Waterschoot M P, Cordonnier M, Van Nechel C, Vanheesbeke A, Zanen A
Service d'Ophtalmologie, Hôpital Erasme, Bruxelles.
Bull Soc Belge Ophtalmol. 1994;254:93-105.
It is acknowledged that high-dose corticotherapy, radiotherapy, or surgical decompression of the orbit are often efficient in dysthyroid optic neuropathy. Corticotherapy and radiotherapy are also given to patients with dysfunction of eye-muscle motility and/or proptosis in the absence of visual loss. The latter indication has been retrospectively evaluated in 13 patients. The limited character of our series is partially explainable by strict inclusion criteria (objective evaluation of muscle dysfunction and proptosis). We failed to demonstrate any significant functional improvement after oral corticotherapy and/or radiotherapy. It thus appears that our study sheds doubt on the actual efficacy of these treatments in patients presenting with not very evolutive involvement of eye-muscle motility. A larger study aimed at comparing the benefits and drawbacks of these treatments is consequently to be encouraged.
公认的是,大剂量皮质激素治疗、放射治疗或眼眶减压手术在甲状腺功能障碍性视神经病变中通常是有效的。对于没有视力丧失但存在眼肌运动功能障碍和/或眼球突出的患者,也会给予皮质激素治疗和放射治疗。后一种适应症已在13例患者中进行了回顾性评估。我们的系列研究样本有限,部分原因是采用了严格的纳入标准(对肌肉功能障碍和眼球突出进行客观评估)。我们未能证明口服皮质激素治疗和/或放射治疗后有任何显著的功能改善。因此,我们的研究似乎对这些治疗方法在眼肌运动受累不太严重的患者中的实际疗效提出了质疑。因此,鼓励开展一项更大规模的研究,以比较这些治疗方法的利弊。