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Espessamento do tendão muscular na oftalmopatia de Graves / Muscle tendon enlargment in Graves´ophthalmopathy
Abreu, Elvira Barbosa.
  • Abreu, Elvira Barbosa; Instituto Penido Burnier. Campinas. BR
Rev. bras. oftalmol ; 70(6): 378-383, nov.-dez. 2011. ilus, tab
Article in Portuguese | LILACS | ID: lil-612910
RESUMO

OBJETIVO:

Estudar a frequência do espessamento do tendão muscular em pacientes com oftalmopatia de Graves buscando estabelecer correlações com as diferentes formas clínicas da doença. A diversidade clínica e laboratorial na oftalmopatia de Graves pode levar à confusão quanto ao diagnóstico, conduta e prognóstico. Os achados radiológicos variam desde o aumento isolado do tecido adiposo até o espessamento da musculatura extraocular, caracteristicamente poupando os tendões. Em 2004,no entanto, Ben Simon descreveu o espessamento do tendão muscular na oftalmopatia de Graves.

MÉTODOS:

Foram avaliados 20 pacientes, de ambos os sexos, com idades entre 20 e 80 anos, com formas clínicas designadas comoforma benigna (retração palpebral),forma intermediária (diplopia na posição primária do olhar) e forma maligna ou infiltrativa (sinais de comprometimento do nervo óptico).Todos os pacientes foram submetidos à tomografias computadorizadas de órbita. Os pacientes estavam eutiroideanos, há pelo menos um ano. Os padrões tomográficos foram estudados e divididos em dois grupos com e sem espessamento dos tendões da musculatura extraocular.

RESULTADOS:

Uma relação estatisticamente significativa entre espessamento do tendão e a forma clínica intermediária foi encontrada (p <0,012).

CONCLUSÃO:

O espessamento do tendão extraocular, encontrado em 30 por cento dos pacientes com oftalmopatia de Graves, relaciona-se positivamente com a forma intermediária da doença, caracterizada pela presença de diplopia e que constitui um achado de grande valor clínico.
ABSTRACT

PURPOSE:

The aim is therefore to study the frequency of tendon enlargment in Graves' ophthalmopathy, seeking to estabilish its clinical correlations. Clinical and laboratory diversity in Graves' Ophthalmopathy sometimes may mislead its diagnosis. Radiological findings are more reliable for the diagnosis of Graves' Ophthalmopathy. Since then, a number of patterns have been described. Extraocular muscle involvement in this pathology is considered as always sparing the tendons. In 2004, Ben Simon described extraocular muscles tendon enlargment in some patients with diplopia in Graves' orbitopathy.

METHODS:

20 patients, aged between 20 and 80 years, of both sexes, designated as benign (eyelid retraction), intermediate(diplopia in primary sight position) and malignant or infiltrative(signs of optic nerve compromise) forms were evaluated by orbital tomography. All patients had already been euthyroidean for at least one year. Tomographic patterns were studied and divided into two groups with or without extraocular muscle tendons enlargment.

RESULTS:

Statistically significant relationship was found between tendon enlargment and intermediate form (p<0.012).

CONCLUSION:

Extraocular tendon involvement present in 30 percent of the patients with Graves' ophthalmopathy, and is positively correlated to intermediary form of the disease, characterized by diplopia, a very important clinical landmark.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Tendons / Graves Disease / Oculomotor Muscles Type of study: Prognostic study Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: Portuguese Journal: Rev. bras. oftalmol Journal subject: Ophthalmology Year: 2011 Type: Article Affiliation country: Brazil Institution/Affiliation country: Instituto Penido Burnier/BR

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Full text: Available Index: LILACS (Americas) Main subject: Tendons / Graves Disease / Oculomotor Muscles Type of study: Prognostic study Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: Portuguese Journal: Rev. bras. oftalmol Journal subject: Ophthalmology Year: 2011 Type: Article Affiliation country: Brazil Institution/Affiliation country: Instituto Penido Burnier/BR