characteristics

Abstract

The clinical manifetstations of endocrine orbitopathy (EOP) significantly because autoimmune process may involve various anatomical structures of the eye. Choosing an effective method for EOP treatment requires to determine the selectivity of orbital tissue damage, which is difficult when only clinical criteria are applied. 102 patients with EOP and Graves’ disease were examined. All patients underwent the standard ophthalmological examination and multispiral computed tomography of orbits. The analysis of clinical and tomographic parameters allowed us to distinguish 3 variants of EOP flow: classical, lipogenic, and myogenic. The prevailing symptoms of patients with the lipogenic variant were distinct exophthalmos without a disturbance of the function of extraocular muscles (EOM) and visual disturbances. Oculomotor disorders, diplopia, strabismus, and decreased vision were prevalent in patients with the myogenic variant. Patients with the classical variant suffered from exophthalmos, periorbital edema, and oculomotor disorders. The identification of independent clinical variants of EOP with specific clinical symptoms and different tomographic characteristics testifies different pathogenetic mechanisms of EOP development is to determine personalized approaches to treatment.