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Effect of orbital bony decompression for Graves' orbitopathy on the volume of extraocular muscles
  1. Adel H Alsuhaibani1,
  2. Keith D Carter2,
  3. Bruno Policeni3,
  4. Jeffrey A Nerad4
  1. 1Department of Ophthalmology, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
  2. 2Department of Ophthalmology and Visual Sciences, University of Iowa Hospital and Clinics, Iowa City, Iowa, USA
  3. 3Department of Radiology, University of Iowa Hospital and Clinics, Iowa City, Iowa, USA
  4. 4Cincinnati Eye Institute, Cincinnati, Ohio, USA
  1. Correspondence to Dr Adel H Alsuhaibani, Department of Ophthalmology, King Abdulaziz University Hospital, King Saud Unversity, PO Box 245, Riyadh 11411, Saudi Arabia; adelsu{at}


Aim To evaluate the change in the rectus muscle volume following orbital bony wall decompression for Graves' orbitopathy.

Methods We used a computer program (syngo Volume Evaluation) to measure the rectus muscles from the digital preoperative and postoperative orbital CT.

Results Of the 25 patients (20 women and five men; mean age 46 (range 18–64) years) enrolled in the study. A significant increase (mean 0.23 ml (16.5%) of preoperative volume; p=0.005) in the volume of the medial rectus muscle (MRM) was detected postoperatively, whereas no significant changes were found in the volume of the other rectus muscles and between eyes that underwent surgery in the active and inactive phases of the disease. A significant negative association was observed between the time of postoperative CT scans and the change in the MRM volume (p=0.0004) (a mean increase of 68% of preoperative MRM volume for those measured between 3 and 9 months, and a mean decrease in the volume of 50% for those measured between 41 and 50 months).

Conclusion The change in the volume of the MRM may partly explain the variability in the proptosis reduction following orbital decompression.

  • Graves'
  • orbitopathy
  • rectus muscle
  • decompression
  • muscles
  • orbit

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  • Funding This work was supported in part by an unrestricted educational grant from Research to Prevent Blindness, Inc., New York, USA; King Saud University, Saudi Arabia; and The University of Iowa Department of Ophthalmology and Visual Sciences Resident and Fellow Research Program.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Obtained from the Institutional Review Board of University of Iowa Hospitals and Clinics.

  • Provenance and peer review Not commissioned; externally peer reviewed.