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PubMed1996

Spontaneous cardiomyopathy and exophthalmos in cotton rats (Sigmodon hispidus).

Exophthalmos and clinical signs of heart failure occurred sporadically in 3- to 12-month-old cotton rats (Sigmodon hispidus) in a colony originally derived from three male and four female littermates. Macroscopic lesions in severely affected animals included subcutaneous edema, hydrothorax, right ventricular dilatation, unilateral or bilateral atrial thrombosis, and exophthalmos. Hearts from 17 cotton rats that were found dead or were euthanatized because of exophthalmos or dyspnea and 33 control cotton rats were examined microscopically. Myocardial lesions were present in 46 of 46 cotton rats > or = 1 month of age and consisted of multifocal cardiac myocyte necrosis, mineralization, and mononuclear inflammatory cell infiltration. Cotton rats > 5 months of age also had foci of interstitial fibrosis and myocyte atrophy. Twelve of 24 (50%) necropsied cotton rats had chronic pulmonary congestion, and livers from eight of 24 (33%) had chronic periacinar congestion and atrophy. Thrombi were present in one or both cardiac atria in nine of 50 (18%) hearts, and in at least one orbital venous sinus in 14 of 24 (58%) necropsied cotton rats and in 12 of 14 (86%) with exophthalmos. Exophthalmos in this colony of cotton rats appears to have resulted predominantly from orbital venous sinus thrombosis caused by stasis of venous blood secondary to right heart failure associated with a heritable cardiomyopathy.

Animals↗
PubMed1975

Production and measurement of exophthalmos-producing factor in guinea pigs.

Although the extent of proptosis in exophthalmic Graves' disease has been measured directly and shown to correlate with serum content of a bioassayable exophthalmus-producing factor (EPS;1), a comparable relationship in an experimental model has not been reported. Progressive exophthalmos, measured from photographs and expressed as a ratio of intercorneal distance to intersupraorbital ridge distance, was produced in male guinea pigs when thyroid status was altered either by surgical thyroidectomy supplemented with 131-I treatment or by the administration of 6-propyl-2 thiouracil (0.1% in chow). In both groups, at time of sacrifice, serum content of EPF estimated by a modified goldfish bioassay using a known exophthalmogeric TSH preparation (Ambinon, Organon-Oss) as standard was positively correlated (r equals 0.804) with the terminal degree of exophthalmos. Daily replacement therapy with T4 (15mug/kg body wt) failed to alter significantly the exophthalmos which developed, even when replacement was initiated prior to the alterations of thyroid gland function; this observation tends to eliminate thyroid hormone deficiency per se as the causal event in exophthalmos. T4 treatment did, however, reverse or prevent the rises in serum TSH levels (McKenzie bioassay) thus dissociating TSH activity from EPF activity in the guinea pig. Treatment of guinea pigs with synthetic TRH (0.5, 1.0 OR 10 mug/kg body wt) for 21 days failed to produce demonstrable exophthalmos or assayable EPF levels although plasma TSH was significantly elevated.

Animals↗
PubMed2000

[The measurement of normal values of exophthalmos, interpupillary distance and interorbital distance of children and adolescence in Xiamen and the rule of their development].

OBJECTIVE: To investigate the developing rhythm of children and adolescent exophthalmos, interorbital distance (IOD) and interpupillary distance (IPD) and their mutual relationships. The study will provide biometry data for formulating juvenile criteria of correcting spectacles. METHODS: Random sampling was performed among children and adolescence aged 5 - 17 years in Xiamen. Adopting epidemic survey, we measured the biometry values of IOD, IPD and exophthalmos with a sliding gauge and exophthalmometer. RESULTS: The average value of exophthalmos was (14.48 +/- 1.71) mm. For the 5 - 8 years old children, the value of exophthalmos trended to increase with the increase of age, meanwhile the value of exophthalmos of adolescence aged 9 - 17 years old tended to be stabilized. The average value of IOD was (95.55 +/- 5.32) mm and the average value of IPD was (56.99 +/- 3.93) mm. Both the values of the IOD and IPD of the male were higher than that of the female. The results of the IOD and IDP distance increased with the increase of age and it trended to be periodic. There was positive correlation between the development of IOD and that of IPD, and it could be described by a linear equation. CONCLUSIONS: There is only one rush-increase stage of ocular development which is before the 8 years old in children. The rule of its development is in accordance with the growing and developing mode of neurological system.

