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

2020 ◽  
Author(s):  
Mizuki Tagami ◽  
Shigeru Honda ◽  
Atsushi Azumi
Keyword(s):  
Visual Acuity ◽  
Optic Neuropathy ◽  
Japanese Patients ◽  
Decompression Surgery ◽  
Orbital Decompression ◽  
Clinical Factors ◽  
Dysthyroid Optic Neuropathy ◽  
Visual Outcomes ◽  
Additional Surgery ◽  
Case Series Study

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.

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

2020 ◽  
Author(s):  
Mizuki Tagami ◽  
Shigeru Honda ◽  
Atsushi Azumi
Keyword(s):  
Visual Acuity ◽  
Optic Neuropathy ◽  
Japanese Patients ◽  
Decompression Surgery ◽  
Orbital Decompression ◽  
Clinical Factors ◽  
Dysthyroid Optic Neuropathy ◽  
Visual Outcomes ◽  
Additional Surgery ◽  
Case Series Study

Abstract Purpose: 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.

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

2019 ◽  
Author(s):  
Mizuki Tagami ◽  
Shigeru Honda ◽  
Atsushi Azumi
Keyword(s):  
Visual Acuity ◽  
Optic Neuropathy ◽  
Japanese Patients ◽  
Decompression Surgery ◽  
Orbital Decompression ◽  
Clinical Factors ◽  
Dysthyroid Optic Neuropathy ◽  
Visual Outcomes ◽  
Additional Surgery ◽  
Case Series Study

Abstract Purpose: 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 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, 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.

scholarly journals Outcomes following orbital decompression surgery for dysthyroid optic neuropathy associated with Graves’ ophthalmopathy.

2015 ◽  
Vol 14 (3) ◽  
pp. 97-107
Author(s):  
Jerome How Ing Ha ◽  
James Leong ◽  
Peter Martin ◽  
Raf Ghabrial ◽  
Ross Benger
Keyword(s):  
Visual Acuity ◽  
Standard Deviation ◽  
Confidence Interval ◽  
Optic Neuropathy ◽  
P Value ◽  
Decompression Surgery ◽  
Orbital Decompression ◽  
Dysthyroid Optic Neuropathy ◽  
Graves Ophthalmopathy ◽  
Orbital Wall

Purpose: To investigate the outcomes of orbital decompression surgery for dysthyroid optic neuropathy associated with severe Graves’ ophthalmopathy. Design: Ten years (2000-2010) retrospective case series.Methods: Thirty-eight orbits (with dysthyroid optic neuropathy) of 119 surgical orbital decompressions. Patients with dysthyroid optic neuropathy associated with Graves’ ophthalmopathy, who underwent orbital decompression surgery at Sydney Eye Hospital (Sydney, Australia), were investigated for outcome measures.Results: Thirty-five orbits were eligible for data analysis. Orbital decompression surgery improved visual acuity in 29 orbits and maintained visual acuity in four orbits. In patients with dysthyroid optic neuropathy, there was a statistically significant mean improvement in visual acuity of 2.8 lines postoperatively (standard deviation = 3.2; 95% confidence interval 3.9 to 1.7, p-value < 0.05). There were no statistically significant differences invisual acuity amongst different combinations of orbital walls being decompressed, with the majority of orbits had the medial orbital wall decompressed. This may reflect the small number of decompressions performed in each subgroup. Orbital decompression surgery reduced proptosis by a mean of 3.2 mm (standard deviation = 2.9; 95% confidence interval -4.32 to -2.07; p-value < 0.05). Medial and lateral orbital walls decompression resulted in the greatest mean reduction in proptosis. There were no severe visual impairment cases postoperatively (VA worse than 6/60). There were two patients with new onset diplopia postoperatively. There were three orbits with bleeding and one orbit with CSF leakage, all without major sequelae postoperatively.Conclusion: Regardless of surgical access, orbital decompression surgery is effective and safe in the management of dysthyroid optic neuropathy and in reducing proptosis in patients with Graves’ ophthalmopathy.

scholarly journals Therapeutic difference between orbital decompression and glucocorticoids administration as the first-line treatment for dysthyroid optic neuropathy: a systematic review

2021 ◽  
Vol 14 (7) ◽  
pp. 1107-1113
Author(s):  
Ming-Na Xu ◽  
◽  
Yun-Hai Tu ◽  
He-Qing Tao ◽  
Ke-Si Shi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Visual Acuity ◽  
Optic Neuropathy ◽  
Controlled Trial ◽  
Case Series ◽  
Cochrane Library ◽  
Clinical Activity ◽  
High Dose ◽  
Orbital Decompression ◽  
Dysthyroid Optic Neuropathy

