Color Doppler Imaging Of The Superior Ophthalmic Vein In Patients With Thyroid Related Immune Orbitopathy

Objectives:To study and compare superior ophthalmic vein (SOV) blood flow parameters measured with Color Doppler flow imaging (CDFI) in patients with congestives Thyroid related immune orbitopathy(TRIO) before and after treatment and in normal controls. And analyze the relevance between the blood flow parameters and the occurrence and development of TRIO.Methdos:(1) Use the U.S. company GE E8Color Doppler Ultrasound diagnostic apparatus, to detect the SOV blood flow parameters on sixty-two orbits from31patients with TRIO whose thyroid function is normal and forty-eight orbits from24normal controls, record its spectrum and measure the maximum, minimum velocity.CDFI was repeated after treatment in the group of patients with TRIO, which included orbital decompression in44orbits and corticosteroids in18orbits.(2) To analyze the difference among the blood flow parameters are significant, and analyze the correlation between the blood flow parameters and the clinical characteristics and treatment.(3)Statistical Methods:The t test is used to compare the samples mesn; The X2test is used to compare the ratio.Results:(1) In the group of orbits with congestive disease, SOV flow was detected in58orbits (anteroposteriorally in51and in the opposite direction in seven) and was undetectable in four. After treatment, SOV flow was detected and anteroposterior in61and undetected in one orbit. In normals, SOV flow was detected anteroposterior in47orbits and undetectable in one orbits. A significant difference was found between TRIO orbits before treatment and the control orbits (p<0.05). No significant difference was found between the TRIO orbits after treatment and the control orbits(p>0.05).(2) Compares SOV flow values for the two TRIO groups and for normal controls. The results of the unpaired t-test revealed a significant difference between TRIO patients before treatment and controls with regard to the maximum and minimum SOV flow (p<0.05). There was no significant difference between the TRIO patients after treatment and the controls with regard to the maximum and minimum flow (p>0.05).The paired t-test revealed a significant difference in the maximum and minimum SOV flow in GO patients before and after treatment (p>0.05).Conclusions:(1) SOV flow was significantly reduced in the congestive stage of TRIO and normalized after treatment of active orbitopathy suggests that venous congestion plays a significant role in the pathogenesis of the disease.(2) Our study lends support to the notion that clinical improvement with treatment is due to the control of not only the autoimmune process but also orbital venous congestion.(3) On the basis of these findings, we believe that if diminished SOV flow persists despite adequate clinical treatment, orbital decompression should be considered to improve congestive signs in order to avoid dysthyroid optic neuropathy.