Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Marked Enlargement of a Single Extraocular Muscle: Clinical and Imaging Patterns in the Prediction of Malignancy.","authors":"Kaveh Vahdani, Katharina Kampik, Jimmy M Uddin, David H Verity, Geoffrey E Rose","doi":"10.1097/IOP.0000000000002988","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002988","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical presentation, imaging patterns, histopathology, and predictors of malignancy in patients with enlargement of a single extraocular muscle.</p><p><strong>Methods: </strong>Retrospective review, with imaging categorized into 3 groups: single-muscle only (SMO), single excessively-enlarged muscle, and single-muscle with lacrimal gland enlargement (SMLG). Histopathology was classified as specific or nonspecific myositis, atypical thyroid eye disease, malignancy, or other diagnosis.</p><p><strong>Results: </strong>Among 142 patients (54% female), 60/142 (43%) had SMO, 53 (37%) single excessively-enlarged muscle, and 29 (20%) single-muscle with lacrimal gland. The commonest diagnoses were myositis (43%), atypical thyroid eye disease (27%), and malignancy (27%). Malignancy-mainly lymphoma or metastases-was commonest in SMO (43%), while atypical thyroid eye disease predominated in single excessively-enlarged muscle (49%), and myositis in the single-muscle with lacrimal gland group (69%). From univariate analysis, predictors of malignancy included age ≥60 years (odds ratio [OR]: 2.6; p = 0.012), prior malignancy (OR: 15.6; p < 0.001), subjective visual impairment (OR: 3.5; p = 0.024), LogMAR ≥0.5 (OR: 9.0; p = 0.009), ≥3 mm relative exophthalmos (OR: 3.1; p = 0.008), SMO (OR: 4.8; p < 0.001), lateral rectus involvement (OR: 3.7; p = 0.008), the \"amphora sign\" (OR: 28.2; p < 0.001), and maximum muscle diameter ≥10 mm (OR: 35.5; p < 0.001). Multivariate analysis confirmed prior malignancy (OR: 27.7; p = 0.013) and muscle diameter ≥10 mm (OR: 24.8; p = 0.005) as independent predictive variables. The prevalence of pain or diplopia and symptom duration were not significantly different in patients with myositis or those with malignancy.</p><p><strong>Conclusion: </strong>Excessive enlargement of a single extraocular muscle poses a diagnostic challenge due to the overlap of inflammatory and neoplastic features. Given the substantial proportion of malignancies, a high index of suspicion and early biopsy should be considered, particularly with SMO, a muscle diameter ≥10 mm, or prior history of cancer.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Unique Case of Pediatric Orbital Nodular Fasciitis with a Confirmed USP6 Fusion Mutation.","authors":"Rachel L Frauches, Pooya Roozdar, Jonathan H Lin, Natalie A Homer","doi":"10.1097/IOP.0000000000002981","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002981","url":null,"abstract":"<p><p>Nodular fasciitis is a benign, pseudoneoplastic condition often misdiagnosed as sarcoma due to its rapid growth, high cellularity, and mitotic activity. Herein is reported a case of a 7-year-old patient with a painless, enlarging nodule in the left superolateral orbit. Ultrasound revealed a 7.5 mm cystic mass, which was excised via an upper eyelid crease anterior orbitotomy. Histopathologic studies showed benign spindle cells, and molecular testing identified a UBC::USP6 fusion, confirming the diagnosis of nodular fasciitis. Nodular fasciitis is most common in the limbs, trunk, and head or neck region, with fewer than 1% of cases occurring in the orbit. Molecular testing is critical in differentiating this condition from malignancies. Complete surgical excision is the preferred treatment, with a low recurrence rate of 1% to 2%. This is the first reported pediatric case of orbital nodular fasciitis with a UBC::USP6 fusion mutation.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lacrimal Gland Fibrosis in Patients With Moderate-to-Severe Thyroid Eye Disease.","authors":"Nilay Yuksel, Mehtap Balaban, Asiye Sozeri, Zarife Nurbanu Mendi, Ferhan Guler","doi":"10.1097/IOP.0000000000002991","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002991","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the elasticity and size of the lacrimal gland (LG) in patients with moderate-to-severe thyroid eye disease (TED) using strain ultrasound elastography and to compare these results with those of healthy subjects.</p><p><strong>Methods: </strong>This prospective, comparative case series included the right eyes of 26 patients with bilateral inactive moderate-to-severe TED and 49 healthy subjects, who served as the control group. Schirmer test, tear breakup time, ocular surface disease index, and corneal staining were assessed in both groups. The anteroposterior and transverse diameters of the LG were measured, and the strain index of the LG was calculated as the ratio of the LG to orbital fat tissue.</p><p><strong>Results: </strong>The anteroposterior diameter of the LG was 4.18 ± 1.02 mm in the TED group and 5.32 ± 1.54 mm in the control group (p = 0.002). The transverse diameter of the LG was 7.48 ± 1.63 mm in the TED group and 9.46 ± 2.61 mm in the control group (p = 0.001). The strain index of the LG was 3.91 ± 1.40 in the TED group and 1.03 ± 0.62 in the control group (p < 0.001). Schirmer test and tear breakup time values were significantly lower, while ocular surface disease index scores and corneal staining scores were significantly higher in the TED group compared with the control group.