Thyroid Eye Disease
Conditions
Keywords
Orbital decompression, Graves' orbitopathy, Dysthyroid optic neuropathy
Brief summary
Graves' orbitopathy (GO) is an disfiguring and disabling autoimmune condition. Sight-threatening GO is an most severe form and occurs in about 5% of patients with Graves' disease. It can cause blurred vision, color vision and vision function damage, and affects the quality of life. The goal of this retrospective cohort study is to propose a customized orbital decompression algorithm for patients with sight-threatening Graves'ophthalmopathy and to explore the therapeutic effect of customized orbital decompression in sight-threatening patients.
Interventions
PROCEDUREModified multiple orbital wall decompression
Thyroid dysfunction of all patients is stabilized by ATDs until treatment of TAO is completed. All patients with sight-threatening GO were admitted for emergency steroid pulse therapy. And additional drugs for protecting gastrointestinal mucous membrane, potassium and calcium supplements, and sedatives were used. All emergency cases, whose signs of visual impairment clinically attributable to GO existed despite first-line steroid treatment, were referred and discussed at the surgical board of our interdisciplinary center for prompt surgical orbital decompression. Urgent orbital decompression was performed when response is absent or poor within 1-2 weeks.
Sponsors
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Inclusion criteria
* Sight-threatening patients undergoing interdisciplinary discussion and orbital decompression operation. * The sight-threatening GO refer to those with DON, exposure keratitis or corneal breakdown. * DON was diagnosed according to the following clinical findings including optic nerve head edema, visual field defect, impaired color vision, afferent pupil defect, retinal folds, radiologic evidence of apical optic nerve compression or globe subluxation. * Diagnosis of exposure keratitis or corneal breakdown was made based on physical exam signs, e.g. microepithelial defects, abrasion or ulcer. A minimum follow-up of 12 months was required for inclusion.
Exclusion criteria
* Patients were excluded if exophthalmos, rather than acute visual loss, was the indication for surgery. * Cases with a history of previous ocular surgery, glaucoma, and visual defects from other ocular conditions were excluded from the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| BCVA | 12 months | best corrected visual acuity in logMAR |
| CAS | 12 months | clinical activity score |
| proptosis | 12 months | proptosis in mm |
| EVP | 12 months | Visual Evoked Potential |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| GO-QOL | 12 months | Graves' Ophthalmopathy Quality of Life |
Countries
China
Contacts
Primary ContactPeng Tian, PhD., M.D.
Backup ContactMei Wang, PhD., M.D.
Outcome results
None listed