Abstract：
OBJECTIVE: To investigate the relationship between the kinematics of spontaneous blinks and the anterior area of the levator palpebrae superioris muscle in patients with Graves orbitopathy (GO).
METHODS: This is a case-control study. The authors measured the margin reflex distance of the upper eyelid (margin reflex distance 1), the kinematics of spontaneous blinks, and the anterior area of levator palpebrae superioris muscle in CT coronal scans of patients with Graves upper eyelid retraction (GO) and a control group. The eye with the greatest margin reflex distance 1 was selected for analysis in each group.
RESULTS: A total of 68 participants were included, with 36 in the GO group and 32 in the control group. In the GO group, the mean margin reflex distance 1 measured 6.5 mm, while in the control group, it was 3.9 mm. Almost all parameters related to the closing phase of spontaneous blinking activity, including amplitude, velocity, blinking rate, and interblink time, did not differ between the two groups. However, the effectiveness of the blink\'s amplitude (ratio of blink amplitude to margin reflex distance 1) and the main sequence (relationship between amplitude and velocity) were significantly reduced in the GO group compared with the control group. The area of the levator palpebrae superioris muscle was significantly larger in GO than in controls, with 71.4% of patients\' muscles outside of the maximum range of the controls.
CONCLUSIONS: In patients with GO, there is a reduction in blinking effectiveness, also known as blink lagophthalmos, which is a factor in the common occurrence of ocular surface symptoms. The increase in velocity with amplitude is also reduced in GO.
METHODS: This is a case-control study. The authors measured the margin reflex distance of the upper eyelid (margin reflex distance 1), the kinematics of spontaneous blinks, and the anterior area of levator palpebrae superioris muscle in CT coronal scans of patients with Graves upper eyelid retraction (GO) and a control group. The eye with the greatest margin reflex distance 1 was selected for analysis in each group.
RESULTS: A total of 68 participants were included, with 36 in the GO group and 32 in the control group. In the GO group, the mean margin reflex distance 1 measured 6.5 mm, while in the control group, it was 3.9 mm. Almost all parameters related to the closing phase of spontaneous blinking activity, including amplitude, velocity, blinking rate, and interblink time, did not differ between the two groups. However, the effectiveness of the blink\'s amplitude (ratio of blink amplitude to margin reflex distance 1) and the main sequence (relationship between amplitude and velocity) were significantly reduced in the GO group compared with the control group. The area of the levator palpebrae superioris muscle was significantly larger in GO than in controls, with 71.4% of patients\' muscles outside of the maximum range of the controls.
CONCLUSIONS: In patients with GO, there is a reduction in blinking effectiveness, also known as blink lagophthalmos, which is a factor in the common occurrence of ocular surface symptoms. The increase in velocity with amplitude is also reduced in GO.
摘要：
目的：探讨Graves眼眶病（GO）患者自发性眨眼的运动学与上睑提上肌前区的关系。
方法：这是一项病例对照研究。作者测量了上眼睑的边缘反射距离（边缘反射距离1），自发闪烁的运动学，在Graves上睑退缩（GO）患者和对照组的CT冠状扫描中，上睑提肌前区。在每组中选择具有最大边缘反射距离1的眼睛进行分析。
结果：共包括68名参与者，GO组36例，对照组32例。在GO组中，测量的平均边缘反射距离1为6.5mm，而在对照组中，它是3.9毫米。几乎所有与自发眨眼活动的关闭阶段有关的参数，包括振幅，速度,闪烁速率,和眨眼时间，两组之间没有差异。然而,与对照组相比，GO组的眨眼幅度（眨眼幅度与边缘反射距离的比率1）和主要序列（幅度与速度之间的关系）的有效性显着降低。GO上睑提肌面积明显大于对照组，71.4%的患者肌肉超出对照的最大范围。
结论：在GO患者中，闪烁效果降低，也被称为眨眼斜眼，这是常见眼表症状发生的一个因素。速度随振幅的增加在GO中也减小。
方法：这是一项病例对照研究。作者测量了上眼睑的边缘反射距离（边缘反射距离1），自发闪烁的运动学，在Graves上睑退缩（GO）患者和对照组的CT冠状扫描中，上睑提肌前区。在每组中选择具有最大边缘反射距离1的眼睛进行分析。
结果：共包括68名参与者，GO组36例，对照组32例。在GO组中，测量的平均边缘反射距离1为6.5mm，而在对照组中，它是3.9毫米。几乎所有与自发眨眼活动的关闭阶段有关的参数，包括振幅，速度,闪烁速率,和眨眼时间，两组之间没有差异。然而,与对照组相比，GO组的眨眼幅度（眨眼幅度与边缘反射距离的比率1）和主要序列（幅度与速度之间的关系）的有效性显着降低。GO上睑提肌面积明显大于对照组，71.4%的患者肌肉超出对照的最大范围。
结论：在GO患者中，闪烁效果降低，也被称为眨眼斜眼，这是常见眼表症状发生的一个因素。速度随振幅的增加在GO中也减小。
