ULTRASOUND EXAMINATION OF EXTRAOCULAR MUSCLES IN PATIENTS DIAGNOSED WITH ENDOCRINE OPHTHALMOPATHY

Abstract

Endocrine ophthalmopathy (ICD-10 code: H06.2) is a chronic progressive autoimmune eye disease, which often develops as a result of thyroid gland dysfunction and is characterized by inflammation of periorbital tissues, swelling of extraocular muscles. This pathological condition manifested by pathological protrusion of the eyeball from the orbital cavity (bilateral thyrotoxic exophthalmos) and visual impairment [1,5,10]. According to the age category, endocrine ophthalmopathy is more common among the working population (20-45 years old) [3,4,8]. In clinical practice, conducting an ultrasound examination of the eyeball and periorbital tissue in every patient with this type of orbital pathology allows to assess important information, in particular, the degree of edema of the extraocular muscles or the degree of fibrotization in the soft tissues of the orbit [ 2,6,9]. Despite the development and wide clinical application of new methods of obtaining diagnostic images, ultrasound examination one of the most convenient, safe and informative methods [4,11,12].

Endocrine ophthalmopathy (synonyms: thyroid ophthalmopathy, Graves' orbitopathy) is a complex concept that includes pathological changes in the soft tissues of the orbit and, in addition to several independent clinical symptoms, like dysthyroid neuroopticopathy. According to literature analysis, there are 3 main mechanisms of development of thyrotoxic exophthalmos: - orbital intercellular infiltration (neutrophils, plasmatic cells, "mast cells" ) and tissue fibrotization; - increase of periorbital adipose tissue based on pathological adipogenesis; - changes of the venous flow in the orbit. Currently, there is a growing need for modern non-invasive diagnostic methods to assess changes in periorbital tissues in endocrine ophthalmopathy.