American journal of ophthalmology · 2026
Quantifying Orbital Segmentation in Thyroid Eye Disease- Fat to Muscle Ratio Correlates With Restrictive Strabismus.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Armarnik Sharon, Hilewitz Daniel, Kinori Michael, Barnea Hamama Noa, Lederer Mor, Bachar Orr, Zloto Ofira, Simon Guy Ben, Landau-Prat Daphna, Haviv Limor, Orkin Dina, Priel Ayelet
Аннотация
OBJECTIVE: To evaluate the contribution and application of orbital fat-to-muscle ratio (FMR) in Thyroid Eye Disease related restrictive strabismus.
DESIGN: Retrospective cross-sectional study.
SUBJECTS, PARTICIPANTS: Adult patients (≥18 years) with a confirmed diagnosis of TED evaluated at a tertiary referral thyroid eye disease clinic between 2017 and 2025 who had high-resolution orbital CT imaging available for quantitative analysis.
METHODS: Orbital CT scans were analyzed using three-dimensional (3D) volumetric segmentation to quantify orbital fat and extraocular muscle (EOM) volumes. The FMR was calculated for each orbit. A simplified single-slice two-dimensional (2D) FMR was also measured for comparison. Clinical data included presence and magnitude of strabismus, restrictive ocular motility, Clinical Activity Score (CAS), thyroid-stimulating immunoglobulin (TSI) levels, and surgical history. Associations were assessed using correlation analyses, multivariable logistic regression, intraclass correlation coefficients (ICC), and receiver operating characteristic (ROC) analysis.
MAIN OUTCOME MEASURES: Association of FMR with TED factors associated with disease severity, restrictive ocular motility and strabismus presence.
RESULTS: Of 579 screened patients, 197 met inclusion criteria (mean age 54.9 ± 16.3 years; 69.7% female). Restrictive ocular motility was present in 39.1% and was associated with significantly lower FMR compared with nonrestrictive disease (0.69 ± 0.36 vs 0.91 ± 0.42; P < .001). Strabismus angle correlated inversely with FMR (r = -0.169; P = .030), as did the number of EOMs operated during strabismus surgery (r = -0.160; P = .027). FMR was negatively correlated with CAS (r = -0.186; P = .010) and TSI (r = -0.188; P = .047). In multivariable analysis, lower FMR remained an independent predictor of restrictive motility. An FMR cutoff of 0.66 best discriminated the presence of strabismus (sensitivity 0.59; specificity 0.72). Agreement between 2D and 3D measurements was good (ICC = 0.77).
CONCLUSIONS: Quantitative FMR derived from CT segmentation is a clinically relevant imaging biomarker in TED that reflects a continuous spectrum of muscle and fat involvement. Lower FMR identifies patients at increased risk for restrictive motility, strabismus, and inflammatory activity. Three-dimensional FMR provides superior anatomical and clinical relevance compared with 2D measurements and may enhance risk stratification and longitudinal assessment in TED.
DESIGN: Retrospective cross-sectional study.
SUBJECTS, PARTICIPANTS: Adult patients (≥18 years) with a confirmed diagnosis of TED evaluated at a tertiary referral thyroid eye disease clinic between 2017 and 2025 who had high-resolution orbital CT imaging available for quantitative analysis.
METHODS: Orbital CT scans were analyzed using three-dimensional (3D) volumetric segmentation to quantify orbital fat and extraocular muscle (EOM) volumes. The FMR was calculated for each orbit. A simplified single-slice two-dimensional (2D) FMR was also measured for comparison. Clinical data included presence and magnitude of strabismus, restrictive ocular motility, Clinical Activity Score (CAS), thyroid-stimulating immunoglobulin (TSI) levels, and surgical history. Associations were assessed using correlation analyses, multivariable logistic regression, intraclass correlation coefficients (ICC), and receiver operating characteristic (ROC) analysis.
MAIN OUTCOME MEASURES: Association of FMR with TED factors associated with disease severity, restrictive ocular motility and strabismus presence.
RESULTS: Of 579 screened patients, 197 met inclusion criteria (mean age 54.9 ± 16.3 years; 69.7% female). Restrictive ocular motility was present in 39.1% and was associated with significantly lower FMR compared with nonrestrictive disease (0.69 ± 0.36 vs 0.91 ± 0.42; P < .001). Strabismus angle correlated inversely with FMR (r = -0.169; P = .030), as did the number of EOMs operated during strabismus surgery (r = -0.160; P = .027). FMR was negatively correlated with CAS (r = -0.186; P = .010) and TSI (r = -0.188; P = .047). In multivariable analysis, lower FMR remained an independent predictor of restrictive motility. An FMR cutoff of 0.66 best discriminated the presence of strabismus (sensitivity 0.59; specificity 0.72). Agreement between 2D and 3D measurements was good (ICC = 0.77).
CONCLUSIONS: Quantitative FMR derived from CT segmentation is a clinically relevant imaging biomarker in TED that reflects a continuous spectrum of muscle and fat involvement. Lower FMR identifies patients at increased risk for restrictive motility, strabismus, and inflammatory activity. Three-dimensional FMR provides superior anatomical and clinical relevance compared with 2D measurements and may enhance risk stratification and longitudinal assessment in TED.