Graves' Orbitopathy. Группа авторов

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      Prof. Chantal Daumerie

      Service d’Endocrinologie et de Nutrition, Université Catholique de Louvain

      Cliniques Universitaires Saint-Luc

      Avenue Hippocrate 54, UCL 54.74

      BE–1200 Brussels (Belgium)

      E-Mail [email protected]

       Diagnosis and Pathogenesis

      Wiersinga WM, Kahaly GJ (eds): Graves’ Orbitopathy: A Multidisciplinary Approach – Questions and Answers.

       Basel, Karger, 2017, pp 41–60 (DOI: 10.1159/000475948)

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Pathogenesis

      Mario Salvi^a · Utta Berchner-Pfannschmidt^b · Marian Ludgate^c

      ^aGraves’ Orbitopathy Center, Department of Endocrinology, Fondazione Cà Granda IRCCS, University of Milan, Milan, Italy; ^bMolecular Ophthalmology, Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany; ^cDivision of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK

What Are the Pathological Changes in Orbital Tissue in Graves’ Orbitopathy?

      The pathological processes within the orbit include:

      •inflammatory infiltration of retro-ocular tissues within the orbit;

      •expansion of the adipose tissue within the connective tissue located in (endomysium) and around (perimysium) the eye muscles and the fatty connective tissue which fills the intermuscular space;

•excess production by orbital fibroblasts of glycosaminoglycans (GAGs) resulting in an increase in the volume of the extraocular muscles and orbital fat/connective tissue (Fig. 1).

Orbit imaging shows a variable balance among patients between muscle enlargement (the most frequent abnormality observed) and expansion of orbital fat/connective tissue (Fig. 2). Preferential expansion of adipose tissue has been described in patients below 40 years of age, as has a predominant enlargement of extraocular muscles in older individuals with Graves’ orbitopathy (GO) [1].

Muscles СКАЧАТЬ