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International Journal of Research and Scientific Innovation (IJRSI) |Volume IX, Issue X, October 2022|ISSN 2321-2705

Assessment of disease activity of Graves’ using Orbital Ultrasonography

Hadi Khazaei. M.D., M.S., M.C.R.*, Khazaei D, Ashraf D, Mikkilineni S, Ng J
Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, 97239, USA
*Corresponding author

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Abstract: Orbital ultrasound also has a wide range of clinical indications. For example, following examination of a patient with ocular discomfort or pain, clinicians can use ultrasonography to help confirm a diagnosis of scleritis, orbital myositis, or dacryoadenitis. Clinicians can use ultrasonography to evaluate retrobulbar tissue, including the extraocular muscles, in a patient with exophthalmos and suspected soft tissue expansion secondary to Graves’ disease.
Although imaging can help narrow the range of diagnoses to consider, images are only useful in that they reveal patterns and locations of tissue involvement which may statistically be more common in certain disease entities.


The concept of disease activity originates from observations of the natural course of the eye signs in patients left untreated for the ophthalmopathy, and from a small number of histologic studies performed on orbital tissues from patients with variable duration of the eye disease.
Nevertheless, Kessel et al noted that there was a tendency towards spontaneous regression of the eye signs over time, though without reaching the pre-morbid state. He found that the eye disease begins with a dynamic phase, characterized by ingravescence and remissions, followed by a static phase: depicted as Rundle’s curve (Fig. 1). A similar curve was made by Dobyns. Both authors agreed that despite some remission, the eye disease often is still severe when the static phase is reached.


Thyroid Associated Orbitopathy (TAO), also referred to as Graves’ ophthalmopathy, Graves’ orbitopathy, and thyroid eye disease, is a constellation of signs and symptoms resulting from chronic autoimmune-related orbital inflammation.