</p><p><strong>Discussion: </strong>Strain ultrasound elastography revealed that the LGs of TED patients were stiffer than those of healthy subjects. Additionally, both the anteroposterior and transverse diameters of the LG were smaller in the TED group. These findings suggest that increased LG stiffness and reduced size may contribute to dry eye symptoms.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Botulinum Toxin Injections for Epiphora Management: A Systematic Review and Meta-Analysis.","authors":"Abdulrahman Alfarhan, Abdulrahman Alsubhi, Ghadeer Daghistani, Mohammed Khoshhal, Anas Alsaif, Eman M Al-Sharif, Mashael Alkhayyal, Hamad Alsulaiman","doi":"10.1097/IOP.0000000000002986","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002986","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review and meta-analysis evaluate the efficacy and safety of lacrimal gland botulinum toxin (BTX) injection for managing epiphora.</p><p><strong>Methods: </strong>Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search of MEDLINE, Cochrane CENTRAL, and EMBASE databases was conducted to include studies published from 2000 to March 2024 that evaluated patients treated with lacrimal gland BTX injections for epiphora. Data extraction covered study design, patient demographics, types of BTX used, injection techniques, dosage, follow-up duration, and outcomes, including (Schirmer test and Munk scores) and adverse events. Methodological quality was assessed for each study type.</p><p><strong>Results: </strong>From 517 studies identified in the literature search, 19 studies met the inclusion criteria involving 415 glands injected with BTX. Schirmer test scores decreased at 3 months (mean difference = 8.80; 95% confidence interval: 5.28-12.32; p < 0.01) and at 6 months (mean difference = 5.33; 95% confidence interval: 2.77-7.90; p < 0.01). The overall incidence of adverse events was 22% (95% confidence interval: 12-32%), and ptosis (63%) and diplopia (21%) were the most common. Reinjection was more common in the functional epiphora group, with a pooled rate of 81%, compared with 43% in the nonfunctional group (p = 0.12).</p><p><strong>Conclusions: </strong>Injecting as little as 2.5 units of BTX into the lacrimal gland is effective in reducing tear production in epiphora, with sustained clinical benefits and a transient adverse event profile. These findings support its use as a nonsurgical alternative, particularly for patients ineligible for or averse to invasive procedures. Further studies are needed to refine dosing and long-term efficacy.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pigmented Epithelioid Melanocytoma of the Eyelid: A Case Report.","authors":"Nihanth Devarapalli, Michelle Teo, Nima Mesbah Ardakani, Jean-Louis DeSousa","doi":"10.1097/IOP.0000000000003002","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003002","url":null,"abstract":"<p><p>Pigmented epithelioid melanocytoma is a rare, intermediate-grade melanocytic tumor presenting in a broad age range, often as a pigmented skin lesion. It is characterized by heavily pigmented epithelioid and dendritic melanocytes and shares histological features with epithelioid blue nevus and animal-type melanoma. Pigmented epithelioid melanocytoma typically presents as a slow-growing pigmented lesion and may metastasize to regional lymph nodes, although systemic spread is exceedingly rare. The authors report a unique case of pigmented epithelioid melanocytoma in an 11-year-old boy with an asymptomatic, progressively enlarging pigmented lesion on the lower eyelid. A complete excision of the lesion was performed, with the histopathological analysis showing a symmetrical, intensely pigmented, well-circumscribed melanocytic proliferation with no overt malignant features and no mitotic activity. Immunohistochemical analysis demonstrated negative B-type Raf kinase VE1 staining and partial loss of protein kinase A regulatory subunit 1 alpha staining, consistent with pigmented epithelioid melanocytoma. Current literature emphasizes case-by-case management, with complete surgical excision and vigilant follow-up remaining the mainstay of management.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zig-Zag Incision for Temporal Artery Biopsy: Technique and Rationale.","authors":"Grant Slagle, Mont J Cartwright","doi":"10.1097/IOP.0000000000002987","DOIUrl":"https://doi.org/10.1097/IOP.0000000000002987","url":null,"abstract":"<p><strong>Purpose: </strong>Giant cell arteritis is a potentially devastating condition that relies on temporal artery biopsy (TAB) for definitive diagnosis. Although women are more likely to be affected by giant cell arteritis, they tend to endure shorter TAB lengths. This may be due to concerns for postsurgical scalp scarring. This paper describes a technique for TAB that utilizes a zig-zag incision to improve intraoperative exposure, increase biopsy length, and minimize risk of post-TAB scarring.