Adolescent↗
PubMed2006

[Screening for endocrine exophthalmos-associated genes/cDNA fragments].

This study was conducted to screen the endocrine exophthalmos-associated genes or cDNA fragments and provide a basis for exploring the pathogenesis. The cDNA from the thyroid tissues of patients with hyperthyroidism and endocrine exophthalmos (HT&EE) was used as tester cDNA, and that from the thyroid tissues of patients with HT but free from EE was used as driver cDNA. The subtractive PCR products between tester and driver cDNA were obtained through two cycles of subtraction hybridization and two cycles of PCR by using suppression subtractive hybridization, and then were inserted into pT-Adv, a cloning vector. The ligated DNAs were transformed into E. coli DH5alpha competent cells and incubated for proper blue/white color development. Forty-eight white colonies were randomly picked and their inserts were colony PCR amplified. The PCR product from one of the colonies contained two inserts; the others contained single insert, having a size of 0.2 kb to 2 kb. The inserts of transformants were arrayed on nylon membrane. After cDNA/Rsa I digestion the thyroid tissues of patients with HT, and of patients with HT&EE, were labeled with digoxigenin; the nylon membranes were then hybridized respectively with the two cDNA probes for a high throughput screening for positive clones. The clones which were hybridized with the cDNA probe of HE&EE patients but not hybridized with the probe of the HT patients or showed only faint signal of hybridization, were chosen as positive clones and their inserts were candidates for the endocrine exophthalmos genes or cDNA fragments. About 50% of the clones were confirmed as positive clones. The cDNA fragments in the positive clones were the endocrine exophthalmos-associated genes or cDNA fragments. Endocrine exophthalmos

Cloning, Molecular↗
PubMed1975

Unilateral exophthalmos. Occurrence after treatment for perichiasmatic neoplasms.

Unilateral exophthalmos developed shortly after treatment in three patients with chromophobe adenoma of the pituitary gland and craniopharyngioma. In two patients, the exophthalmos followed surgery, while in the third it did not appear until after radiation treatment. The pathogenesis of the exophthalmos in these cases in obscure. However, the other findings and subsequent course indicate that the exophthalmos is not due to recurrence of the neoplasm nor to a complication of therapy.

Adenoma, Chromophobe↗
PubMed2003

Dexamethasone-induced exophthalmos in a group of Holstein calves.

Six Holstein calves were evaluated for progressive exophthalmos. The affected calves were receiving daily injections of dexamethasone (30 microg/kg subcutaneously twice daily) as part of a metabolic study. The control calves did not exhibit exophthalmos. The ocular examinations were normal except for the exophthalmos, which ranged from mild to marked in severity. Upon postmortem examination, marked deposition of retrobulbar adipose tissue was noted in the affected calves. Dexamethasone administration appears to increase deposition of retrobulbar adipose tissue resulting in a progressive exophthalmos.

Animals↗
PubMed1989

Eye muscle antibodies in endocrine exophthalmos. Clinical and serological observations.

Serum samples were obtained from 65 patients with endocrine exophthalmos class I-V. In 33/65 patients who were treated either with prednisone or with ciclosporin, blood was sampled before, during and after therapy. Antibodies against eye muscle were determined during the course of immunosuppressive therapy in order to have an objective parameter of the therapeutic effect. To ascertain the specificity of the reaction both eye and abdominal muscles were used as antigens in an ELISA system. Both IgG and IgM antibodies were detected. In 45/65 patients (71%) eye muscle antibodies were positive before starting therapy. Antibodies were mostly detected in patients with active disease. Patients with exophthalmos of recent onset always had IgM antibodies whereas patients with chronic exophthalmos were mostly IgG positive. Patients with relapse showed mostly IgG but also IgG and IgM positivity in 2 cases. In 58% of cases only IgG antibodies were found whereas in 34% both IgG and IgM were detected and in 8% only IgM antibodies. There was no association between antibodies directed against eye muscle and thyroid microsomal and thyroglobulin antibodies or with the state of thyroid function. Furthermore there was no correlation between exophthalmos classes and eye muscle antibody binding activity. The antibody level declined during therapy with prednisone or with ciclosporin but rose again 8-12 weeks after stopping the drug in patients with progressive disease.

