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眼眶减压术对甲状腺相关眼病性视神经病变的影响:一项回顾性病例系列研究。

Effect of orbital decompression on dysthyroid optic neuropathy: A retrospective case series.

作者信息

Liang Qiao-Wen, Yang Huasheng, Luo Wenjing, He Jian-Feng, Du Yi

机构信息

Department of Ophthalmology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong.

出版信息

Medicine (Baltimore). 2019 Jan;98(3):e14162. doi: 10.1097/MD.0000000000014162.

Abstract

In this study, we try to explore the effect of orbital decompression treatment on severe dysthyroid optic neuropathy.We retrospectively collected demographic and clinical characteristics of thyroid eye disease patients who performed orbital decompression. Then we analyzed the change of best-corrected visual acuity and exophthalmometry after surgery and the correlations among clinical parameters.A total of 22 cases (30 eyes) were included in the study. After orbital decompression, visual acuities improved in 16 eyes, declined in 8 eyes, and had no change in 5 eyes. Best-corrected visual acuity was significantly improved (0.1 vs 0.4, P = .039) and exophthalmometry was significantly declined (22.0 mm vs 16.5 mm, P = .001) after orbital decompression. Better postoperative best-corrected visual acuity was significantly correlated with better preoperative best-corrected visual acuity (r = 0.718, P < .05), and with normal optic disc (r = 0.568, P < .05), but not with age, exophthalmometry, keratopathy, and clinical activity score.These results showed that orbital decompression is a useful approach to manage dysthyroid optic neuropathy. The optimal time for surgery should be chosen based on clinical parameters, such as visual acuity and degree of crowding of orbital apex.

摘要

在本研究中,我们试图探讨眼眶减压治疗对重度甲状腺相关性视神经病变的影响。我们回顾性收集了接受眼眶减压治疗的甲状腺眼病患者的人口统计学和临床特征。然后分析了手术后最佳矫正视力和眼球突出度的变化以及临床参数之间的相关性。本研究共纳入22例(30只眼)。眼眶减压术后,16只眼视力提高,8只眼视力下降,5只眼视力无变化。眼眶减压术后最佳矫正视力显著提高(从0.1提高到0.4,P = 0.039),眼球突出度显著下降(从22.0mm降至16.5mm,P = 0.001)。术后较好的最佳矫正视力与术前较好的最佳矫正视力显著相关(r = 0.718,P < 0.05),与视盘正常相关(r = 0.568,P < 0.05),但与年龄、眼球突出度、角膜病变和临床活动评分无关。这些结果表明,眼眶减压是治疗甲状腺相关性视神经病变的一种有效方法。应根据临床参数,如视力和眶尖拥挤程度,选择最佳手术时机。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac5c/6370065/ed449bd7c78c/medi-98-e14162-g004.jpg

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