Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan 17;20(1):30.
doi: 10.1186/s12886-020-1314-8.

Preoperative clinical factors and visual outcomes following orbital decompression with dysthyroid optic neuropathy

Mizuki Tagami  1   2 , Shigeru Honda  3 , Atsushi Azumi  4
Affiliations

Preoperative clinical factors and visual outcomes following orbital decompression with dysthyroid optic neuropathy

Mizuki Tagami et al. BMC Ophthalmol. .

Abstract

Background: To investigate preoperative clinical factors and visual outcomes of Japanese patients with dysthyroid optic neuropathy (DON) after urgent orbital decompression.

Methods: This retrospective, observational case series study investigated 44 patients who exhibited several preoperative clinical factors that might be associated with the need for urgent orbital decompression due to DON. Additionally, the visual acuity of DON patients was compared between the patients preoperatively and at 1 and 6 months postoperatively.

Results: All 44 patients received steroid and with or without radiation therapy, with 27 patients able to avoid undergoing urgent surgery. However, the remaining 17 patients required urgent orbital decompression following a lack of response to the therapy. None of the patients who initially avoided surgery required additional surgery for DON. Factors significantly associated with the need for urgent orbital decompression surgery included: female gender, older age, long disease duration, unilateral significant DON, history of resistance to pulsed steroid therapy, unstable thyroid function, high TRAb (Thyrotrophin receptor antibody)value, poor visual acuity, presence of central diplopia, and presence of corneal problems (P < 0.05 each). The results also showed that postoperative visual outcomes of surgery for DON were acceptable.

Conclusion: This study revealed several preoperative clinical factors for DON that appear to be associated with the need for urgent orbital decompression surgery in Japanese patients.

Keywords: Dysthyroid optic neuropathy; Graves’ orbitopathy; Japanese; Orbital decompression; Visual outcome.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Pre- and postoperative (1 month after orbital decompression) visual acuity. Eyes in which visual acuity improved following orbital decompression are located below the diagonal line. P-value, repeated-measures analysis of variance, n = 24
Fig. 2
Fig. 2
Pre- and postoperative (6 months after orbital decompression) visual acuity. Eyes in which visual acuity improved following orbital decompression are located below the diagonal line. P-value, repeated-measures analysis of variance, n = 24
See this image and copyright information in PMC

References

    1. Currò N, Covelli D, Vannucchi G, Campi I, Pirola G, Simonetta S, Dazzi D, Guastella C, Pignataro L, Beck-Peccoz P, Ratiglia R, Salvi M. Therapeutic outcomes of high-dose intravenous steroids in the treatment of dysthyroid optic neuropathy. Thyroid. 2014;24:897–905. doi: 10.1089/thy.2013.0445. - DOI - PubMed
    1. Wakelkamp IM, Baldeschi L, Saeed P, Mourits MP, Prummel MF, Wiersinga WM. Surgical or medical decompression as a first-line treatment of optic neuropathy in Graves' ophthalmopathy? A randomized controlled trial. Clin Endocrinol. 2005;63:323–328. doi: 10.1111/j.1365-2265.2005.02345.x. - DOI - PubMed
    1. Bartley GB, Fatourechi V, Kadrmas EF, Jacobsen SJ, Ilstrup DM, Garrity JA, Gorman CA. The treatment of Graves' ophthalmopathy in an incidence cohort. Am J Ophthalmol. 1996;121:200–206. doi: 10.1016/S0002-9394(14)70585-9. - DOI - PubMed
    1. Bartalena L, Baldeschi L, Boboridis K, Eckstein A, Kahaly GJ, Marcocci C, Perros P, Salvi M, Wiersinga WM, European Group on Graves' Orbitopathy (EUGOGO) The 2016 European thyroid association/European group on Graves' orbitopathy guidelines for the management of Graves' orbitopathy. Eur Thyroid J. 2016;5:9–26. doi: 10.1159/000443828. - DOI - PMC - PubMed
    1. Choi SU, Kim KW, Lee JK. Surgical outcomes of balanced deep lateral and medial orbital wall decompression in Korean population: clinical and computed tomography-based analysis. Korean J Ophthalmol. 2016;30:85–91. doi: 10.3341/kjo.2016.30.2.85. - DOI - PMC - PubMed