Adolescent↗
PubMedDate not supplied

Exophthalmos in obesity.

AIMS: To establish the relationship between exophthalmos and obesity. METHODS: A group of 19 obese patients (body mass index, BMI >/=30 kg/m(2)) was compared with a control group of 45 nonobese individuals (26 > BMI >/= 20 kg/m(2)). Both groups underwent Hertel's exophthalmometry, Goldmann applanation tonometry and measurement of the medial rectus muscle by echography. RESULTS: Obese patients had higher Hertel values and enlarged medial rectus muscle diameter (p < 0.05). Indeed, bilateral exophthalmos was observed in 33% of obese subjects. However, this did not cause any ocular morbidity. In some cases the difference in intraocular pressure was enlarged but together with the exophthalmos not statistically significant. CONCLUSIONS: Standard values for exophthalmometry and orbital echography may have to be adapted for obese individuals. In several cases the eye signs had a remarkable resemblance to patients with Graves' orbitopathy. So in each patient with bilateral exophthalmos and eye signs suspicious of Graves' orbitopathy obesity should be considered as a possible cause.

Adult↗
PubMed1993

Polyarteritis nodosa (PN) complicated with unilateral exophthalmos.

A 58-year-old woman suddenly developed right exophthalmos. A CT scan of her orbit revealed an increase in volume and density of extraocular muscles and intraorbital soft tissues that resembled exophthalmos in Graves' disease. The exophthalmos gradually improved without treatment. Two months later she developed mononeuritis multiplex in her limbs, and then showed a sudden onset of swelling of her right calf. Sural nerve biopsy was performed and the diagnosis of polyarteritis nodosa (PN) was established from the histological findings. A rare case of PN with exophthalmos is herein reported with a review of the literature.

Exophthalmos↗
PubMed1993

Malignant exophthalmos associated with multiple myeloma.

We report a patient with malignant exophthalmos associated with multiple myeloma which showed no evidence of direct orbital involvement of plasma cells. This exophthalmos had similarities with Graves' ophthalmopathy, but the patient had no detectable autoimmune thyroid diseases. Plasmapheresis was effective not only for the treatment of heart and renal failure due to the myeloma kidney but also for the malignant exophthalmos. As the serum monoclonal IgG level was decreased by plasmapheresis, the improvement of proptosis, visual acuity, and hypertrophy of the extraocular muscle as measured by magnetic resonance imaging were observed. It is suggested that humoral factors removed by plasmapheresis might be involved in the pathogenesis of this nonendocrine exophthalmos.

Aged↗
PubMed2003

[Observation of clinical results of orbital decompression in 30 cases of malignant exophthalmos].

OBJECTIVE: To evaluate the effectiveness and safety of orbital decompression for the treatment of malignant exophthalmos. METHODS: Thirty four eyes of malignant exophthalmos were followed-up for 3 months to 9 years (averaged 6 years) after orbital decompression (two walls decompression in 22 eyes, three walls decompression in 12 eyes). The postoperative vision, protrusion value and appearance of the patients were examined and analyzed. RESULTS: Complete closure of palpebral fissure was attained in all cases and the visual acuity was increased in 25 eyes, remained the same in 5 eyes and decreased in 4 eyes. The mean recession of exophthalmos after operation was 3.8 mm in two walls decompression and 7.1 mm in three walls decompression, respectively. CONCLUSION: Orbital decompression is an effective method for the treatment of malignant exophthalmos.

Adult↗
PubMedDate not supplied

[Effect of the treatment of hyperthyroidism on the course of exophthalmos].

