Abstract
OBJECTIVE: To investigate the correlation between intraorbital tissue structures and diplopia in patients with thyroid-associated ophthalmopathy (TAO) using magnetic resonance imaging (MRI) technology. METHODS: A retrospective analysis was conducted on 228 patients with TAO who were diagnosed and treated at the Affiliated Hospital of Yunnan University between March 2021 and June 2024. Patients were divided into a diplopia group (n=105) and a non-diplopia group (n=123) based on the presence or absence of diplopia. RESULTS: Logistic regression analysis showed that a higher thyroid-stimulating hormone receptor antibody (TRAb) level was an independent protective factor against diplopia in TAO, whereas increased thickness of the inferior rectus (IR), medial rectus (MR), and lateral rectus (LR), as well as greater extraocular muscle volume (EMV), were independent risk factors (all P<0.05). The areas under the ROC curve (AUCs) for TRAb, IR, EMV, MR, and LR in predicting diplopia were 0.909, 0.863, 0.834, 0.732, and 0.637, respectively. The combined model achieved an AUC of 0.986, indicating excellent predictive performance. Moreover, the duration of diplopia was positively correlated with IR, MR, and LR thickness. CONCLUSION: MRI enables quantitative evaluation of intraorbital structural alterations in TAO patients. When integrated with clinical characteristics, it provides valuable guidance for the early identification and intervention of diplopia.