The Arched Rainbow Brow in Thyroid Eye Disease.
Citation: Ophthalmic Plastic & Reconstructive Surgery. 2022 Mar 30PMID: 35353778Institution: MedStar Washington Hospital CenterDepartment: Ophthalmology ResidencyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2022ISSN:- 0740-9303
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 35353778 | Available | 35353778 |
CONCLUSIONS: The Rainbow Brow is a distinct entity in TED and is likely consequent to brow fat pad expansion. Patients with a Rainbow Brow have different eyebrow curvature as compared to both normal age-sex-matched controls and TED patients without a Rainbow Brow. Copyright © 2022 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
METHODS: A retrospective study was conducted of TED patients and age-sex-matched normal controls. The arched Rainbow Brow appearance in TED patients was determined by unanimous agreement of 3 oculoplastic surgeons. Eyebrow curvature was assessed by plotting 15 points along the eyebrow in ImageJ. The fourth-degree polynomial (y = ax + bx + cx + dx + e) was fitted to each eyebrow.
PURPOSE: To morphologically describe and mathematically quantify a novel clinical feature of thyroid eye disease (TED).
RESULTS: Two hundred seventy-one eyes were analyzed (200 TED and 71 age-sex-matched normal controls). A Rainbow Brow was identified in 42% of TED patients. A unilateral Rainbow Brow was seen in 15% of patients. The fourth-degree polynomial coefficients yielded significant differences between Rainbow Brow patients and age-sex-matched normal controls for the coefficients a, b, c, and d. Similar analysis of TED patients with and without a Rainbow Brow showed differences in coefficients a and b. Age >50 years (p = 0.009) and the presence of brow fat expansion (p < 0.001) were associated with the presence of a Rainbow Brow. Proptosis >24 mm showed a trend toward association with the presence of a Rainbow Brow (p = 0.057). When considering the contribution of these features in a multivariable analysis, only brow fat expansion was a significant contributing factor (p = 0.009).
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