The exophthalmos evolution in hyperthyroid patients was investigated: twenty patients were randomly assigned to treatment with radioiodine (group I followed 2-162 months) and 20 to treatment with thyroidectomy (group II followed 2-158 months). There was no correlation of sex age and follow up with exophthalmos evolution. In group I, exophthalmos improved in one patient (5%), did not change in ten (50%) and worsened in nine (45%). In group II it got better in six (30%), did not change in seven (35%) and got worse in seven (35%). The differences between the two groups were not statistically significant (p greater than 0.05). The postsurgical thyroid gamma-gram with one mCi of I-131 in group II showed absence of thyroid tissue in nine patients (45%) and remainders of the gland in 11 (55%) and apparently this did not influence the post treatment evolution. The length of pretreatment evolution did not influence the evolution post treatment. In summary, there was no correlation between exophthalmos evolution and kind of treatment in Graves' disease.

Adult↗
PubMed1987

[Importance of the assay of T3 and T4 tears and plasma for the diagnosis of endocrine exophthalmos].

In the control subject, the thyroidal hormones have been found to be always present in similar quantities in both eyes tears. The proportion of T3 is much more important in the tears (23-40%) than in the plasma (1-2%). It is close to the concentration of deiodinated T4 found in many tissues. In ocular tissues, the T3 is thus very little or even not broken down. This led us to define the tear plasma relationship parameters. We studied lacrimo-plasmatic thyroidal parameters in cases with thyroidal dysfunction without ocular affection: 3 cases of hyperthyroidism, and 2 of hypothyroidism, to study modifications in case of endocrinal problems only. We also studied various types of exophthalmos: 31 cases of endocrine exophthalmos, whether the thyroidal plasma values were normal or not, and 2 cases of exophthalmia with expansive orbital hyperplasia in which there had been no previous thyroidal disturbance. An exophthalmia patient studied, including those with expansive orbital tissue, important changes, specific enough were associated in the tear/plasma parameters, correlated with the changes in the retro-orbital muscular tissues or fat detected by scanning. The study of these parameters, lacrimal thyroid is thus interesting for the diagnosis of endocrine exophthalmos and shows that only a local modification of the metabolism of T3 and T4, mainly from deiodination , process is probably implied in the pathology of these exophthalmos.

Adult↗
PubMed1979

Photically induced experimental exophthalmos: role of Harderian and pituitary glands.

Exposure of adult male and female albino rats to high-intensity illumination for 17.5 hr results in a marked, transient exophthalmos, which persists for approximately 48 hr after the light exposure. Upon examination of the Harderian glands in these rats, a significant glandular weight increase was observed up to 2 days after light treatment. Analysis of individual glandular components showed that this weight increase was due to an increase in fluid content of the glands. The lipid and residue contents in the Harderian glands of exposed rats decreased significantly. When animals were hypophysectomized (HYPEX) prior to the short-term illumination period, there was no visible exophthalmos. However, when the Harderian glands were analyzed at necropsy, they had a similar relative increase in weight as compared to glands of intact rats, and this again was the result of increased fluid composition. The exophthalmos induced in intact animals resulting from an enlargement of the Harderian glands seemingly was due directly to a radiant energy-dependent mechanism and not to any pituitary hormone mediation. The edematous phenomenon was similar in Harderian glands of HYPEX rats, but visible exophthalmos was lacking, probably because of the atrophied condition of the glands in the absence of the pituitary.

Animals↗
PubMed1980

[Ipsilateral exophthalmos in chronic extradural fluid-hematoma, case report (author's transl)].

A case of chronic extradural hematoma with liquid contents that had showed ipsilateral exophthalmos was reported. A 10-year-old girl fell and struck on her head. Neurological examination, on admission to our hospital on tenth day after the injury, revealed left exophthalmos and slight right hemiparesis. Plain craniogram showed linear fractures of frontal bone and orbital roof on left side. Left carotid angiogram and computerized tomogram revealed a huge extradural hematoma with liquid contents in the left frontal region. Extirpation of the hematoma was performed on the twenty-third day after the injury. When a burr hole was drilled on the left frontal region, there was no capsule of the hematoma and contents of the hematoma was dark brownish fluid. The source of bleeding in our case was considered to be the diploic vein. The blow to the head at the time of the injury distorted the skull and separated the dura from the bone. The venous bleeding developed in the space thus formed, and a small hematoma was produced. The small hematoma might have enlarged by a process similar to that postulated in chronic subdural hematoma. Thus a huge extradural hematoma with liquid contents might have been produced. There may be two factors as causes of exophthalmos. 1) Blood from the frontal extradural hematoma through the fracture of orbital roof into the orbit is postulated to have compressed the periorbita. 2) Direct pressure by the frontal hematoma on the cavernous sinus and the superior ophthalmic vein produced venous circulatory disturbance of the orbit and was postulated to have caused the ipsilateral exophthalmos.

