Thyroid eye disease
Suspected thyroid eye disease, worsening symptoms, sight threatening, retro-orbital pain, worse on left side,
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Bilateral proptosis, right more than left.
Bilateral intraocular muscle enlargement, in particular the medial, inferior and superior rectus muscles. The muscular enlargement is marginally more pronounced on the left. The signal characteristics indicate muscular edema. The muscular enlargement spares the tendinous insertions in keeping with a coca cola bottle appearance.
The optic nerves on both sides remain surrounded by ocular adipose tissue including at the orbital apex.
A typical example of thyroid orbitopathy with coca cola appearance to the intraorbital musculature.