{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T22:43:00Z","timestamp":1791326580701,"version":"4.3.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To introduce the increase rate of effective orbital volume (IREOV) as a novel indicator for evaluating outcomes of endoscopic orbital decompression in thyroid-associated orbitopathy (TAO).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective study, 69 subjects (124 orbits) underwent either medial wall decompression (MWD) or lateral wall decompression (LWD) combined with fat decompression for TAO. Artificial intelligence was used to segment the orbit and calculate IREOV to compare MWD and LWD effectiveness. The impact of postoperative extraocular muscle expansion on IREOV was also assessed, with patients categorized into muscle hypertrophy and fat hyperplasia groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using Artificial Intelligence OrbitNet system, the average IREOV was 0.14 \u00b1 0.08. Postoperative IREOV was significantly higher for MWD (0.17 \u00b1 0.07) than for LWD (0.05 \u00b1 0.05) (P&amp;lt;0.001). Medial rectus muscle expansion had the greatest impact on IREOV after MWD, while lateral rectus muscle expansion affected IREOV after LWD. Most importantly, TAO patients with muscle hypertrophy exhibited higher IREOV after MWD compared to those with fat hypertrophy (P&amp;lt;0.001). Proptosis reduction was 3.20 \u00b1 1.37mm for MWD and 3.02 \u00b1 0.68mm for LWD, with no significant difference (P&amp;gt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Accurate IREOV calculation through artificial intelligence is crucial for evaluating the efficacy of orbital decompression surgery. For TAO patients presenting with fat hyperplasia, LWD should be prioritized to minimize the risk of postoperative extraocular muscle expansion. In cases where MWD is performed on fat hyperplasia patients, rigorous postoperative surveillance for extraocular muscle expansion is essential.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1527376","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T04:51:45Z","timestamp":1744087905000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A novel indicator in evaluating endoscopic orbital decompression for thyroid-associated orbitopathy"],"prefix":"10.3389","volume":"16","author":[{"given":"Jieliang","family":"Shi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoqi","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunhai","family":"Tu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhirong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwan","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wentao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wencan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0905750","article-title":"Graves\u2019 ophthalmopathy","volume":"362","author":"Bahn","year":"2010","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2014.10.029","article-title":"Endoscopic medial orbital fat decompression for proptosis in type 1 graves orbitopathy","volume":"159","author":"Wu","year":"2015","journal-title":"Am J Ophthalmol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2021.08.013","article-title":"Endoscopic transconjunctival deep lateral wall decompression for thyroid-associated orbitopathy: A minimally invasive alternative: transconjunctival endoscopic with wall decompression for TAO","volume":"235","author":"Tu","year":"2022","journal-title":"Am J Ophthalmol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12060937","article-title":"Increased orbital muscle fraction diagnosed by semi-automatic volumetry: A risk factor for severe visual impairment with excellent response to surgical decompression in graves\u2019 Orbitopathy","volume":"12","author":"Steiert","year":"2022","journal-title":"J Pers Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/IOP.0b013e3181b80fae","article-title":"Radiographic analysis of extraocular muscle volumetric changes in thyroid-related orbitopathy following orbital decompression","volume":"26","author":"Hu","year":"2010","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1159\/000348246","article-title":"Differential involvement of orbital fat and extraocular muscles in graves\u2019 ophthalmopathy","volume":"2","author":"Wiersinga","year":"2013","journal-title":"Eur Thyroid J"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2015.06.005","article-title":"Use of computed tomography to assess volume change after endoscopic orbital decompression for Graves\u2019 ophthalmopathy","volume":"36","author":"Schiff","year":"2015","journal-title":"Am J Otolaryngol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-019-04500-1","article-title":"Computed tomography-based prediction of exophthalmos reduction after deep lateral orbital wall decompression for graves\u2019 Orbitopathy","volume":"257","author":"Kitaguchi","year":"2019","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0420.2005.00617.x","article-title":"Magnetic resonance imaging determination of extraocular eye muscle volume in patients with thyroid-associated ophthalmopathy and proptosis","volume":"84","author":"Kvetny","year":"2006","journal-title":"Acta Ophthalmol Scand"},{"key":"B10","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1186\/s12886-021-01911-9","article-title":"A new radiological measurement method used to evaluate the modified transconjunctival orbital fat decompression surgery","volume":"21","author":"Li","year":"2021","journal-title":"BMC