Correlation between clinical and histological analyses in retroocular connective tissues and extraocular muscles from patients with Graves' ophthalmopathy

Twenty-two patients with Graves' ophthalmopathy underwent biopsy, and two p atients had both eyes biopsied. The samples for the control group (n = 4) w ere obtained during routine non-thyroid-related corrective strabismus surge ry. Ophthalmological evaluation with clinical activity score (CAS), endocri nological evaluation, and ultrasound were used in our study. Correlation be tween clinical and histological analyses in connective tissues and extraocu lar muscles from patients with Graves' ophthalmopathy was done. The echogra phy results disclosed an enlargement in all extraocular recti muscles with the exception of one patient. Periodic acid-Schiff and Giemsa stains reveal ed a moderate number of mast cells in the endomysial connective tissue, non e of which displayed significant degranulation. There were no signs of musc le cell damage. Fifteen of the biopsies showed weak cellular reactions with only scattered inflammatory cells. Furthermore, the inflammatory process m ay be localized and not equally distributed throughout the muscle. Thus, th e biopsies might not be representative for the whole muscle. Statistical si gnificance analysis was found when sex and CAS were compared (p = 0.001683) using the Fisher test. In conclusion, our investigation indicates a pleomorphic pattern of histolo gic findings in connective tissue and extraocular muscles in Graves' ophtha lmopathy.