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调强放射治疗联合眶周注射曲安奈德治疗活动期眼外肌受累但临床活动度评分较低的甲状腺眼病患者的疗效评估

A curative effect evaluation of intensity-modulated radiation therapy combined with periorbital triamcinolone acetonide injection in treating thyroid eye disease patients with active extraocular muscle but low CAS.

作者信息

Zhang Hao, He Weimin

机构信息

Department of Ophthalmology, West China Hospital of Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041, Sichuan, China.

出版信息

Sci Rep. 2025 Jan 25;15(1):3222. doi: 10.1038/s41598-025-88142-w.

Abstract

The purpose of this study is to evaluate the effectiveness of intensity-modulated radiation therapy (IMRT) combined with periorbital triamcinolone acetonide injection in treating thyroid eye disease (TED) patients with active extraocular muscle but low CAS. The retrospective observational study was conducted. A total of 156 eligible patients were selected from the TED patient database of the Ophthalmology Department of West China Hospital of Sichuan University. The patient's relevant medical history was recorded, including gender, age of initial onset, onset eye, the interval between onset and the first visit to our hospital, extraocular muscle condition, smoking status, CAS, NOSPECS, thyroid function, symptoms and signs, and the condition of the affected extraocular muscle. We found that IMRT combined with periorbital triamcinolone acetonide injection has a good therapeutic effect on TED patients with low CAS but significant active extraocular muscles, and there is a significant improvement at 3 months after treatment. Thyroid function and CAS can affect the curative effect of IMRT. Patients with hyperthyroidism had worse effect than those with normal thyroid function. The higher the CAS, the better the effect.

摘要

本研究的目的是评估调强放射治疗(IMRT)联合眶周注射曲安奈德治疗甲状腺眼病(TED)患者眼外肌活跃但临床活动度评分(CAS)较低的有效性。进行了一项回顾性观察研究。从四川大学华西医院眼科的TED患者数据库中选取了156例符合条件的患者。记录患者的相关病史,包括性别、初发年龄、发病眼别、发病至首次来我院就诊的间隔时间、眼外肌状况、吸烟状况、CAS、NOSPECS分级、甲状腺功能、症状体征以及患侧眼外肌情况。我们发现,IMRT联合眶周注射曲安奈德对CAS较低但眼外肌明显活跃的TED患者有良好的治疗效果,且治疗后3个月有显著改善。甲状腺功能和CAS会影响IMRT的疗效。甲状腺功能亢进的患者疗效比甲状腺功能正常的患者差。CAS越高,效果越好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a09/11763082/5df45d7cfad3/41598_2025_88142_Fig1_HTML.jpg

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