</p><p><strong>Methods: </strong>After marking Pitanguy line, a zig-zag incision is made posterior to the temporal hairline and dissection is performed to the superficial temporal fascia. The temporal artery is identified, ligated, and removed for biopsy. Careful attention is given to closure, with the deep and superficial layers closed separately. A retrospective analysis was completed on all TABs done with a zig-zag incision between September 2023 and February 2025. Demographic information, biopsy length, and complications were evaluated.</p><p><strong>Results: </strong>Thirteen biopsies of 11 patients were included in the analysis. The zig-zag incision for TAB facilitated excellent intraoperative exposure without increasing incision length. Mean (±standard deviation) TAB length was 4.8 ± 0.8 cm. No postoperative complications were reported, and excellent cosmetic results were achieved. The technique facilitated optimal TAB length while addressing concerns about scarring that might otherwise reduce diagnostic yield, especially in females.</p><p><strong>Conclusions: </strong>The Zig-zag incision for TAB is safe and produces good cosmetic outcomes. Adoption of this technique may lead to increased TAB lengths and reduce the risk of a cosmetically unappealing post-surgical scar.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shortened Fornix Syndrome After Posterior-Approach Ptosis Repair.","authors":"Marissa K Shoji, Eman Al-Sharif, Catherine Y Liu, Bobby S Korn, Don O Kikkawa","doi":"10.1097/IOP.0000000000002866","DOIUrl":"10.1097/IOP.0000000000002866","url":null,"abstract":"<p><strong>Purpose: </strong>The authors aimed to describe and characterize shortened fornix syndrome (SFS), a rare complication following posterior-approach ptosis repair using conjunctival Müller muscle resection.</p><p><strong>Methods: </strong>This retrospective case series evaluates 4 patients who developed SFS after conjunctival Müller muscle resection. Clinical characteristics, surgical histories, management, and outcomes are reviewed.</p><p><strong>Results: </strong>A total of 4 patients (2 females, 2 males; aged 61-74 years old) presented with ptosis associated with fornix shortening and symblepharon following conjunctival Müller muscle resection performed at outside hospitals. Potential contributing factors included intraoperative complications and multiple posterior-approach surgeries. Management strategies varied, including 5-fluorouracil and triamcinolone injections into the symblepharon, ocular surface reconstruction with symblepharon lysis and amniotic membrane grafting, and external levator advancement. All patients showed improvement in the SFS and eyelid height with treatment.</p><p><strong>Conclusion: </strong>SFS, characterized by symblepharon, fornix shortening, and associated functional issues including ptosis and restricted eye movements, is a rare but significant complication of posterior-approach ptosis repair. Only one prior report has documented a similar entity in patients after conjunctival Müller muscle resection using glaucoma drops; interestingly, the authors' cases occurred in patients without significant ocular surface or topical ocular medication use, suggesting SFS can develop independently of such treatments. Prevention strategies include meticulous intraoperative technique and a cautious approach to large resections or repeat posterior-based surgeries, with consideration of anterior-based techniques if appropriate. Management of SFS via a staged approach involving ocular surface reconstruction followed by anterior-based ptosis repair may lead to satisfactory outcomes. Awareness of this complication is crucial for proper patient selection and management of ptosis.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"404-407"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observations on the Etiology of Involutional Entropion.","authors":"Philip L Custer","doi":"10.1097/IOP.0000000000002859","DOIUrl":"10.1097/IOP.0000000000002859","url":null,"abstract":"<p><strong>Purpose: </strong>To review evidence supporting proposed anatomic etiologies of involutional entropion and propose additional potential contributing factors.</p><p><strong>Methods: </strong>A literature review was performed to identify publications describing possible etiologies of involutional entropion. The author's clinical observations and information supporting new proposed causes are presented.</p><p><strong>Results: </strong>The frequency of perceived anatomic causes of entropion listed in modern publications include retractor dehiscence (97%), horizontal eyelid laxity (89%), orbicularis override (89%), enophthalmos (33%), tarsal atrophy (16%), and fat prolapse (10%). Evidence suggests attenuation of the retractors is a predominant factor in most patients. Tarsal atrophy, enophthalmos, and fat prolapse likely play a role in some individuals. The eyelid distraction test often shows horizontal margin laxity, although the eyelids typically are not elongated. Poor deep fixation and increased inferior mobility of the lateral canthus may contribute to marginal laxity and predispose patients to entropion. Lateral rectus capsulopalpebral fascia attenuation could lead to this canthal instability and reduced horizontal stability of the tarsal base.