Leone C R
Ophthalmology. 1984 Jul;91(7):770-9. doi: 10.1016/s0161-6420(84)34221-x.
From a series of 124 consecutive patients, parameters were developed in the management of Graves' disease. Patients who were stable with symptomatic treatment were observed and followed. Oral steroids, 40 to 80 mg prednisone daily, were moderately effective in reducing progressive soft tissue inflammatory signs, but were less effective in controlling myopathy and lid retraction. Radiotherapy, 1000 rad from each lateral port, was most effective in halting the progressive inflammatory component, particularly in those who had a recent rapid rate of change. Dysthyroid optic neuropathy required high dose steroids; if it was not effective, decompression of the orbit was carried out. Once the disease became stable, myopathy, lid retraction, and exophthalmos were surgically treated on an elective basis. The techniques utilized were tarsorrhaphy, lateral canthoplasty, upper and lower eyelid retractor release, and one- to three-wall orbital decompression.
从连续的124例患者中，制定了格雷夫斯病的治疗参数。对经对症治疗病情稳定的患者进行观察和随访。口服类固醇，每日40至80毫克泼尼松，在减轻进行性软组织炎症体征方面有一定效果，但在控制肌病和眼睑退缩方面效果较差。放射治疗，从每个侧野给予1000拉德，在阻止进行性炎症成分方面最有效，特别是在那些近期变化迅速的患者中。甲状腺功能异常性视神经病变需要高剂量类固醇治疗；如果无效，则进行眼眶减压。一旦病情稳定，对肌病、眼睑退缩和眼球突出择期进行手术治疗。采用的技术包括睑缘缝合术、外眦成形术、上下眼睑牵开器松解术以及一至三壁眼眶减压术。
