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Congestive thyroid-related orbitopathy (CT)

Coronal sections identify the classic enlargement of extraocular muscle bellies. The most common muscles involved (in order and degree) are the inferior rectus, medial rectus, superior rectus, and lateral rectus, in that order. In this case, it appears the superior oblique muscles may even be slightly enlarged. The lateral rectus is rarely enlarged to a significant degree. This is a classic presentation of extreme diffuse muscle enlargement resulting in compressive optic neuropathy. (Contributed by Dr. Mark Duffy.)

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