Bony Orbital Volume Expansion in Thyroid Eye Disease

Purpose: To quantify changes to the bony orbital volume (BOV) in patients with thyroid eye disease (TED) relative to normal controls. Methods: In this case–control study, all patients affected with TED seen over a 2-year period were screened for study entry. Eligible participants were adults with clinical evidence of TED and CT scans of their orbits obtained during the course of their routine care. Exclusion criteria included the history of decompression surgery and/or medical or other ophthalmic conditions that could alter the orbital anatomy. The primary outcome was the measurement of the BOV. Secondary outcome measures included the relationships between BOV and muscle volume, fat volume, Hertel measurements, duration of the disease, and the occurrence of dysthyroid optic neuropathy in patients with TED. Three-dimensional reconstructions of the orbits were created to measure BOV, muscle volume, and fat volume. Results: A total of 100 participants were included in the study, contributing 200 orbits. This sample was comprised of 50 patients with TED (37 female, 13 male) and 50 controls (37 female and 13 male). There were no differences between the control and patient groups in age or sex. Of the patients with TED, 14 were diagnosed with dysthyroid optic neuropathy (15 orbits, 1 case was bilateral). The mean (standard deviation [SD]) clinical activity score for males was 4.1 (2.29) and 4.35 (2.63) for females. The mean (SD) BOV for males in the TED group was 28.62 ml (3.47), while that of the control group was 24.59 ml (2.19). This difference was significant (p

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