Treatment with bimatoprost for exophthalmos in patients with inactive thyroid-associated ophthalmopathy

Figures & data

Figure 1 Exophthalmos measurement.

Note: Exophthalmos value was defined as the perpendicular distance from the top point of the corneal surface to the line between the bilateral frontal processes of the zygomatic bones.

Figure 2 Volume measurement.

Notes: Regions of interest (ROIs) were drawn around tissue on MR images, and cross-sectional areas of the ROIs were measured. The volume of each tissue type was calculated by multiplying the sum of the cross-sectional area by the slice thickness (1.5 mm). (A) Axial slice shows cross-sectional areas of orbital fat (Fat). (B) Axial slice shows the cross-sectional areas of the lateral rectus (LR) and medial rectus (MR) muscles, eyeball (EB), and optic nerve (ON). (C) Sagittal slice shows the cross-sectional areas of the superior rectus (SR) and inferior rectus (IR) muscles. (D) Axial slice shows the cross-sectional area of the superior oblique (SO) muscle. (E) Coronal slice shows the cross-sectional areas of the inferior oblique (IO) muscle.

Table 1 Characteristics of patients with TAO

Case	Age	Sex	TAO duration before treatment (months)	Thyroid disease	Thyroid function before treatment	History of methylprednisolone pulse therapy	History of orbital surgery and orbital radiotherapy
1	50	M	11	G	Euthyroid	−	−
2	38	F	77	G	Euthyroid	−	−
3	66	F	44	G	Hyperthyroid	−	−
4	45	F	11	G	Euthyroid	+	−
5	46	F	60	G	Euthyroid	+	−
6	56	M	2	G	Hyperthyroid	−	−
7	40	F	8	G	Euthyroid	+	−
8	61	F	8	G	Euthyroid	−	−
9	35	F	8	G	Hyperthyroid	+	−

Abbreviations: G, Graves’s disease; TAO, thyroid-associated ophthalmopathy.

Figure 3 Diagram of patients who were included and dropped out.

Notes: Thirteen patients were included in this study. Four of the 13 dropped out. In the final analysis, we analyzed nine orbits of nine patients.
Abbreviation: TAO, thyroid-associated ophthalmopathy.

Table 2 Changes in exophthalmos values and orbital tissue volume from before to after treatment with bimatoprost

	Before treatment	After 12 months of treatment	Change value	95% CI	P-value
Exophthalmos (mm)	21.7±2.2	21.7±2.0	0.05±0.71	−0.60 to 0.49	0.82
Orbital fat (cm^3)	17.2±2.5	17.0±3.0	−0.13±0.94	−0.60 to 0.85	0.70
Total extraocular muscles (cm^3)	4.0±0.7	3.8±0.9	−0.21±0.59	−0.25 to 0.66	0.32
Eyeball (cm^3)	9.3±1.1	9.3±0.9	−0.07±0.38	−0.22 to 0.36	0.60
Optic nerve (cm^3)	0.5±0.1	0.4±0.1	−0.05±0.12	−0.48 to 0.14	0.29

Figure 4 Exophthalmos values.

Note: Mean values after 12 months of treatment were not significantly different from those before treatment (P=0.82).

Figure 5 Orbital fat volume.

Note: Mean volume after 12 months of treatment was not significantly different from that before treatment (P=0.70).

Figure 6 Extraocular muscle volume.

Note: Mean volume after 12 months of treatment was not significantly different from that before treatment (P=0.32).

Table 3 Exophthalmos values and orbital tissue volume from before treatment to last MRI examination in patients who dropped out

	Before treatment	At last MRI
Exophthalmos (mm)	21.5±1.3	21.4±1.3
Orbital fat (cm^3)	15.6±2.4	14.5±1.1
Total extraocular muscles (cm^3)	3.9±1.3	3.7±1.1
Eyeball (cm^3)	8.4±1.3	8.6±1.2
Optic nerve (cm^3)	0.5±0.1	0.5±0.1

Abbreviation: MRI, magnetic resonance imaging.