Please use this identifier to cite or link to this item: https://doi.org/10.3174/ajnr.A1413
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dc.titleGraves ophthalmopathy: The bony orbit in optic neuropathy, its apical angular capacity, and impact on prediction of risk
dc.contributor.authorChan, L.-L
dc.contributor.authorTan, H.-E
dc.contributor.authorFook-Chong, S
dc.contributor.authorTeo, T.-H
dc.contributor.authorLim, L.-H
dc.contributor.authorSeah, L.-L
dc.date.accessioned2020-11-23T09:01:45Z
dc.date.available2020-11-23T09:01:45Z
dc.date.issued2009
dc.identifier.citationChan, L.-L, Tan, H.-E, Fook-Chong, S, Teo, T.-H, Lim, L.-H, Seah, L.-L (2009). Graves ophthalmopathy: The bony orbit in optic neuropathy, its apical angular capacity, and impact on prediction of risk. American Journal of Neuroradiology 30 (3) : 597-602. ScholarBank@NUS Repository. https://doi.org/10.3174/ajnr.A1413
dc.identifier.issn0195-6108
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/183920
dc.description.abstractOptic neuropathy (ON), a serious complication of Graves ophthalmopathy, is often subclinical and masked by symptoms of orbitopathy. We examined herein bony and soft-tissue CT features associated with ON, including an angular assessment of orbital apex capacity, and their usefulness in the risk prediction of ON. MATERIALS AND METHODS: The CT scans of 41 patients with Graves ophthalmopathy (17 men, 24 women; mean age, 49.1 years) clinically diagnosed with (19 patients, 32 orbits) or without ON were evaluated by 2 independent raters. Quantitative linear and angular measurements of the orbital structures and bony walls and categoric scores of apical crowding and intracranial fat prolapse were assessed on a clinical workstation. Inter- and intrarater variability of these features was determined. The CT features of the 2 patient groups were compared, and multivariate logistic regression analysis was performed to evaluate the predictive features of ON. RESULTS: Bony orbital angles (P < .005), length of the lateral orbital wall (P< .05), muscular diameters (P < .0005), muscular bulk of the medial rectus muscle relative to the bony orbit (P < .05), and apical crowding (P < .0005) were associated with clinical ON. Stepwise multivariate logistic regression analysis revealed the muscle diameter index and medial and lateral wall angles to be independent predictors. Combining these in a single multivariate equation yielded sensitivity, specificity, and positive and negative predictive values of 73%, 90%, 82%, and 85%, respectively. CONCLUSIONS: Orbital wall angles, especially the medial wall, and muscular enlargement are independent risk predictors.
dc.publisherAmerican Society of Neuroradiology
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceUnpaywall 20201031
dc.subjectadult
dc.subjectarticle
dc.subjectclinical article
dc.subjectcomputer assisted tomography
dc.subjectendocrine ophthalmopathy
dc.subjectfemale
dc.subjecthuman
dc.subjectmale
dc.subjectoptic nerve disease
dc.subjectorbit
dc.subjectprediction
dc.subjectrisk assessment
dc.subjectsensitivity and specificity
dc.subjectAdult
dc.subjectAged
dc.subjectFemale
dc.subjectGraves Ophthalmopathy
dc.subjectHumans
dc.subjectLogistic Models
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMultivariate Analysis
dc.subjectOculomotor Muscles
dc.subjectOptic Nerve
dc.subjectOptic Nerve Diseases
dc.subjectOrbit
dc.subjectPredictive Value of Tests
dc.subjectRisk Factors
dc.subjectSensitivity and Specificity
dc.subjectSeverity of Illness Index
dc.subjectTomography, X-Ray Computed
dc.typeArticle
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.contributor.departmentDEPT OF OPHTHALMOLOGY
dc.description.doi10.3174/ajnr.A1413
dc.description.sourcetitleAmerican Journal of Neuroradiology
dc.description.volume30
dc.description.issue3
dc.description.page597-602
dc.published.statepublished
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