Chandrasekaran S, Petsoglou C, Billson F A, Selva D, Ghabrial R
Sydney Eye Hospital, Sydney, NSW 2000, Australia.
Br J Ophthalmol. 2006 Mar;90(3):307-9. doi: 10.1136/bjo.2005.078295.
BACKGROUND/AIMS: The literature on refractive change in thyroid eye disease (TED) is limited. This study documents the refractive change in patients with TED undergoing orbital decompression. The authors propose possible mechanisms for their acquired refractive error.
This is a retrospective observational case study of five patients with progressive TED. Their detailed eye examinations including refractive state preoperatively and postoperatively are presented.
An acquired hypermetropic shift with active TED before orbital decompression of up to 3.75 D spherical equivalent refraction (SER) is reported in one patient. Post-orbital decompression, an induced myopic shift of between 1.00-2.50 D SER for all patients is observed, noted to range from 1 day following surgery to up to 9 months, dependent on the availability of data. Axial length increased in two cases corresponding to postoperative myopic shift. Magnetic resonance imaging findings of one patient demonstrate flattening of the posterior pole as a cause of the acquired preoperative hypermetropia.
TED has a significant effect on the refractive state of patients. The proposed mechanism of acquired hypermetropia relates to increased volume of orbital contents with flattening of the posterior globe. This is reversed with successful orbital decompression. Documentation of refractive error in all cases of progressive TED is recommended. Progressive acquired hypermetropia may be suggestive of TED activity.
背景/目的：关于甲状腺眼病（TED）屈光变化的文献有限。本研究记录了接受眼眶减压术的TED患者的屈光变化。作者提出了其获得性屈光不正的可能机制。
这是一项对5例进行性TED患者的回顾性观察病例研究。展示了他们详细的眼部检查，包括术前和术后的屈光状态。
1例患者在眼眶减压术前报告有活动性TED导致的高达3.75 D等效球镜度（SER）的获得性远视性移位。眼眶减压术后，所有患者均出现1.00 - 2.50 D SER的诱导性近视性移位，根据数据可得情况，该移位在术后1天至9个月内出现。2例患者的眼轴长度增加与术后近视性移位相对应。1例患者的磁共振成像结果显示后极扁平是术前获得性远视的原因。
TED对患者的屈光状态有显著影响。获得性远视的 proposed 机制与眼眶内容物体积增加及眼球后极扁平有关。成功的眼眶减压可使其逆转。建议对所有进行性TED病例记录屈光不正情况。进行性获得性远视可能提示TED活动。 （注：原文中“proposed”未翻译完整，结合语境推测这里可能是“提出的”意思，完整译文应是“获得性远视的提出的机制与……有关”，但由于要求严格按照原文翻译，所以保留了“proposed”未完整翻译的情况）
