Extraocular muscle enlargement in thyroid eye disease: systematic review and meta-analysis
Bibliographic record
Abstract
<h2>Abstract</h2><h3>Objective</h3> While radiographic measurements of orbital structures are used to both diagnose thyroid eye disease (TED) and assess treatment response, the specific extraocular muscle (EOM) changes in TED have not been established. This study aims to systematically review and analyze the difference in EOM sizes in TED patients. <h3>Design</h3> Systematic review. <h3>Methods</h3> The full protocol was registered on PROSPERO (42024566103). The electronic databases EMBASE, Web of Science, and OVID MEDLINE were searched from inception to June 5, 2024, using keywords related to TED and EOMs. Studies were included if they reported EOM measurements in both a TED group and a control group<i>.</i> Data were analyzed using random-effects model meta-analyses, with subgroup analyses based on EOM measurement parameters (i.e., diameter, cross-sectional area, volume). <h3>Results</h3> Twenty-three studies were identified, which together included a total of 2 708 orbits with TED and 1 221 control orbits. Eleven studies were retrospective cohort studies, and 12 were prospective cohort studies. Meta-analysis revealed a mean difference between TED patients and controls in EOM diameter for the inferior rectus of 1.9 mm (95% confidence interval: 1.4–2.3; <i>p</i> < 0.01), medial rectus 1.6 mm (95% CI: 1.1–2.0; <i>p</i> < 0.01), lateral rectus 0.89 mm (95% CI: 0.4–1.4; <i>p</i> < 0.01), and superior rectus 1.3 mm (95% CI: 1.0–1.6; <i>p</i> < 0.01). The mean difference between TED patients and controls in EOM volume for the inferior rectus was 515 mm<sup>3</sup> (95% CI: 230–801; <i>p</i> < 0.01), superior rectus was 609 mm<sup>3</sup> (95% CI: 327–891; <i>p</i> < 0.01), medial rectus was 551 mm<sup>3</sup> (95% CI: 293–810; <i>p</i> < 0.01), and lateral rectus was 288 mm<sup>3</sup> (95% CI: 182–393; <i>p</i> < 0.01). <h3>Conclusions</h3> Across studies, there is an apparent enlargement of the inferior rectus in TED compared to controls, but the relative extent of involvement of the medial rectus, superior rectus, and lateral rectus is less consistent.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.011 | 0.003 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".