Clinical Study
Eye (2006) 20, 440–446. doi:10.1038/sj.eye.6701898; published online 22 April 2005
Corneal astigmatism in Graves' ophthalmopathy
Presented in part at the 18th Meeting of the European Society of Ophthalmic Plastic and Reconstructive Surgery, Paris, France, September 2000, and at the seventh International Symposium on Graves' Ophthalmopathy, Pisa, Italy, February 2003.
I Mombaerts1, S Vandelanotte1 and L Koornneef1,
1Orbital Clinic, Department of Ophthalmology, University Hospital Leuven, Leuven, Belgium
Correspondence: I Mombaerts, Department of Ophthalmology, University Hospital Leuven, UZ St. Raphaël, Kapucijnenvoer 33, 3000 Leuven, Belgium. Tel: +32-16-332660; Fax +32-16-332367; E-mail: Ilse.Mombaerts@uz.kuleuven.ac.be
Died on 23 April 2001 in Laren, The Netherlands.
Received 15 August 2004; Revised 28 February 2005; Accepted 28 February 2005; Published online 22 April 2005.
Abstract
Purpose
To describe corneal astigmatism in patients under the age of 55 years with Graves' ophthalmopathy and to compare it to a control group.
Methods
Retrospective, nonrandomized comparative observational case series. A total of 109 patients with inactive Graves' ophthalmopathy and 109 age- and gender-matched control individuals without Graves' ophthalmopathy were examined with manual corneal keratometry. In the Graves' patients, 52% had a CT scan available for review, and 41% underwent orbital, strabismus, and/or eyelid surgery with a follow-up of keratometry over a mean period of 1.7 years after surgery.
Results
For the dioptres, there was a statistically significant difference between the Graves' and the control eyes at 3–3.25 dioptres in both eyes (t-test, right eyes, P=0.042; left eyes, P=0.041). For the meridians, the astigmatism was found to be greater at the meridians 95–100° (t-test, P=0.044) and 105°–110° (t-test, P=0.017) in the right eyes only. In 10 (9%) Graves' patients, the astigmatism had caused newly acquired reduced visual acuity. Greater astigmatism in dioptres did not correlate with specific CT scan findings (
2-test, df=2, P=0.187). Following orbital, strabismus, and eyelid surgery, the dioptres and meridians of the astigmatism did not change in 56 (68%) and 66 (81%) eyes, respectively.
Conclusions
Graves' ophthalmopathy may be associated with greater with-the-rule corneal astigmatism, which, overall, is not influenced by orbital, strabismus, or eyelid surgery. The astigmatism may possibly be caused by soft-tissue fibrosis in the superolateral orbital region.
Keywords:
corneal astigmatism, Graves' ophthalmopathy, keratometry, orbit, cornea, visual acuity
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