Graves ophthalmopathy

Case contributed by Shervin Sharifkashani
Diagnosis certain

Presentation

Pronounced bilateral proptosis with a history of longstanding Graves disease.

Patient Data

Age: 45 years
Gender: Male
ct

Pronounced bilateral proptosis, enlarged superior rectus muscle, medial rectus muscle, and inferior rectus muscle with hypodense streaks and increased orbital fat. Prolapsed lacrimal glands with fatty changes within the glands are also noted. The relatively larger superior rectus muscles on both sides are due to the upward gaze of the patient. Note also decreased thickness of optic nerve sheath complex due to proptosis. A retention cyst of the maxillary sinus on the left side and exodeviation of the left eye are also seen.

Case Discussion

The case illustrates the typical distribution of extraocular muscles involvement and hypodense streaks within the muscles in Graves ophthalmopathy.

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