</p><p><strong>Conclusions: </strong>Various age-related anatomic changes predispose patients to involutional entropion. Findings may vary among individuals. Tarsal atrophy and relative enophthalmos reduce appositional tension between the eyelid and globe. Lower eyelid retractor dehiscence causes poor anterior lamellar fixation and rotary instability of the tarsal base. Orbital fat prolapse may displace the tarsal base and alter orbicularis mechanics. Dysfunction of the lateral rectus capsulopalpebral fascia may contribute to both canthal instability and reduced horizontal tension near the tarsal base. Each patient's findings should be considered when individualizing surgical repair.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"365-371"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Patients With Symptomatic Nasolacrimal Duct Stenosis.","authors":"Geoffrey E Rose, Kaveh Vahdani","doi":"10.1097/IOP.0000000000002870","DOIUrl":"10.1097/IOP.0000000000002870","url":null,"abstract":"<p><strong>Purpose: </strong>The objective was to characterize symptoms and signs for patients with tearing eye(s) and ipsilateral nasolacrimal duct stenosis (NLDS), as defined by delayed fluorescein disappearance test and ocular reflux of saline during gentle irrigation of a patent drainage system.</p><p><strong>Methods: </strong>Retrospective case-note review of a consistent grading of 4 symptoms and 7 signs, together with estimates of the degree of fluid reflux and nasal fluid passage on gentle saline syringing. Characteristics, including gender differences, were compared for unilateral or bilateral symptoms. A side-to-side comparison was performed in unilateral cases, and assessed for concordance of signs and/or symptoms.</p><p><strong>Results: </strong>The average age of presentation was 62.4 years in 386 patients (37% male), with a third having unilateral symptoms. Systemic atopy (22%) and chronic nasal disease (27%) were frequent. Patients with unilateral symptoms were significantly younger (males 9.5, females 5.5 years; p < 0.000001) and had shorter symptom duration ( p = 0.0025). Three-quarters of asymptomatic sides had objective evidence of nasolacrimal duct stenosis, and there was significant side-to-side concordance for 7/9 clinical signs. Among 640 symptomatic systems, many of the presenting (subjective) symptoms and/or objective signs showed a significant direct or inverse correlation.</p><p><strong>Conclusion: </strong>The lack of laterality- or gender bias for symptoms and signs suggests that patients with nasolacrimal duct stenosis might seek treatment for the epiphora per se, rather than for issues with ocular dominance or visual requirements. The close correlation between subjective symptom-severity and objective estimates of signs suggests that thorough clinical assessment can be very reliable, and that several factors probably contribute to symptoms in these patients.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"421-428"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Radiologic Predictors of Response to Teprotumumab: A 3D Volumetric Analysis of 35 Patients.","authors":"Shoaib Ugradar, Emanuil Parunakian, Erin Zimmerman, Emil Malkhasyan, Pershanjit Raika, Raymond N Douglas, Andrea L Kossler, Raymond S Douglas","doi":"10.1097/IOP.0000000000002867","DOIUrl":"10.1097/IOP.0000000000002867","url":null,"abstract":"<p><strong>Purpose: </strong>Teprotumumab, a novel human monoclonal antibody, has been shown to reverse the clinical manifestations of thyroid eye disease. Previous reports have suggested that it demonstrates disease-modifying properties through the reduction of orbital fat and muscle volumes. This study aims to analyze orbital volumetric change following treatment and to identify clinical and radiological predictors of response.</p><p><strong>Methods: </strong>This was a prospective longitudinal study with 35 consecutive patients who had available pre- and posttreatment orbital imaging. Three-dimensional volumetric calculations of orbital fat, extraocular muscles, and proptosis were measured using previously validated image processing software. This information was used with demographic data to create a multivariate regression model to review which baseline clinical or radiological factors were predictors of proptosis response.</p><p><strong>Results: </strong>In the study orbit, 20 patients (57%) had a proptosis reduction of ≥2 mm. In the fellow orbit, 18 patients (51%) had a proptosis reduction of ≥2 mm. Regression modeling revealed that baseline proptosis and baseline muscle volumes were significant predictors of proptosis response ( p < 0.01 and p < 0.05, respectively). Further, changes in muscle volume and fat volume were significantly associated with proptosis response ( r = 0.5, p < 0.001 and r = 0.3, p = 0.012, respectively).</p><p><strong>Conclusion: </strong>Teprotumumab significantly reduces orbital fat and muscle volumes. This is manifested by a significant reduction in proptosis. Baseline proptosis and muscle volumes are significant predictors of proptosis response.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"408-414"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}