To assess all available data to compare the efficacy of glucocorticoids treatment and orbital decompression for dysthyroid optic neuropathy (DON). PubMed, EMBASE, the Cochrane Library databases as well as other sources were searched by two independent reviewers followed by extensive hand-searching for the identification of relevant studies. The primary outcomes were the improvement in visual acuity and responder rate. Secondary outcomes were the proptosis reduction, change in diplopia, and clinical activity score (CAS). One randomized controlled trial, three retrospective case series and one prospective case series met the inclusion criteria. They were divided into intravenous high-dose glucocorticoids (ivGC) group and orbital decompression (OD) group. Both groups demonstrated improvement in visual acuity. In addition, the proportion of patients with improved vision in OD group was higher than that in ivGC group (P<0.001). Post-treatment proptosis reduction was also reported in both groups. Overall, weighted mean in proptosis reduction estimated at 1.64 and 5.45 mm in patients treated with ivGC and OD respectively. This study also presented results regarding pre-existing and new-onset diplopia. Apart from diplopia, a wide variety of minor and major complications were noted in 5 included studies. The most common complication in ivGC group and OD group was Cushing’s syndrome and epistaxis respectively. The present systematic review shows that both glucocorticoids treatment and OD are effective in treating DON and OD may work better in improving visual acuity and reducing proptosis. However, high-quality, large-sample, controlled studies need to be performed in the future.

scholarly journals Comparison of 2-wall versus 3-wall orbital decompression against dysthyroid optic neuropathy in visual function

Medicine ◽  
2021 ◽  
Vol 100 (8) ◽  
pp. e24513
Author(s):  
Sheng-Nan Cheng ◽  
Yue-Qi Yu ◽  
Ya-Yan You ◽  
Jin Chen ◽  
Xiao-Huan Pi ◽  
...  
Keyword(s):  
Optic Neuropathy ◽  
Visual Function ◽  
Orbital Decompression ◽  
Dysthyroid Optic Neuropathy

Efficacy of transethmoidal orbital decompression in patients with dysthyroid optic neuropathy

2020 ◽  
Vol 85 (6) ◽  
pp. 52
Author(s):  
Y.O. Grusha ◽  
P.A. Kochetkov ◽  
D.S. Ismailova ◽  
V.M. Svistushkin ◽  
N.V. Zhorzholadze ◽  
...  
Keyword(s):  
Optic Neuropathy ◽  
Orbital Decompression ◽  
Dysthyroid Optic Neuropathy

scholarly journals Orbital Volumetry in Graves' Orbitopathy: Muscle and Fat Involvement in relation to Dysthyroid Optic Neuropathy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Moug Al-Bakri ◽  
Åse Krogh Rasmussen ◽  
Carsten Thomsen ◽  
Peter Bjerre Toft
Keyword(s):  
Optic Nerve ◽  
Optic Neuropathy ◽  
Ct Scans ◽  
Orbital Decompression ◽  
Orbital Fractures ◽  
Relative Significance ◽  
Dysthyroid Optic Neuropathy ◽  
Orbital Fat ◽  
Graves Orbitopathy ◽  
Fat Volume

Purpose. We wanted to investigate the relative significance of fat and muscle enlargement in the development of dysthyroid optic neuropathy (DON) in Graves’ orbitopathy (GO). Methods. Preoperative coronal CT scans of 13 patients with and without DON who subsequently underwent orbital decompression were retrospectively analyzed. Thirteen patients imaged for unilateral orbital fractures served as controls. Results. The retrobulbar muscle volume was 2.1 ± 0.5 cm3 (mean ± SD) in controls, 4.3 ± 1.5 cm3 in GO without DON, and 4.7 ± 1.7 cm3 in GO with DON. The retrobulbar fat volume was 5.4 ± 1.6 cm3 in controls, 8.7 ± 8.0 cm3 in GO without DON, and 9.4 ± 3.1 cm3 in GO with DON. The muscle and fat volumes were higher in patients with GO than in controls (P<0.001), but the volumes in orbits with and without DON were not significantly different. The volume of the optic nerve were similar in the 3 groups. The number of apical, coronal 2 mm thick slices with no fat was 2.9 ± 0.9 in normal orbits, it was 4.1 ± 1.0 in GO orbits without DON and 5.3 ± 0.8 in GO orbits with DON (P=0.007). Conclusion. Apical muscle enlargement may be more important than orbital fat enlargement in the development of DON. However, the fact that apical crowding and muscle enlargement also occur in orbits without DON suggests that other factors also play a role in the development of DON.

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