RETROBULBAR CONNECTIVE TISSUE CHANGES IN MALIGNANT EXOPHTHALMOS

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Abstract
Three cases of malignant exophthalmos are presented, in which retrobular connective tissue was studied with special reference to the ground substance, the mast cells and the mucopolysaccharide content of the extraocular muscles. The connective tissue contained numerous fibroblasts and well-granulated mast cells. The number of connective tissue mast cells is increased parallel with an increase of metachromatic ground substance. The fat is mobilized and replaced by mucinous connective tissue containing mucopolysaccharides, which are water-binding. In one of the cases, a strongly metachromatic substance is seen inside the sarcolemmic membrane of an extraocular muscle (M. rectus inferior). Since some important retrobulbar changes in human malignant exophthalmos and in experimental exophthalmos in guinea pigs are similar, the authors suggested that the eye symptoms may be due to similar connective tissue changes in cases of other thyro-hypophyseal disorders.