Hamédani M, Obéric A
Hôpital ophthalmique Jules Gonin, Lausanne.
Rev Med Suisse. 2013 Jan 9;9(368):66-71.
Mild to moderate forms of orbitopathy are common in auto-immune thyroid diseases, whereas severe forms are rare. Euthyroidism restoration, no smoking, and ocular local lubricants are necessary for all the patients. In case of mild orbitopathy, treatment by selenium is now indicated. Active forms of thyroid orbitopathy are better treated by IV steroids. Surgery is indicated in optic neuropathy resistant to steroids and in sequellar forms of the disease.
轻至中度眼眶病在自身免疫性甲状腺疾病中很常见,而重度眼眶病则较为罕见。所有患者都需要恢复甲状腺功能正常、戒烟并使用眼部局部润滑剂。对于轻度眼眶病,现在建议使用硒进行治疗。甲状腺眼眶病的活动期采用静脉注射类固醇治疗效果更佳。对于对类固醇耐药的视神经病变以及疾病后遗症形式,建议进行手术治疗。