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August 1966

Dysthyroid Ocular Myopathy: Anatomy, Histology, and Electron Microscopy

Author Affiliations

Miami, Fla; Boston
From the Howe Laboratory of Ophthalmology, Harvard University Medical School, Massachusetts Eye and Ear Infirmary, Boston. Dr. Kroll is now at the Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Miami, Fla.

Arch Ophthalmol. 1966;76(2):244-257. doi:10.1001/archopht.1966.03850010246017

The ocular myopathy associated with dysthyroid1 (endocrine) exophthalmos remains an intriguing problem. The gross and histologic findings are well-known.2-7 Grossly, the extraocular muscles are firm, rubbery, and very much enlarged. Histologically, there is interstitial edema, round cell infiltration, and, in some cases, degenerative change within muscle cells. Similar changes are found in the orbital tissues in experimentally produced exophthalmos in guinea pigs.6,8-15 The edema is believed to be due to an increased content of waterbinding mucopolysaccharide, probably hyaluronic acid.16-18 The round cell infiltrate in animals and man includes lymphocytes, plasma cells, macrophages, and mast cells.16,18-20

The fine structure characteristics of extraocular muscle in dysthyroid exophthalmos have not yet been reported.

Materials and Methods  Biopsy material was obtained at the time of Krönlein orbital decompression from 19 mucles of 17 eyes of ten patients with dysthyroid exophthalmos37 (Table). The patients' ages ranged from 41 to

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