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New research · Ophthalmology
European journal of ophthalmology · 2d
Cohort studyEuropean journal of ophthalmology · 2026

Clinical characteristics of thyroid eye disease with restrictive strabismus.

Hao Zhang, Weimin He
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OphthalmologyCohort study

Restrictive strabismus occurred in 6.5% of thyroid eye disease patients.

Clinical characteristics of thyroid eye disease with restrictive strabismus.

Hao Zhang, Weimin He
European journal of ophthalmology · 2026
Background

Restrictive strabismus is a major cause of diplopia and impaired quality of life in thyroid eye disease (thyroid eye disease), but its clinical and imaging characteristics remain incompletely understood.

Purpose

This study investigated the clinical and magnetic resonance imaging (magnetic resonance imaging) characteristics of thyroid eye disease patients with restrictive strabismus at initial presentation.

Methods

Among 5,234 thyroid eye disease patients treated between 2009 and 2024, 339 patients (6.5%) with clinically confirmed restrictive strabismus and supportive magnetic resonance imaging findings were retrospectively included.

n = 339 patients
6.5%
Results
6.5%
eye movement was limited due to muscle restriction in a minority of patients
n = 339 patients
More results

Patients with active extraocular muscles had higher Clinical Activity Score scores than those with stable muscles ( P < 0.01).

Monocular-onset patients showed higher Clinical Activity Score and NOSPECS scores (both P < 0.01).

Hyperthyroid patients had higher NOSPECS scores than euthyroid patients ( P < 0.01).

More results

Longer disease duration before presentation was associated with smaller muscle area, less inflammation, and reduced edema, whereas higher Clinical Activity Score scores correlated with larger muscle area and more severe edema.

“
Conclusion

Orbital magnetic resonance imaging may help evaluate extraocular muscle activity and guide strabismus surgery timing.

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