Maeda Kengo, Kume Shinji, Nishio Yoshihiko, Maeda Shiro, Nishida Yasuhiro, Suzuki Mikio, Nakaguchi Takahiro, Kawabata Toru, Hashimoto Osamu, Hisanaga Takashi, Kashiwagi Atsunori, Yasuda Hitoshi
Division of Neurology, Department of Medicine, Shiga University of Medical Science.
Rinsho Shinkeigaku. 2006 Apr;46(4):266-9.
We report a 53-year-old woman with severe Graves' ophthalmopathy accompanied by uncontrolled myasthenia gravis. She presented remarkable exophthalmos, chemosis, and restriction of eye movement. Despite plasma exchange, steroid pulse therapy, local injection of steroid, and irradiation, ocular symptoms did not ameliorate. Since optic neuropathy was seen, orbital decompression surgery was performed in the left eye. Bilateral chemosis was improved after the surgery. Five years after surgery, there was no ocular palsy in the operated left eye, but in the contralateral eye. For the good prognosis of the eye movement, orbital decompression might be recommended in the severe Graves' ophthalmopathy accompanied by the optic neuropathy and/or ophthalmoplegia with proptosis.
我们报告了一名53岁女性,患有严重的格雷夫斯眼病并伴有未得到控制的重症肌无力。她表现出明显的眼球突出、结膜水肿和眼球运动受限。尽管进行了血浆置换、类固醇冲击疗法、局部类固醇注射和放射治疗,眼部症状仍未改善。由于出现了视神经病变,对左眼进行了眼眶减压手术。术后双侧结膜水肿有所改善。手术后五年,手术的左眼没有出现眼肌麻痹,但对侧眼出现了。对于眼球运动的良好预后,对于伴有视神经病变和/或伴有眼球突出的眼肌麻痹的严重格雷夫斯眼病,可能建议进行眼眶减压手术。