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电休克治疗诱发甲状腺功能不稳定患者原发性开角型青光眼:一例报告

ECT-induced primary open-angle glaucoma in a patient with unstable thyroid function: a case report.

作者信息

Fu Cuiyuan, Yang Xiuzhen, Li Kun

机构信息

Department of Physical Therapy, Shandong Daizhuang Hospital, Jining, China.

Jining Key Laboratory of Neuromodulation, Jining, China.

出版信息

Front Psychiatry. 2025 Mar 5;16:1497205. doi: 10.3389/fpsyt.2025.1497205. eCollection 2025.

Abstract

BACKGROUND

Schizophrenia is a prevalent and severe psychiatric disorder for which electroconvulsive therapy (ECT) is frequently utilized as a treatment modality. Although ECT can transiently elevate intraocular pressure, the incidence of ECT-related adverse ophthalmic events in patients with coexisting hyperthyroidism is not well documented.

CASE REPORT

In this report, we describe an elderly woman with schizophrenia and hyperthyroidism. Before undergoing ECT, she had no previous history of glaucoma, and her thyroid function was in an unstable state. After three sessions of ECT, the patient exhibited conjunctival congestion and was subsequently diagnosed with primary open-angle glaucoma, which was not treated. Her intraocular pressure normalized prior to and following the fourth ECT session, and she experienced no further ocular discomfort during subsequent treatments (fifth through eighth sessions).

CONCLUSIONS

Although ECT has been used in patients with coexisting psychiatric and thyroid dysfunction, there is a lack of reports addressing the risk of inducing or exacerbating glaucoma in the context of unstable thyroid function. This case emphasizes the necessity of monitoring intraocular pressure in patients with unstable thyroid function during ECT, to mitigate the risk of ocular complications.

摘要

背景

精神分裂症是一种常见且严重的精神障碍,电休克疗法(ECT)常被用作一种治疗方式。尽管ECT可使眼压短暂升高,但甲状腺功能亢进症患者中与ECT相关的不良眼科事件的发生率尚无充分记录。

病例报告

在本报告中,我们描述了一名患有精神分裂症和甲状腺功能亢进症的老年女性。在接受ECT治疗前,她既往无青光眼病史,且甲状腺功能处于不稳定状态。经过三次ECT治疗后,患者出现结膜充血,随后被诊断为原发性开角型青光眼,但未接受治疗。她的眼压在第四次ECT治疗前后恢复正常,并且在随后的治疗(第五至第八次)期间未再出现眼部不适。

结论

尽管ECT已用于患有精神疾病和甲状腺功能障碍的患者,但缺乏关于在甲状腺功能不稳定的情况下诱发或加重青光眼风险的报告。该病例强调了在ECT期间对甲状腺功能不稳定的患者监测眼压的必要性,以降低眼部并发症的风险。

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