Brain Injuries↗
PubMed1994

[Exophthalmos in children caused by vascular orbital neoformation].

BACKGROUND--Exophthalmos or proptosis may be a result of several causes; when unilateral, it leads to search a variety of orbital tumors. CASE 1--A 2 month-old baby presented with a right exophthalmos which developed within a few days. Computed tomography showed infiltration of the orbit by a mass. Surgical biopsy showed capillary hemangioma. The patient was given prednisone 2 mg/kg/day for 2 months; exophthalmos disappeared within 10 days and the child was normal 7 years later. CASE 2--A 13 year-old boy was examined because he had developed left exophthalmos within 2-3 weeks. Ultrasonography and computed tomography showed an orbital tumor compressing the eye and the optic nerve. This tumor was excised and histological examination showed that it was a thrombotic arterial aneurysm. CONCLUSIONS--Vascular lesions can be responsible for a rapidly developing orbital tumor. Their diagnosis can be difficult and must be made in order to avoid aggressive surgery.

Adolescent↗
PubMed2000

The effect of retrobulbar irradiation on exophthalmos, ductions and soft tissue signs in Graves' ophthalmopathy: a retrospective analysis of 90 cases.

PURPOSE: Retrospective analysis of the effect of retrobulbar irradiation on exophthalmos, ductions and soft tissue signs in patients with Graves' ophthalmopathy. METHODS: We analysed the charts of 111 consecutive patients who were treated with retrobulbar irradiation according to standardised intake criteria between 1992 and 1997. After exclusion of patients who underwent other treatment (with steroids or orbital decompression) shortly before or within 6 months after irradiation, and on whom insufficient data were available, 90 patients were included. For these 90 patients, we analysed the exophthalmometry, ductions, soft tissue signs and visual acuity shortly before irradiation and after 3 and 6 months, respectively. RESULTS: In the whole group, the Hertel value was on average 22 mm (SD 2.9) both before irradiation and after 3 and 6 months of follow-up. Separate analysis of data on 25 patients with bilateral exophthalmos of more than 24 mm also revealed no change in exophthalmos at follow-up. In the whole group, both abduction and elevation had improved by about 1 degree (SD 6.6 degrees; p = 0.05) after 3 months. This improvement has little clinical significance. In a subgroup of 14 patients who showed more than 10 degrees of restricted eye motility in one or more directions, both abduction and elevation had increased by about 4 degrees (SD 10 degrees; p = 0.02) at 3 and 6 months follow-up. Soft tissue signs had improved at 6 months after irradiation. We found no change in visual acuity after irradiation. CONCLUSION: Retrobulbar irradiation in Graves' ophthalmopathy does not seem to reduce exophthalmos. It probably improves eye motility in patients with severe restrictions. The late improvement in soft tissue signs may either be a late effect of irradiation or be related to the natural history of the disease.

Adult↗
PubMed1991

Treatment of exophthalmos.

Current procedures for Graves' exophthalmos fail to achieve complete correction. The standard orbital decompressions were therefore modified to maximize the degree of volumetric increase behind the axis of the globe. In 15 orbits, the preoperative exophthalmos averaged 9.5 mm, whereas the postoperative exophthalmos was 4.1 mm. Postoperative CT study demonstrated that the remaining posterior orbital wall, combined with the persistently increased intraocular muscle volume, blocked retrodisplacement of the globe, despite adequate total volumetric increase. The increased muscle volume varied from 2 to 5 cc. Despite this residual exophthalmos, the modified four-wall expansion provides excellent aesthetic results with visual improvement and resolution of chemosis and exposure keratitis.

Female↗