Isolated Superior Oblique Muscle Swelling Causing Acute Vertical Strabismus in Graves’ Disease
Purpose. To report a case of isolated superior oblique muscle swelling causing acute vertical strabismus in Graves’ disease. Case. A 26-year-old woman with a 1-month history of misalignment of the right eye and diplopia was referred to us. Her visual acuity and intraocular pressures were normal in b...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Ophthalmological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2020/8829655 |
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| author | Keiichi Aomatsu Shunji Kusaka |
| author_facet | Keiichi Aomatsu Shunji Kusaka |
| author_sort | Keiichi Aomatsu |
| collection | DOAJ |
| description | Purpose. To report a case of isolated superior oblique muscle swelling causing acute vertical strabismus in Graves’ disease. Case. A 26-year-old woman with a 1-month history of misalignment of the right eye and diplopia was referred to us. Her visual acuity and intraocular pressures were normal in both eyes, but eye movement tests showed clear misalignment of her right eye. Antibody tests for myasthenia gravis were negative. However, blood tests revealed abnormal levels of thyroid-related factors, such as decreased thyroid-stimulating hormone, elevated free T3 and T4, and elevated anti-thyroid-stimulating hormone receptor antibody. We performed magnetic resonance imaging (MRI), which showed slight enlargement of the left superior oblique muscle. The patient was eventually diagnosed with Graves’ disease with superior oblique muscle involvement and underwent a thyroidectomy. Three months postoperatively, her diplopia and abnormal eye movements had substantially resolved. Conclusion. Isolated superior oblique muscle involvement may be a presenting symptom of Graves’ disease. It should be taken into consideration that, in the early stages of thyroid-associated ophthalmopathy (TAO) in adults, only the superior oblique muscle may be enlarged. |
| format | Article |
| id | doaj-art-90cfb48f8e2e40f8957b37596787a0fc |
| institution | OA Journals |
| issn | 2090-6722 2090-6730 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Ophthalmological Medicine |
| spelling | doaj-art-90cfb48f8e2e40f8957b37596787a0fc2025-08-20T02:09:44ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302020-01-01202010.1155/2020/88296558829655Isolated Superior Oblique Muscle Swelling Causing Acute Vertical Strabismus in Graves’ DiseaseKeiichi Aomatsu0Shunji Kusaka1Department of Ophthalmology, Nara Hospital, Kindai University Faculty of Medicine, Nara, JapanDepartment of Ophthalmology, Kindai University Faculty of Medicine, Osaka, JapanPurpose. To report a case of isolated superior oblique muscle swelling causing acute vertical strabismus in Graves’ disease. Case. A 26-year-old woman with a 1-month history of misalignment of the right eye and diplopia was referred to us. Her visual acuity and intraocular pressures were normal in both eyes, but eye movement tests showed clear misalignment of her right eye. Antibody tests for myasthenia gravis were negative. However, blood tests revealed abnormal levels of thyroid-related factors, such as decreased thyroid-stimulating hormone, elevated free T3 and T4, and elevated anti-thyroid-stimulating hormone receptor antibody. We performed magnetic resonance imaging (MRI), which showed slight enlargement of the left superior oblique muscle. The patient was eventually diagnosed with Graves’ disease with superior oblique muscle involvement and underwent a thyroidectomy. Three months postoperatively, her diplopia and abnormal eye movements had substantially resolved. Conclusion. Isolated superior oblique muscle involvement may be a presenting symptom of Graves’ disease. It should be taken into consideration that, in the early stages of thyroid-associated ophthalmopathy (TAO) in adults, only the superior oblique muscle may be enlarged.http://dx.doi.org/10.1155/2020/8829655 |
| spellingShingle | Keiichi Aomatsu Shunji Kusaka Isolated Superior Oblique Muscle Swelling Causing Acute Vertical Strabismus in Graves’ Disease Case Reports in Ophthalmological Medicine |
| title | Isolated Superior Oblique Muscle Swelling Causing Acute Vertical Strabismus in Graves’ Disease |
| title_full | Isolated Superior Oblique Muscle Swelling Causing Acute Vertical Strabismus in Graves’ Disease |
| title_fullStr | Isolated Superior Oblique Muscle Swelling Causing Acute Vertical Strabismus in Graves’ Disease |
| title_full_unstemmed | Isolated Superior Oblique Muscle Swelling Causing Acute Vertical Strabismus in Graves’ Disease |
| title_short | Isolated Superior Oblique Muscle Swelling Causing Acute Vertical Strabismus in Graves’ Disease |
| title_sort | isolated superior oblique muscle swelling causing acute vertical strabismus in graves disease |
| url | http://dx.doi.org/10.1155/2020/8829655 |
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