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Stuijfzand et al., Utrecht and Amsterdam, The Netherlands, showed
the use of MRI in dynamic video-recording of the orbits of patients with
TAO. The enlargement of extraocular eyemuscles and increase of retrobulbar
fat tissue are clearly shown on the static images. Apart from this, stretching
of the optic nerve in patients with exophthalmos is shown in dynamic video-MRI
and this stretching appeared to contribute to the restriction of eye-movement.
This inhibition of movement by stretching of the optic nerve could not
be seen on the static images. The authors conclude that this technique
is a new and excellent method to show the different causes of restricted
eye-movement in patients with TAO.
Gerding et al., Amsterdam, The Netherlands, tested the reproducibility and the clinical usefulness of octreotide scintigraphy (OCS) in patients with TAO. To establish reproducibility, OCS was done twice in 18 patients. Reproducibility was increased when occipital uptake was used for background measurement. Subsequently 22 patients with moderately severe TAO were investigated before and 6 months after retrobulbar irradiation. Twelve patients, who responded to therapy, had a higher initial OCS than non-responders. OCS scanning had a positive predictive value for response of 75%, a negative predictive value of 70%, a sensitivity of 75%, and a specificity of 70%. It is concluded that OCS scanning is promising in predicting therapeutic outcome of immunosuppressive treatment in TAO. |
