Occult Thyroid Eye Dieae in Patient With Unexplained Ocular Mialignment Identified by tandardized Orbital Echography Original Reearch Article

Purpoe To decribe the clinical preentation, orbital echography (OE) finding, and neuroimaging reult of patient with chronic unexplained ocular mialignment, which include patient with clinically occult thyroid eye dieae (TED) that i identifiable through a characteritic OE appearance. Deign Retropective obervational cae erie. Method eventy-eight patient with chronic ocular mialignment upected of TED becaue of a hitory of ytemic thyroid dieae, proptoi, dymotility, poitive forced duction, or eyelid retraction or lag were categorized a TED poitive, negative, and indeterminate with the ue of tandardized OE. Demographic, clinical, OE, computed tomography, and magnetic reonance imaging information wa collected. Analye determined the prevalence of TED and difference between TED poitive, negative, and indeterminate group. Reult Fifty-five percent of the finding were upiciou for and mot conitent with TED (TED poitive); 26% of the finding were TED negative, and 19% of the finding were TED indeterminate. Of 30 patient with newly diagnoed TED by OE, 70% had no lid retraction, and 20% had no other finding of TED. The inferior rectu followed by the uperior rectu/levator complex, medial rectu, and lateral rectu mucle were the mot frequently involved mucle. Neuroimaging that wa performed in only 26 of 78 patient (33%) did not appear to yield additional diagnotic information. Concluion TED i a potential caue of chronic unexplained ocular mialignment in a ubtantial proportion of patient. Thee patient frequently preent in an occult fahion without other clinical finding that are typical of TED. In thee patient, a diagnoi of TED by OE can reduce further cotly evaluation. OE appear to have ignificant clinical uefulne in the diagnoi of TED in patient with unexplained ocular mialignment.