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Aim <p>Although most patients with thyroid eye disease (TED) present with hyperthyroidism, some remain euthyroid or hypothyroid throughout long-term follow-up. We aimed to evaluate TED using MRI-based orbital measurements and investigate the influence of thyroid function on proptosis, extraocular muscles (EOM) and retrobulbar fat edema.</p> Methods <p>Patients with TED who underwent orbital MRI were included. Patients were categorized as hyperthyroid or euthyroid/hypothyroid based on thyroid function. The total EOM thickness was calculated as the sum of the diameters of the EOMs. Proptosis was evaluated by measuring the distance between the anterior globe and the interzygomatic line. T2 signal intensity and retrobulbar fat edema were assessed, with edema graded on a 0–3 scale.</p> Results <p>Seventy-four patients were included: 59(79.7%) with hyperthyroid and 15(20.3%) with euthyroid/hypothyroid. The groups did not differ in sex, age, or clinical activity score (CAS)(<i>p</i> &gt; 0.05). The hyperthyroid group showed greater anterior globe–interzygomatic line distance(<i>p</i> &lt; 0.05), while retrobulbar fat edema was more pronounced in the euthyroid/hypothyroid TED group(<i>p</i> &lt; 0.05). Total EOM thickness, asymmetry, and T2 signal heterogeneity did not differ significantly between groups(<i>p</i> &gt; 0.05). In the regression model, total EOM thickness was independently associated with the highest thyroid-stimulating immunoglobulin (TSI) value of patients (β = 0.335,<i>p</i> = 0.045), whereas asymmetric EOM involvement, CAS, proptosis, T2 signal intensity, and retrobulbar fat edema showed no significant associations.</p> Conclusion <p>Although the hyperthyroid and euthyroid/hypothyroid TED groups differed in proptosis and retrobulbar fat edema, the total EOM thickness and asymmetric involvement did not differ significantly. Total EOM thickness was associated with the highest TSI values after covariate adjustment.</p>

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MRI-based evaluation of orbital structures in relation to thyroid function in thyroid eye disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月2日

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  • Tugba Barlas,
  • Mehmet Muhittin Yalcin,
  • Esra Temel,
  • Emetullah Cindil,
  • Bercin Tarlan,
  • Onur Konuk,
  • Goksun Ayvaz,
  • Fusun Balos Toruner

摘要

Aim

Although most patients with thyroid eye disease (TED) present with hyperthyroidism, some remain euthyroid or hypothyroid throughout long-term follow-up. We aimed to evaluate TED using MRI-based orbital measurements and investigate the influence of thyroid function on proptosis, extraocular muscles (EOM) and retrobulbar fat edema.

Methods

Patients with TED who underwent orbital MRI were included. Patients were categorized as hyperthyroid or euthyroid/hypothyroid based on thyroid function. The total EOM thickness was calculated as the sum of the diameters of the EOMs. Proptosis was evaluated by measuring the distance between the anterior globe and the interzygomatic line. T2 signal intensity and retrobulbar fat edema were assessed, with edema graded on a 0–3 scale.

Results

Seventy-four patients were included: 59(79.7%) with hyperthyroid and 15(20.3%) with euthyroid/hypothyroid. The groups did not differ in sex, age, or clinical activity score (CAS)(p > 0.05). The hyperthyroid group showed greater anterior globe–interzygomatic line distance(p < 0.05), while retrobulbar fat edema was more pronounced in the euthyroid/hypothyroid TED group(p < 0.05). Total EOM thickness, asymmetry, and T2 signal heterogeneity did not differ significantly between groups(p > 0.05). In the regression model, total EOM thickness was independently associated with the highest thyroid-stimulating immunoglobulin (TSI) value of patients (β = 0.335,p = 0.045), whereas asymmetric EOM involvement, CAS, proptosis, T2 signal intensity, and retrobulbar fat edema showed no significant associations.

Conclusion

Although the hyperthyroid and euthyroid/hypothyroid TED groups differed in proptosis and retrobulbar fat edema, the total EOM thickness and asymmetric involvement did not differ significantly. Total EOM thickness was associated with the highest TSI values after covariate adjustment.