Subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association

Klio I Chatzistefanou,1 Christianna Samara,2 Ioannis Asproudis,3 Dimitrios Brouzas,1 Marilita M Moschos,1 Elisabeth Tsianta,1 George Piaditis4 1First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens, Greece; 2Department of Radiology and Endocrinolog...

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Autores principales:	Chatzistefanou KI, Samara C, Asproudis I, Brouzas D, Moschos MM, Tsianta E, Piaditis G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	subconjunctival orbital fat prolapse elderly age-related Graves ophthalmopathy thyroid associated orbitopathy autoimmune thyroidopathy Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/d4584e8509574b65a2bdd94006e87b82
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spelling	oai:doaj.org-article:d4584e8509574b65a2bdd94006e87b822021-12-02T00:37:20ZSubconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association1178-1998https://doaj.org/article/d4584e8509574b65a2bdd94006e87b822017-02-01T00:00:00Zhttps://www.dovepress.com/subconjunctival-orbital-fat-prolapse-and-thyroid-associated-orbitopath-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Klio I Chatzistefanou,1 Christianna Samara,2 Ioannis Asproudis,3 Dimitrios Brouzas,1 Marilita M Moschos,1 Elisabeth Tsianta,1 George Piaditis4 1First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens, Greece; 2Department of Radiology and Endocrinology, 3Department of Ophthalmology, University of Ioannina, Ioannina, Greece; 4Athens General Hospital “G. Gennimatas”, Athens, Greece Background: Thyroid associated orbitopathy (TAO) comprises a spectrum of well-recognized clinical signs including exophthalmos, eyelid retraction, soft tissue swelling, ocular misalignment, keratopathy as well as a number of less common manifestations. Subconjunctival fat prolapse is a rare clinical condition occurring typically spontaneously in elderly patients with a mean age of 65–72 years. We describe subconjunctival prolapse of orbital fat as an uncommon clinical association of TAO. Materials and methods: Observational study of six patients presenting with a subconjunctival protrusion under the lateral canthus in a series of 198 consecutive cases with TAO examined at a tertiary care referral center. Results: A superotemporally located yellowish, very soft, freely mobile subconjunctival protrusion developed unilaterally in two and bilaterally in four patients with TAO (incidence 3.03%). It was one of the presenting manifestations of TAO in four of ten eyes studied and incited the diagnostic work-up for TAO in two of six patients in this series. Magnetic resonance imaging of the orbit indicated fat density in continuity with intraorbital fat in the area of protrusion. A male to female preponderance of 4:2 and an advanced mean age at onset of TAO is noteworthy for these six patients compared to the pool of 192 patients (64.8 versus 51.8 years, respectively, P=0.003) not bearing this sign. Conclusion: Subconjunctival orbital fat prolapse, a clinically impressive age-related ocular lesion, may occasionally predominate amid other clinical manifestations of TAO. It is a nonspecific sign developing most commonly among patients with a relatively advanced age at presentation. Awareness of this association may alert to the diagnosis of thyroid orbitopathy and reassure the patient and physician as to the benign character of the lesion. Keywords: subconjunctival orbital fat prolapse, elderly, age-related, Graves ophthalmopathy, thyroid associated orbitopathy, autoimmune thyroidopathyChatzistefanou KISamara CAsproudis IBrouzas DMoschos MMTsianta EPiaditis GDove Medical Pressarticlesubconjunctival orbital fat prolapseelderlyage-relatedGraves ophthalmopathythyroid associated orbitopathyautoimmune thyroidopathyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 359-366 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	subconjunctival orbital fat prolapse elderly age-related Graves ophthalmopathy thyroid associated orbitopathy autoimmune thyroidopathy Geriatrics RC952-954.6
spellingShingle	subconjunctival orbital fat prolapse elderly age-related Graves ophthalmopathy thyroid associated orbitopathy autoimmune thyroidopathy Geriatrics RC952-954.6 Chatzistefanou KI Samara C Asproudis I Brouzas D Moschos MM Tsianta E Piaditis G Subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association
description	Klio I Chatzistefanou,1 Christianna Samara,2 Ioannis Asproudis,3 Dimitrios Brouzas,1 Marilita M Moschos,1 Elisabeth Tsianta,1 George Piaditis4 1First Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens, Greece; 2Department of Radiology and Endocrinology, 3Department of Ophthalmology, University of Ioannina, Ioannina, Greece; 4Athens General Hospital “G. Gennimatas”, Athens, Greece Background: Thyroid associated orbitopathy (TAO) comprises a spectrum of well-recognized clinical signs including exophthalmos, eyelid retraction, soft tissue swelling, ocular misalignment, keratopathy as well as a number of less common manifestations. Subconjunctival fat prolapse is a rare clinical condition occurring typically spontaneously in elderly patients with a mean age of 65–72 years. We describe subconjunctival prolapse of orbital fat as an uncommon clinical association of TAO. Materials and methods: Observational study of six patients presenting with a subconjunctival protrusion under the lateral canthus in a series of 198 consecutive cases with TAO examined at a tertiary care referral center. Results: A superotemporally located yellowish, very soft, freely mobile subconjunctival protrusion developed unilaterally in two and bilaterally in four patients with TAO (incidence 3.03%). It was one of the presenting manifestations of TAO in four of ten eyes studied and incited the diagnostic work-up for TAO in two of six patients in this series. Magnetic resonance imaging of the orbit indicated fat density in continuity with intraorbital fat in the area of protrusion. A male to female preponderance of 4:2 and an advanced mean age at onset of TAO is noteworthy for these six patients compared to the pool of 192 patients (64.8 versus 51.8 years, respectively, P=0.003) not bearing this sign. Conclusion: Subconjunctival orbital fat prolapse, a clinically impressive age-related ocular lesion, may occasionally predominate amid other clinical manifestations of TAO. It is a nonspecific sign developing most commonly among patients with a relatively advanced age at presentation. Awareness of this association may alert to the diagnosis of thyroid orbitopathy and reassure the patient and physician as to the benign character of the lesion. Keywords: subconjunctival orbital fat prolapse, elderly, age-related, Graves ophthalmopathy, thyroid associated orbitopathy, autoimmune thyroidopathy
format	article
author	Chatzistefanou KI Samara C Asproudis I Brouzas D Moschos MM Tsianta E Piaditis G
author_facet	Chatzistefanou KI Samara C Asproudis I Brouzas D Moschos MM Tsianta E Piaditis G
author_sort	Chatzistefanou KI
title	Subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association
title_short	Subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association
title_full	Subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association
title_fullStr	Subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association
title_full_unstemmed	Subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association
title_sort	subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/d4584e8509574b65a2bdd94006e87b82
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Subconjunctival orbital fat prolapse and thyroid associated orbitopathy: a clinical association

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