Management of patients with dysthyroid optic neuropathy treated with intravenous corticosteroids and/or orbital decompression surgery.

Autor: Rezar-Dreindl S; Department of Ophthalmology and Optometry, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria., Papp A; Department of Ophthalmology and Optometry, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria., Baumann A; Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Vienna, Austria., Neumayer T; Department of Ophthalmology and Optometry, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria., Eibenberger K; Department of Ophthalmology and Optometry, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria., Stifter E; Department of Ophthalmology and Optometry, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. eva.stifter@meduniwien.ac.at., Schmidt-Erfurth U; Department of Ophthalmology and Optometry, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
Jazyk: angličtina
Zdroj: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2022 Nov; Vol. 260 (11), pp. 3683-3691. Date of Electronic Publication: 2022 Jun 22.
DOI: 10.1007/s00417-022-05732-4
Abstrakt: Purpose: To assess the characteristics and long-term outcomes of adult patients with dysthyroid optic neuropathy (DON) who underwent orbital decompression surgery and/or received intravenous (IV) methylprednisolone.
Methods: Retrospective chart review of 98 eyes of 49 patients who were diagnosed and treated with bilateral DON between 2007 and 2018 at the Department of Ophthalmology and Optometry and Oral and Maxillofacial Surgery of the Medical University of Vienna.
Results: The mean follow-up period was 4.1 ± 2.7 years. The most common presenting symptoms were eyelid and periorbital swelling (45%) representing active inflammation. Upgaze restriction was the most common clinical finding (73%). At time of diagnosis, the mean clinical activity score was 4 ± 1/4 ± 1 (right/left eye, respectively). Sixty-three percent (31/49) of the patients were treated both with IV methylprednisolone and underwent orbital decompression surgery, 22% (11/49) were treated with IV methylprednisolone alone and 14% (7/49) underwent surgical decompression only. Seventy-one percent (30/42) of the patients underwent 3-wall decompression. The mean reduction of proptosis in patients treated with both IV methylprednisolone and orbital decompression surgery was 4/5 mm. Mean of reduction in proptosis in patients receiving IV methylprednisolone only was 1/0 mm and in patients with surgical decompression only was 5/5 mm. Mean VA was 0.1 ± 0.5/0.1 ± 0.5 logMAR at baseline and 0.05 ± 0.7/0.05 ± 0.7 at final follow-up. In 92% (45/49), VA was preserved or improved at final follow-up.
Conclusions: The majority of patients with DON were treated both with IV corticosteroids and 3-wall decompression surgery. Vision could be successfully preserved in most cases and reduction of proptosis was achieved, especially after orbital decompression surgery.
(© 2022. The Author(s).)
Databáze: MEDLINE
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