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Double motion of upper eyelids in Graves' orbitopathy: an additional sign for detection of thyroid dysfunction or positive thyroid autoantibodies.

Kakizaki H, Takahashi Y, Iwaki M, Ichinose A, Selva D, Leibovitch I - Clin Ophthalmol (2011)

Bottom Line: To assess the effectiveness of the upper eyelid double motion sign in Graves' orbitopathy (GO) in detecting thyroid dysfunction or a positive level of thyroid-related autoantibodies.A pause in double motion was typically seen around the anterosuperior direction of gaze.This previously unreported sign can help in detecting thyroid dysfunction states with positive levels of autoantibodies.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan;

ABSTRACT

Purpose: To assess the effectiveness of the upper eyelid double motion sign in Graves' orbitopathy (GO) in detecting thyroid dysfunction or a positive level of thyroid-related autoantibodies.

Methods: GO was defined when more than two GO-related eyelid symptoms, including the double motion sign, existed with at least one positive thyroid-related blood test. Blood tests were performed in patients with more than two GO-related eyelid symptoms. The double motion was defined when the upper eyelid stopped at least once during downward eye movement. Fifty patients without GO or other eyelid diseases were used as controls.

Results: There were 353 patients who showed more than two GO-related eyelid symptoms including the upper eyelid double motion sign. Of these, 300 patients were diagnosed with GO (300/353, 85.0%). The double motion sign was demonstrated in 267 patients (75.6%). A pause in double motion was typically seen around the anterosuperior direction of gaze. Double motion was not seen in any of the control eyelids. Although only 7.0% were hyperthyroid and 8.6% were hypothyroid, thyroid related autoantibodies were shown in 73.9% of patients. When the double motion sign was removed from the diagnostic criteria of GO, 263 patients had more than two thyroid-related eyelid symptoms, including 223 patients diagnosed as GO (25.7% reduction), although the rate of a correct diagnosis was almost the same (84.8%).

Conclusions: The double motion sign of the upper eyelids is frequently demonstrated in GO patients. This previously unreported sign can help in detecting thyroid dysfunction states with positive levels of autoantibodies.

No MeSH data available.


Related in: MedlinePlus

Double motion sign of the upper eyelid. A) Upper eyelid partially covers the upper part of the cornea on a slight upward gaze. B) The upper eyelid is still in the same position, but the eye moves downward, exposing the sclera between the upper eyelid and the cornea.
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f1-opth-5-327: Double motion sign of the upper eyelid. A) Upper eyelid partially covers the upper part of the cornea on a slight upward gaze. B) The upper eyelid is still in the same position, but the eye moves downward, exposing the sclera between the upper eyelid and the cornea.

Mentions: A total of 267 out of 353 patients (534 eyelids: 75.6%) demonstrated the double motion sign (Figures 1A and 1B). Of these patients, 37 (13.9%) were not diagnosed with GO (Table 1). The double motion was seen around the anterosuperior direction of gaze during downward eye movement. Although the Graefe’s sign was shown in 13 patients (22 eyelids), multiple irregular pauses were demonstrated on downgaze. All eyelids used as control did not demonstrate the double motion sign.


Double motion of upper eyelids in Graves' orbitopathy: an additional sign for detection of thyroid dysfunction or positive thyroid autoantibodies.

Kakizaki H, Takahashi Y, Iwaki M, Ichinose A, Selva D, Leibovitch I - Clin Ophthalmol (2011)

Double motion sign of the upper eyelid. A) Upper eyelid partially covers the upper part of the cornea on a slight upward gaze. B) The upper eyelid is still in the same position, but the eye moves downward, exposing the sclera between the upper eyelid and the cornea.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3065575&req=5

f1-opth-5-327: Double motion sign of the upper eyelid. A) Upper eyelid partially covers the upper part of the cornea on a slight upward gaze. B) The upper eyelid is still in the same position, but the eye moves downward, exposing the sclera between the upper eyelid and the cornea.
Mentions: A total of 267 out of 353 patients (534 eyelids: 75.6%) demonstrated the double motion sign (Figures 1A and 1B). Of these patients, 37 (13.9%) were not diagnosed with GO (Table 1). The double motion was seen around the anterosuperior direction of gaze during downward eye movement. Although the Graefe’s sign was shown in 13 patients (22 eyelids), multiple irregular pauses were demonstrated on downgaze. All eyelids used as control did not demonstrate the double motion sign.

Bottom Line: To assess the effectiveness of the upper eyelid double motion sign in Graves' orbitopathy (GO) in detecting thyroid dysfunction or a positive level of thyroid-related autoantibodies.A pause in double motion was typically seen around the anterosuperior direction of gaze.This previously unreported sign can help in detecting thyroid dysfunction states with positive levels of autoantibodies.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan;

ABSTRACT

Purpose: To assess the effectiveness of the upper eyelid double motion sign in Graves' orbitopathy (GO) in detecting thyroid dysfunction or a positive level of thyroid-related autoantibodies.

Methods: GO was defined when more than two GO-related eyelid symptoms, including the double motion sign, existed with at least one positive thyroid-related blood test. Blood tests were performed in patients with more than two GO-related eyelid symptoms. The double motion was defined when the upper eyelid stopped at least once during downward eye movement. Fifty patients without GO or other eyelid diseases were used as controls.

Results: There were 353 patients who showed more than two GO-related eyelid symptoms including the upper eyelid double motion sign. Of these, 300 patients were diagnosed with GO (300/353, 85.0%). The double motion sign was demonstrated in 267 patients (75.6%). A pause in double motion was typically seen around the anterosuperior direction of gaze. Double motion was not seen in any of the control eyelids. Although only 7.0% were hyperthyroid and 8.6% were hypothyroid, thyroid related autoantibodies were shown in 73.9% of patients. When the double motion sign was removed from the diagnostic criteria of GO, 263 patients had more than two thyroid-related eyelid symptoms, including 223 patients diagnosed as GO (25.7% reduction), although the rate of a correct diagnosis was almost the same (84.8%).

Conclusions: The double motion sign of the upper eyelids is frequently demonstrated in GO patients. This previously unreported sign can help in detecting thyroid dysfunction states with positive levels of autoantibodies.

No MeSH data available.


Related in: MedlinePlus