Orbit and Oculoplasty Services, Narayana Nethralaya, Bengaluru, Karnataka, India.
Indian J Ophthalmol. 2020 Aug;68(8):1622-1627. doi: 10.4103/ijo.IJO_2284_19.
To describe visual morbidity in thyroid orbitopathy in Asian Indians and the factors influencing its onset.
A retrospective chart review was performed for patients with thyroid related orbitopathy seen between May 2014 and April 2019. Three hundred and one patients were included in the study. Relevant history, clinical findings, investigations, and treatment were documented.
Nineteen percent of patients had at least 1 visual morbidity feature such as compressive optic neuropathy, exposure keratopathy or diplopia, requiring intravenous glucocorticoid. Male gender, older age, and diabetes were the significant risk factors for high visual morbidity (all P < 0.05). Systemic thyroid status, degree of proptosis, and duration of disease were not significant. Average dose of intravenous glucocorticoid needed was 3.8 g; 24 (7.9%) patients required orbital decompression, and 13 (4.3%) needed eyelid surgery. At the last follow-up, 97% of patients had vision 6/12 or better in both eyes.
There is significant visual morbidity found in Indian patients with TED, even with moderate proptosis and systemic control of thyroid status. This is the first set of data on the subject.
描述亚洲印第安人甲状腺眼病的视觉发病率及影响其发病的因素。
对 2014 年 5 月至 2019 年 4 月间就诊的甲状腺相关眼病患者进行回顾性图表审查。本研究共纳入 310 例患者。记录了相关病史、临床发现、检查和治疗情况。
19%的患者至少存在 1 种视觉发病率特征,如压迫性视神经病变、暴露性角膜炎或复视,需要静脉注射糖皮质激素。男性、年龄较大和糖尿病是高视觉发病率的显著危险因素(均 P<0.05)。全身甲状腺功能、眼球突出度和疾病持续时间无显著差异。静脉注射糖皮质激素的平均剂量为 3.8 g;24 例(7.9%)患者需要眼眶减压,13 例(4.3%)需要眼睑手术。末次随访时,97%的患者双眼视力均为 6/12 或更好。
即使甲状腺功能得到了适度的控制,印度甲状腺眼病患者的视觉发病率仍很高。这是该主题的第一组数据。