Sawers J S, Irvine W J, Toft A D, Urbaniak S J, Donaldson A A
J Clin Lab Immunol. 1981 Nov;6(3):245-50.
We describe three patients who developed severe endocrine ophthalmopathy at 3, 12 and 18 months after treatment with iodine-131. In two cases with congestive ophthalmopathy steroids alone and plasma exchange alone failed to produce a satisfactory response, but the combination of plasma exchange with steroids or steroids plus cyclophosphamide was followed by resolution of papilloedema and return of visual acuity to normal as well as definite improvement in the other signs of ophthalmopathy. In the remaining case, which did not have papilloedema the signs of ophthalmopathy were progressive despite treatment with steroids. Combined treatment with plasma exchange, steroids and cyclophosphamide resulted in improvement in visual acuity and resolution of periorbital oedema and diplopia. Plasma exchange may be a useful adjunct to immunosuppressive therapy in the treatment of acute progressive endocrine exophthalmos.
我们描述了3例在接受碘-131治疗后3个月、12个月和18个月出现严重内分泌性眼病的患者。在2例患有充血性眼病的患者中，单独使用类固醇和单独进行血浆置换均未能产生满意的效果，但血浆置换与类固醇联合使用或类固醇加环磷酰胺联合使用后，视乳头水肿消退，视力恢复正常，眼病的其他体征也有明显改善。在其余1例没有视乳头水肿的患者中，尽管使用了类固醇治疗，眼病体征仍在进展。血浆置换、类固醇和环磷酰胺联合治疗使视力得到改善，眶周水肿和复视消退。血浆置换可能是免疫抑制治疗急性进行性内分泌性突眼的有用辅助手段。
