| Objective To evaluate the imaging differences of extra ocular muscles（EOM）betweenpatients with GO and normal people, through determining the EOM and T2RT in MR. Also,to evaluate the value of T2RT for the diagnosis of the activity of GO，comparing with CAS.Methods The study included twenty-four normal people and one hundred and six patientswith GO. All the people received the examination of orbital MR, and then EOM and T2RTwere recoreded, together with CAS. Statistical methods were used to compare thedifferences between two groups, and the correlation among EOM, T2RT, and EOM.Results T2RT of the patients in active GO group and in-active GO group were all higherthan that of normal people, and so EOM was. T2RT of the patients in active GO group washigher than that of in-active GO patients(superior rectus96.2vs84.2，t=-3.6，P<0.01；inferior rectus99.9vs91.1，t=-3.7，P<0.01；medial rectus90.2vs79.4，t=-3.5，P=00.01；lateral rectus89.9vs83.4，t=-3.3，P=0.002), and the EOM was larger(superior rectus67.8vs51.2，t=-3.1，P=0.002；inferior rectus75.2vs53.9，t=-3.5，P=0.01；medial rectus61.2vs51.8，t=-2.1，P=0.041；lateral rectus89.9vs83.4，t=-2.0，P=0.047). T2RT waspositively correlated with CAS（r=0.55，P<0.001）.Conclusions Conclutions: MR was more sensitive than CAS for the evaluation of activityof GO. Objective To compare two treatments for active moderate-to-severial GO with high-doseMethylprednisolone(MTP), and to search the dynamic changes of orbital magneticresonance(MR) along with treatment and whether its relationship with the effect of MTP.Methods The study included40patients, and they were randomly assigned into group A orgroup B. Patients in group A received Regimen A, which was the administration of0.5gMTP diluted in250ml normeal saline(NS) intravenously for3consecutive days, in4cyclesat4weekly intervals, which amount to a total dose of6g over12-16weeks. Patients ingroup B received Regimen B, which was the administration of6doses0.5g MTP diluted in250ml NS intra-venously once a week followed by6doses of0.25g/week, for a cumulative dose of4.5g ofMTP iv over12consecutive weeks. All the patients performed orbital MR before treatmentand after every treatment.Results The percentage of successful treatment was82.35%(14/17) for group A vs73.3%(11/15) for group B; there is no statistical difference between the two groups(x2=0.379;P=0.678). The total rate of side-effects of group A is not significantly differentfrom that of group B (82.4%vs60%, P=0.243). After the first treatment, T2RT and thearea of extra ocular muscles(EOM) of the two groups decreased than before(Group ASUM(T2RT)691.98vs665.94, t=-2.601, P=0.02)(Mean(Area)59.83vs54.58, t=6.039,P<0.001；Group B SUM(T2RT)706.78vs674.78, t=-3.374, P=0.006)(Mean(Area)58.39 vs54.48, t=3.725, P=0.003); there is no difference between the two groups(SUM(T2RT)26.04vs31.22, t=-0.368, P=0.716)(Mean(Area)5.25vs3.91, t=0.995, P=0.329). T2RTand the EOM decreased along with the following treatments gradually, but withoutstatistical significance.Conclusions Regimen A is more effective than regimen B, but with higher rate ofside-effects. The image of orbital magnetic resonance (MR) could change gradually alongwith treatment. Objective To systematically evaluate the therapeutic effects of somatostatin analogs forGrave’s ophthalmopathy (GO).Methods Methods PubMed, EMbase, The Cochrane Library, WanFang Data, CNKI, VIPand CBM were searched by computer for randomized controlled trials (RCTs) related to thetreatment of somatostatin analogs for Grave’s ophthalmopathy by the end of march2012.Also, we searched references of the included studies. The literatures were screenedaccording to the inclusion criteria，the qualities of RCTs were appraised and the datas wereextracted by two researchers. Meta-analyses were conducted by RevMan5.0software.Results Results A total of five RCTs were included, which included210patients. Theresults of meta-analysis shew that compared with placebo, somatostatin analogs reduced theCAS（clinical activity score）of GO patients (MD=0.58,95%CI0.02to1.13, P=0.04); andit did not reduce the degree of proptosis (mm)(MD=0.21,95%CI―0.14,0.56, P=0.24).No treatment effects were observed for the degree of proptosis, retrobulbar volume,intraocular pressure, visual acuity or the limitation of eye movement. Evidence was notenough to confirm that somatostatin analogs was effective for GO (OR=1.32,95%CI0.45to3.9, P=0.61).Conclusions Conclusion Somatostatin analogs reduced the CAS of GO patients, but it wasof small clinical significance. Somatostatin analogs did not reduce the degree of proptosis. Evidence was not enough to confirm that somatostatin analogs was effective for GO.Restricted to the quantities and qualities of the RCTs included, more RCTs of high qualitiesare needed to confirm the conclusion. |
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