Fung Shirley, Malhotra Raman, Selva Dinesh
Oculoplastic and Orbital Unit, Department of Ophthalmology, Royal Adelaide Hospital, University of Adelaide, South Australia.
Aust Fam Physician. 2003 Aug;32(8):615-20.
Thyroid orbitopathy (thyroid eye disease, thyroid ophthalmopathy) is an organ specific, autoimmune disorder with the potential to cause severe functional and psychosocial effects.
This article reviews the clinical features with particular emphasis on current management.
Thyroid orbitopathy is most prevalent in women aged 40-50 years and is usually associated with thyroid dysfunction. Clinical manifestations include soft tissue signs, lid retraction, lid lag, proptosis, restrictive myopathy, corneal exposure and optic neuropathy. Thyroid function tests are essential, while thyroid antibodies and imaging to demonstrate extraocular muscle enlargement may also aid diagnosis. Correction of thyroid dysfunction and supportive measures are necessary in all cases. Immunosuppression is reserved for moderate to severe active orbitopathy and rehabilitative surgery is generally used once the disease is quiescent. A good visual and cosmetic outcome requires close cooperation between the general practitioner, endocrinologist and ophthalmologist.
甲状腺眼病(甲状腺相关眼病、甲状腺眼眶病)是一种器官特异性自身免疫性疾病,有可能导致严重的功能和心理社会影响。
本文回顾其临床特征,特别强调当前的治疗方法。
甲状腺眼病在40至50岁女性中最为常见,通常与甲状腺功能障碍有关。临床表现包括软组织体征、眼睑退缩、眼睑滞后、眼球突出、限制性肌病、角膜暴露和视神经病变。甲状腺功能检查至关重要,而甲状腺抗体检查和显示眼外肌增大的影像学检查也有助于诊断。所有病例均需纠正甲状腺功能障碍并采取支持措施。免疫抑制疗法适用于中度至重度活动性眼眶病,康复手术通常在疾病静止后使用。良好的视力和美容效果需要全科医生、内分泌科医生和眼科医生密切合作。