{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:42:47Z","timestamp":1788856967414,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2010,3,1]],"date-time":"2010-03-01T00:00:00Z","timestamp":1267401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2010,3,1]],"date-time":"2010-03-01T00:00:00Z","timestamp":1267401600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["OVS"],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose.<\/jats:title>\n                    <jats:p>This observational case series investigated the occurrence and distribution of proptosis in Japanese patients with dysthyroid ophthalmopathy (DO). The relationship among lid retraction, lid swelling, and enlargement of extraocular muscles was also analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>From 1993 to 2002, 10 931 patients (2240 men and 8691 women, average age; 39.9 \u00b1 14.0 years) with abnormal thyroid function were examined for proptosis. Proptosis was measured using a Hertel exophthalmometer, and lid swelling and retraction were classified. Orbital magnetic resonance imaging or computed tomography was used to quantify enlargement of the extraocular muscles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>Clinically significant proptosis (\u226515 mm) was present in 74.2% patients and was classified as mild (15\u201317 mm, 39.1%), moderate (18\u201320 mm, 25.9%), or severe (&gt;20 mm, 9.2%). The average exophthalmometer reading was 17.2 \u00b1 3.2 mm, with proptosis less pronounced with age (p &lt; 0.001) and more pronounced in men than women (18.2 \u00b1 3.4 mm vs. 17.0 \u00b1 3.1 mm; p &lt; 0.001). Lid retraction was present in 57.7% of patients, lid swelling in 46.9%, and muscle enlargement in 40.8% of patients. Multiple regression analysis revealed proptosis was strongly correlated with a young age and the male gender, followed by extraocular muscle enlargement and lid retraction and swelling (p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>This study assessed the measurable features of proptosis in Japanese patients with DO and contributes to the understanding by correlating symptoms and signs of DO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/opx.0b013e3181ce5702","type":"journal-article","created":{"date-parts":[[2010,2,19]],"date-time":"2010-02-19T03:17:05Z","timestamp":1266549425000},"page":"200-204","source":"Crossref","is-referenced-by-count":34,"title":["Proptosis in Dysthyroid Ophthalmopathy: A Case Series of 10,931 Japanese Cases"],"prefix":"10.1002","volume":"87","author":[{"given":"Ai","family":"Kozaki","sequence":"first","affiliation":[{"name":"Division of Ophthalmology Olympia Eye Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishu","family":"Inoue","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology Olympia Eye Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Komoto","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology Olympia Eye Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshine","family":"Maeda","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology Olympia Eye Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology Olympia Eye Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshu","family":"Inoue","sequence":"additional","affiliation":[{"name":"Showa University Fujigaoka Rehabilitation Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Ayaki","sequence":"additional","affiliation":[{"name":"Showa University Fujigaoka Rehabilitation Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,3,1]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S0002-9394(02)01429-0","article-title":"Comparability of proptosis measurements by different techniques","volume":"133","author":"Segni M","year":"2002","journal-title":"Am J Ophthalmol"},{"key":"e_1_2_6_3_2","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1076\/orbi.22.4.239.17245","article-title":"Hertel exophthalmometry: reliability and interobserver variation","volume":"22","author":"Kashkouli MB","year":"2003","journal-title":"Orbit"},{"key":"e_1_2_6_4_2","first-page":"323","article-title":"Proptosis","volume":"47","author":"Wright JE","year":"1970","journal-title":"Ann R Coll Surg Engl"},{"key":"e_1_2_6_5_2","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/0002-9394(84)90127-2","article-title":"Determination of the normal range of exophthalmometric values for black and white adults","volume":"98","author":"Migliori ME","year":"1984","journal-title":"Am J Ophthalmol"},{"key":"e_1_2_6_6_2","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1097\/00006324-199508000-00004","article-title":"Normal values of ocular protrusion in Saudi Arabian male children","volume":"72","author":"Osuobeni EP","year":"1995","journal-title":"Optom Vis Sci"},{"key":"e_1_2_6_7_2","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1097\/OPX.0b013e3181890dc7","article-title":"Normal values of hertel exophthalmometry in children, teenagers, and adults from Tehran, Iran","volume":"85","author":"Kashkouli MB","year":"2008","journal-title":"Optom Vis Sci"},{"key":"e_1_2_6_8_2","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1089\/thy.2006.0279","article-title":"Exophthalmometric values in a normal Turkish population living in the northeastern part of Turkey","volume":"17","author":"Bilen H","year":"2007","journal-title":"Thyroid"},{"key":"e_1_2_6_9_2","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.bjps.2006.07.001","article-title":"Age\u2010related changes in the normal sagittal relationship between globe and orbit","volume":"60","author":"Ahmadi H","year":"2007","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"e_1_2_6_10_2","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1080\/01676830490504089","article-title":"Reliability of exophthalmos measurement and the exophthalmometry value distribution in a healthy Dutch population and in Graves' patients. 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