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  • Title: Lateral and medial upper eyelid contour abnormalities in graves orbitopathy: the influence of the degree of retraction.
    Author: Ribeiro SF, Milbratz GH, Garcia DM, Fernandes VL, Rocha-Sousa A, Falcão-Reis FM, Cruz AA.
    Journal: Ophthalmic Plast Reconstr Surg; 2013; 29(1):40-3. PubMed ID: 23247033.
    Abstract:
    PURPOSE: To determine the location of contour abnormalities in Graves upper eyelid retraction. METHODS: Multiple midpupil angular eyelid distances of 75 upper eyelids of 55 patients (mean age = 41.7 ± 13.3 SD years) in the inactive phase of Graves orbitopathy were measured with a recently developed custom-made software. Sixty eyelids of 60 normal subjects were also measured as a control group. A contour peak was defined by the highest midpupil angular eyelid distance normalized (divided) by the superior limit of normality (mean + 2SD). RESULTS: In 45 eyelids (60%), the peaks were lateral between 120° and 150°. For high levels of retraction, the peaks tended to be centrally located with a substantial number of medial deformities (30 eyelids). Although the lateral and medial peaks were not affected by exophthalmometry, there was a statistically significant increase of medial peaks when midpupil eyelid distance was greater than 6.75 mm (χ = 5.20, p = 0.02). CONCLUSIONS: Lateral contour abnormalities are more frequent than medial deformities. With minor degrees of retraction, there is a predominance of lateral peaks. With higher degrees of retraction, the number of medial abnormalities is similar to the lateral ones.
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