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Objective <p>To investigate the correlation of extraocular muscle and intraorbital fat involvement with diplopia and their responsiveness to intravenous glucocorticoid therapy in patients with thyroid-associated ophthalmopathy (TAO) using magnetic resonance imaging (MRI).</p> Methods <p>Clinical records, laboratory indices, and imaging parameters were retrospectively collected from 195 patients with TAO (114 with diplopia and 81 without) and 30 contemporaneous patients with normal orbital MRI findings. Parameters, including extraocular muscle thickness, extraocular muscle volume, signal intensity ratio of the extraocular muscle (M-SIR), intraorbital fat volume (FV), SIR of intraorbital fat (F-SIR), and orbital volume (OV), were measured. Univariate and multivariate logistic regression analyses were used to determine independent predictors of TAO-related diplopia and therapeutic efficacy. The diagnostic performance of these indicators was assessed using receiver operating characteristic curves.</p> Results <p>In total, 450 orbits (228 with diplopia, 162 without diplopia, and 60 normal controls) were analyzed. Most parameters were significantly higher in patients with TAO and diplopia compared with those without diplopia. However, stepwise multivariate logistic regression identified inferior rectus thickness, M-SIR<sub>mean</sub>, FV/OV, and F-SIR<sub>mean</sub> as the independent risk factors with the highest diagnostic value for TAO-related diplopia. The combined index of these indicators showed superior diagnostic performance compared with individual parameters. Similarly, M-SIR<sub>mean</sub> and F-SIR<sub>max</sub> were identified as independent determinants of therapeutic responsiveness for diplopia using stepwise multivariate logistic regression.</p> Conclusions <p>TAO-related diplopia and its therapeutic outcomes are associated with extraocular muscle changes and intraorbital fat involvement. A comprehensive analysis of both structures can provide more objective evidence for clinical decision-making.</p>

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Thyroid-associated ophthalmopathy with diplopia: a magnetic resonance imaging–based correlational study of intraorbital tissues and their response to therapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月1日

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  • Guifeng Shi,
  • Xiao Wang,
  • Dan Liu,
  • Mingxian Zhou,
  • Xinlin Guo,
  • Xiaofeng Lin,
  • Xiaolu Bai,
  • Yongbo Duan,
  • Shufen Zhao,
  • Jie Shen,
  • Haixiong Chen

摘要

Objective

To investigate the correlation of extraocular muscle and intraorbital fat involvement with diplopia and their responsiveness to intravenous glucocorticoid therapy in patients with thyroid-associated ophthalmopathy (TAO) using magnetic resonance imaging (MRI).

Methods

Clinical records, laboratory indices, and imaging parameters were retrospectively collected from 195 patients with TAO (114 with diplopia and 81 without) and 30 contemporaneous patients with normal orbital MRI findings. Parameters, including extraocular muscle thickness, extraocular muscle volume, signal intensity ratio of the extraocular muscle (M-SIR), intraorbital fat volume (FV), SIR of intraorbital fat (F-SIR), and orbital volume (OV), were measured. Univariate and multivariate logistic regression analyses were used to determine independent predictors of TAO-related diplopia and therapeutic efficacy. The diagnostic performance of these indicators was assessed using receiver operating characteristic curves.

Results

In total, 450 orbits (228 with diplopia, 162 without diplopia, and 60 normal controls) were analyzed. Most parameters were significantly higher in patients with TAO and diplopia compared with those without diplopia. However, stepwise multivariate logistic regression identified inferior rectus thickness, M-SIRmean, FV/OV, and F-SIRmean as the independent risk factors with the highest diagnostic value for TAO-related diplopia. The combined index of these indicators showed superior diagnostic performance compared with individual parameters. Similarly, M-SIRmean and F-SIRmax were identified as independent determinants of therapeutic responsiveness for diplopia using stepwise multivariate logistic regression.

Conclusions

TAO-related diplopia and its therapeutic outcomes are associated with extraocular muscle changes and intraorbital fat involvement. A comprehensive analysis of both structures can provide more objective evidence for clinical decision-making.