Ophthalmol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"106628","DOI":"10.1016\/j.compbiomed.2023.106628","article-title":"OrbitNet-A fully automated orbit multi-organ segmentation model based on transformer in CT images","volume":"155","author":"Li","year":"2023","journal-title":"Comput Biol Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"108176","DOI":"10.1016\/j.compbiomed.2024.108176","article-title":"Semi-supervised segmentation of orbit in CT images with paired copy-paste strategy","volume":"171","author":"Li","year":"2024","journal-title":"Comput Biol Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1097\/00002341-199403000-00007","article-title":"Extraocular muscle enlargement after orbital decompression for Graves\u2019 ophthalmopathy","volume":"10","author":"Wenz","year":"1994","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2006.10.036","article-title":"Reactivation of Graves\u2019 orbitopathy after rehabilitative orbital decompression","volume":"114","author":"Baldeschi","year":"2007","journal-title":"Ophthalmology"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000000894","article-title":"Lateral rectus muscle expands more than medial rectus following maximal deep balanced orbital decompression","volume":"34","author":"Gupta","year":"2018","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2010.188946","article-title":"Effect of orbital bony decompression for Graves\u2019 orbitopathy on the volume of extraocular muscles","volume":"95","author":"Alsuhaibani","year":"2011","journal-title":"Br J Ophthalmol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-021-05286-x","article-title":"Extraocular muscle expansion after deep lateral orbital wall decompression: influence on proptosis reduction and its predictive factors","volume":"259","author":"Lee","year":"2021","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2009.161372","article-title":"Age and gender-specific reference values of orbital fat and muscle volumes in Caucasians","volume":"95","author":"Regensburg","year":"2011","journal-title":"Br J Ophthalmol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0801880","article-title":"Clinical practice. Graves\u2019 disease","volume":"358","author":"Brent","year":"2008","journal-title":"N Engl J Med"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-21-0479","article-title":"The 2021 European Group on Graves\u2019 orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves\u2019 orbitopathy","volume":"185","author":"Bartalena","year":"2021","journal-title":"Eur J Endocrinol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s40662-021-00238-2","article-title":"Modified endoscopic transnasal orbital apex decompression in dysthyroid optic neuropathy","volume":"8","author":"Tu","year":"2021","journal-title":"Eye Vis (Lond)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.survophthal.2017.03.007","article-title":"Orbital decompression for thyroid eye disease","volume":"63","author":"Rootman","year":"2018","journal-title":"Surv Ophthalmol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2010.181313","article-title":"How predictable is exophthalmos reduction in Graves\u2019 orbitopathy? A review of the literature","volume":"95","author":"Borumandi","year":"2011","journal-title":"Br J Ophthalmol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2014.03.011","article-title":"Surgical effects of various orbital decompression methods in thyroid-associated orbitopathy: computed tomography-based comparative analysis","volume":"42","author":"Kim","year":"2014","journal-title":"J Craniomaxillofac Surg"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1080\/02713683.2020.1776331","article-title":"Clinical management and therapeutic strategies for the thyroid-associated ophthalmopathy: current and future perspectives","volume":"45","author":"Mishra","year":"2020","journal-title":"Curr Eye Res"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2010.04.004","article-title":"Do subtypes of graves\u2019 orbitopathy exist","volume":"118","author":"Regensburg","year":"2011","journal-title":"Ophthalmology"},{"key":"B27","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1186\/s12886-023-02957-7","article-title":"The outcomes of endoscopic orbital decompression combined with fat decompression for thyroid-associated ophthalmopathy","volume":"23","author":"Ye","year":"2023","journal-title":"BMC Ophthalmol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"101620","DOI":"10.1016\/j.beem.2022.101620","article-title":"Pathophysiology of thyroid-associated orbitopathy","volume":"37","author":"Lee","year":"2023","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"B29","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.ajo.2010.08.042","article-title":"Correlation of retrobulbar volume change with resected orbital fat volume and proptosis reduction after fatty decompression for Graves ophthalmopathy","volume":"151","author":"Liao","year":"2011","journal-title":"Am J Ophthalmol"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1527376\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T04:51:46Z","timestamp":1744087906000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1527376\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,8]]},"references-count":29,"alternative-id":["10.3389\/fendo.2025.1527376"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1527376","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,8]]},"article-number":"1527376"}}