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<meta name="DC.Title" content="Graves Ophthalmopathy: The Bony Orbit in Optic Neuropathy, Its Apical Angular Capacity, and Impact on Prediction of Risk" />
<meta name="DC.Identifier" content="10.3174/ajnr.A1413" />
<meta name="DC.Date" content="2009-03-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Optic 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 &lt; .005), length of the lateral orbital wall ( P &lt; .05), muscular diameters ( P &lt; .0005), muscular bulk of the medial rectus muscle relative to the bony orbit ( P &lt; .05), and apical crowding ( P &lt; .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." />
<meta name="DC.Contributor" content="L.-L. Chan" />
<meta name="DC.Contributor" content="H.-E. Tan" />
<meta name="DC.Contributor" content="S. Fook-Chong" />
<meta name="DC.Contributor" content="T.-H. Teo" />
<meta name="DC.Contributor" content="L.-H. Lim" />
<meta name="DC.Contributor" content="L.-L. Seah" />
<meta name="article:published_time" content="2009-03-01" />
<meta name="article:section" content="HEAD &amp;amp; NECK" />
<meta name="citation_title" content="Graves Ophthalmopathy: The Bony Orbit in Optic Neuropathy, Its Apical Angular Capacity, and Impact on Prediction of Risk" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; Optic 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.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; 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.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; Bony orbital angles (&lt;i&gt;P&lt;/i&gt; &amp;lt; .005), length of the lateral orbital wall (&lt;i&gt;P&lt;/i&gt; &amp;lt; .05), muscular diameters (&lt;i&gt;P&lt;/i&gt; &amp;lt; .0005), muscular bulk of the medial rectus muscle relative to the bony orbit (&lt;i&gt;P&lt;/i&gt; &amp;lt; .05), and apical crowding (&lt;i&gt;P&lt;/i&gt; &amp;lt; .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.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSIONS:&lt;/b&gt; Orbital wall angles, especially the medial wall, and muscular enlargement are independent risk predictors.&lt;/p&gt;" />
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<meta name="citation_reference" content="citation_title=British Journal of Ophthalmology;citation_journal_abbrev=Br J Ophthalmol;citation_title=Reversal of dysthyroid optic neuropathy following orbital fat decompression;citation_pages=600-605;citation_volume=84;citation_year=2000;citation_issue=6;citation_issn=0007-1161;citation_pmid=10837384;citation_doi=10.1136/bjo.84.6.600" />
<meta name="twitter:title" content="Graves Ophthalmopathy: The Bony Orbit in Optic Neuropathy, Its Apical Angular Capacity, and Impact on Prediction of Risk" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Optic 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 &lt; .005), length of the lateral orbital wall ( P &lt; .05), muscular diameters ( P &lt; .0005), muscular bulk of the medial rectus muscle relative to the bony orbit ( P &lt; .05), and apical crowding ( P &lt; .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." />
<meta name="og-title" property="og:title" content="Graves Ophthalmopathy: The Bony Orbit in Optic Neuropathy, Its Apical Angular Capacity, and Impact on Prediction of Risk" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/30/3/597" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Optic 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 &lt; .005), length of the lateral orbital wall ( P &lt; .05), muscular diameters ( P &lt; .0005), muscular bulk of the medial rectus muscle relative to the bony orbit ( P &lt; .05), and apical crowding ( P &lt; .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." />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">L.-L. Chan</span>, <span class="highwire-citation-author" data-delta="1">H.-E. Tan</span>, <span class="highwire-citation-author" data-delta="2">S. Fook-Chong</span>, <span class="highwire-citation-author" data-delta="3">T.-H. Teo</span>, <span class="highwire-citation-author" data-delta="4">L.-H. Lim</span> and <span class="highwire-citation-author" data-delta="5">L.-L. Seah</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">March 2009,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">30 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">597-602; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1413 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-7833--61351353691" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">L.-L. Chan </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.-L.%2BChan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Chan%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AL.-L.%2BChan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">H.-E. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 30</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 3 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">March 2009 </div></div>
      
      
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      <div class="highwire-cite-title">Graves Ophthalmopathy: The Bony Orbit in Optic Neuropathy, Its Apical Angular Capacity, and Impact on Prediction of Risk</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">L.-L.</span> <span class="nlm-surname">Chan</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">H.-E.</span> <span class="nlm-surname">Tan</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Fook-Chong</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">T.-H.</span> <span class="nlm-surname">Teo</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.-H.</span> <span class="nlm-surname">Lim</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">L.-L.</span> <span class="nlm-surname">Seah</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2009, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">30 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">597-602; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1413 </span></div>
  
  
  
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      <div class="highwire-cite-title">Graves Ophthalmopathy: The Bony Orbit in Optic Neuropathy, Its Apical Angular Capacity, and Impact on Prediction of Risk</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">L.-L.</span> <span class="nlm-surname">Chan</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">H.-E.</span> <span class="nlm-surname">Tan</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Fook-Chong</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">T.-H.</span> <span class="nlm-surname">Teo</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.-H.</span> <span class="nlm-surname">Lim</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">L.-L.</span> <span class="nlm-surname">Seah</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2009, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">30 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">597-602; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1413 </span></div>
  
  
  
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