Long-term Efficacy of Orbital Decompression for Compressive Optic Neuropathy of Graves' Eye Disease

Thyroid eye disease is an auto-immune mediated orbitopathy which can cause dysthyroid compressive optic neuropathy. Traditional management of active thyroid eye disease includes temporizing high-dose steroids, orbital radiation and surgical decompression, which each possess significant limitations and/or side effects. Teprotumumab is an IGF-IR inhibitor recently FDA-approved for active thyroid eye disease. The authors report reversal of bilateral dysthyroid compressive optic neuropathy managed medically utilizing teprotumumab.

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Long-term visual outcome following orbital decompression for dysthyroid eye disease

Eye ◽

10.1038/eye.1995.143 ◽

1995 ◽

Vol 9 (5) ◽

pp. 578-581 ◽

Cited By ~ 23

Author(s):

B M Hutchison ◽

P M Kyle

Keyword(s):

Visual Outcome ◽

Eye Disease ◽

Orbital Decompression

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ORBITAL DECOMPRESSION FOR OPTIC NEUROPATHY SECONDARY TO THYROID EYE DISEASE

The Laryngoscope ◽

10.1288/00005537-198807000-00004 ◽

1988 ◽

Vol 98 (7) ◽

pp. 712???716 ◽

Cited By ~ 6

Author(s):

STEVEN D. SCHAEFER ◽

JAMES H. MERRITT ◽

LANNY G. CLOSE

Keyword(s):

Optic Neuropathy ◽

Thyroid Eye Disease ◽

Eye Disease ◽

Orbital Decompression

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Compressive Optic Neuropathy and Repeat Orbital Decompression

Ophthalmic Plastic and Reconstructive Surgery ◽

10.1097/iop.0000000000000356 ◽

2015 ◽

Vol 31 (5) ◽

pp. 385-390 ◽

Cited By ~ 18

Author(s):

Courtney Y. Kauh ◽

Shivani Gupta ◽

Raymond S. Douglas ◽

Victor M. Elner ◽

Christine C. Nelson ◽

...

Keyword(s):

Optic Neuropathy ◽

Orbital Decompression ◽

Compressive Optic Neuropathy

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“Balanced” Orbital Decompression for Severe Graves' Orbitopathy: Technique with Treatment Algorithm

Otolaryngology ◽

10.1067/mhn.2003.61 ◽

2003 ◽

Vol 128 (2) ◽

pp. 228-235 ◽

Cited By ~ 44

Author(s):

Kacker Ashutosh ◽

Kazim Michael ◽

Murphy Mark ◽

Trokel Stephen ◽

G. Close Lanny

Keyword(s):

Optic Nerve ◽

Optic Neuropathy ◽

Treatment Algorithm ◽

Orbital Decompression ◽

Nerve Function ◽

Muscle Involvement ◽

Compressive Optic Neuropathy ◽

Average Decrease ◽

Graves Orbitopathy ◽

Low Incidence

BACKGROUND: Graves' orbitopathy can produce proptosis, compressive optic neuropathy, and extraocular motility abnormalities; symptoms result from an increase in orbital volume due to expansion of intraorbital fat, with or without extraocular muscle involvement. STUDY DESIGN: We conducted a chart review of patients who underwent orbital decompression to treat Graves' orbitopathy. Twenty-two orbits (13 patients) underwent orbital bone decompression, of which 17 orbits (9 patients) underwent the combined medial and lateral “balanced” decompression. RESULTS: All patients had significant improvement with an average decrease in proptosis of 5.9 mm in the balanced decompression group. Restoration of normal optic nerve function was achieved in all patients with compressive optic neuropathy. Diplopia was noted in 4 patients (30.7%) preoperatively. Two patients had new postoperative diplopia (15.35%). CONCLUSION: In our experience, “balanced” decompression results in a reduction of proptosis and improved optic nerve function and has a low incidence of complications.

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