Extraocular examination by standardized echography in Graves' disease

Standardized echography allow us to detect and measure all extraocular muscles with a high precision and accuracy. Any single extraocular muscle can be examined in 5 different point along his length. In this way we can enhance any change in thickness and internal structure during the evolution of Graves'. The study of the thickness of extraocular muscles at the orbital apex allow to grading the severity of Graves' orbitopathy. Furthermore this method is useful to reveal a compressive optic neuropathy in a sub clinical step. Nevertheless useful information is regarding to display a fibrosis of the extraocular muscle and to evaluate the efficacy of pharmacological therapy or surgical therapy in the follow up.