1
|
Ye Y, Hu F, Ji Y, Wang R, Zhu K, Kong Q. The outcomes of endoscopic orbital decompression combined with fat decompression for thyroid-associated ophthalmopathy. BMC Ophthalmol 2023; 23:217. [PMID: 37193956 DOI: 10.1186/s12886-023-02957-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/03/2023] [Indexed: 05/18/2023] Open
Abstract
PURPOSE To present the clinical features of thyroid-associated ophthalmopathy (TAO) with different CT types, and to report the outcomes of endoscopic orbital decompression combined with fat decompression (EOD-FD). PATIENTS AND METHODS Thirty-four patients with TAO who underwent EOD-FD between December 2020 and March 2022 in the Ophthalmology Department of Li Huili Hospital Affiliated with Ningbo University, were included in this retrospective interventional case series. Patients were categorized into two groups based on the results of computerized tomography (CT) scans: muscle expansion type and fat hyperplasia type. RESULTS Thirty-four TAO patients (55 eyes) were included in this study, and the mean age was 38.62 years (range 22-60 years). The average eye protrusion (EP) reduced from preoperative 23.20 mm to postoperative 19.66 mm (p < 0.0001). Mean intraocular pressure (IOP) decreased from 20.11 mmHg at baseline to 17.29 mmHg postoperatively (p < 0.0001), with a reduction of 2.84 mmHg (14.12%). Twenty cases of muscle expansion and fourteen cases of fat hyperplasia were definite by CT imaging. The mean IOP in the muscle expansion group was higher than that in the fat hyperplasia group (p < 0.05). Elevated intraocular pressure (IOP) occurred in 23 eyes (36.11%), and it was associated with extraocular muscle involvement, gender, and EP. In 3 cases of impaired vision, the mean best corrected visual acuity (VA) improved from 0.4 preoperatively to 0.84 postoperatively (p < 0.01). There were 8 cases with visual field (VF) damage and/or corneal epithelium damage, and all these damages were reversible. CONCLUSION In this study, we describe the clinical features and experience of EOD-FD in patients with TAO. EOD-FD is an effective technique in reducing IOP and proptosis, with a low incidence of postoperative diplopia.
Collapse
Affiliation(s)
- Yunyan Ye
- Department of Ophthalmology, Li Huili Hospital affiliated with Ningbo University, Xingning Road-57, Yinzhou District, Ningbo City, Zhejiang Province, China
| | - Feng Hu
- Department of Ophthalmology, Li Huili Hospital affiliated with Ningbo University, Xingning Road-57, Yinzhou District, Ningbo City, Zhejiang Province, China
| | - Yuanfei Ji
- Department of Ophthalmology, Li Huili Hospital affiliated with Ningbo University, Xingning Road-57, Yinzhou District, Ningbo City, Zhejiang Province, China
| | - Ruijun Wang
- Department of Ophthalmology, Li Huili Hospital affiliated with Ningbo University, Xingning Road-57, Yinzhou District, Ningbo City, Zhejiang Province, China
| | - Kexuan Zhu
- Department of Ophthalmology, Li Huili Hospital affiliated with Ningbo University, Xingning Road-57, Yinzhou District, Ningbo City, Zhejiang Province, China
| | - Qiao Kong
- Department of Ophthalmology, Li Huili Hospital affiliated with Ningbo University, Xingning Road-57, Yinzhou District, Ningbo City, Zhejiang Province, China.
| |
Collapse
|
2
|
Nowroozzadeh MH, Thornton S, Watson A, Syed ZA, Razeghinejad R. Ocular manifestations of endocrine disorders. Clin Exp Optom 2021; 105:105-116. [PMID: 34751097 DOI: 10.1080/08164622.2021.1986354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Endocrinopathies are prevalent diseases that typically affect multiple organs, and the eye and orbital tissues are often involved in endocrine disorders. Some conditions, such as diabetes and thyroid gland dysfunction, may cause serious eye pathology and even blindness. A clear insight into the pathogenesis of endocrinopathies and their ocular manifestations would enhance preventive and therapeutic measures and reduce the incidence of sight-threatening complications. This review discusses the ocular manifestations of several endocrine disorders that eye care providers are likely to encounter in clinical practice.
Collapse
Affiliation(s)
- M Hossein Nowroozzadeh
- Retina Service, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sarah Thornton
- Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia, PA, USA
| | - Alison Watson
- Oculoplastic Service, Wills Eye Hospital, Philadelphia, PA, USA
| | - Zeba A Syed
- Cornea Service, Wills Eye Hospital, Philadelphia, PA, USA
| | | |
Collapse
|
3
|
Suda K, Akagi T, Ikeda HO, Kameda T, Hasegawa T, Miyake M, Kido A, Nakano E, Tsujikawa A. Atopic dermatitis as a risk factor for severe visual field loss in youth-a retrospective cohort study of glaucoma under steroid treatment. Graefes Arch Clin Exp Ophthalmol 2020; 259:129-136. [PMID: 32936358 DOI: 10.1007/s00417-020-04925-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/12/2020] [Accepted: 09/05/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To assess the characteristics of glaucoma patients who received systemic or topical steroid treatment. METHODS Patients who received steroid treatment were selected from a total of 4256 patients at our tertiary referral center of glaucoma management between August 2011 and October 2017. Clinical characteristics of the subjects were extracted from clinical records. To evaluate the factors influencing highest intraocular pressure during observation (max-IOP) or mean deviations (MDs) of visual field at the first and last visits, univariate and multivariate regression analyses were performed using a generalized estimating equation. RESULTS Three hundred and eighty-two eyes of 196 patients were included in this study. The most frequent disease as the reason for steroid treatment was atopic dermatitis (58 eyes) followed by autoimmune diseases. The patients with atopic dermatitis were significantly younger (38.0 ± 11.2 years old, p < 0.001) and had lower MD (- 9.3 ± 9.1 dB at first visit, p = 0.01; - 10.6 ± 9.2 dB at last visit, p = 0.004) than those with other diseases. In multivariate regression analysis, age and MD at first visit, max-IOP, and atopic dermatitis were correlated with MD at last visit. CONCLUSIONS The results of the present study suggest that patients with atopic dermatitis carry the risk of irreversible visual field loss even in youth. For earlier detection of high intraocular pressure, reinforcement of ophthalmological screening in management of atopic dermatitis should be recommended.
Collapse
Affiliation(s)
- Kenji Suda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Tadamichi Akagi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hanako Ohashi Ikeda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takanori Kameda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tomoko Hasegawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ai Kido
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Eri Nakano
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| |
Collapse
|