Surgical Treatment of Dysthyroid Optic Neuropathy: Long-Term Visual Outcomes with Comparison of 2-Wall versus 3-Wall Orbital Decompression

2015 ◽  
Vol 41 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Safak Korkmaz ◽  
Onur Konuk
Keyword(s):  
Surgical Treatment ◽  
Optic Neuropathy ◽  
Orbital Decompression ◽  
Dysthyroid Optic Neuropathy ◽  
Visual Outcomes

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 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.

Longitudinal Analysis of Visual Outcomes After Surgical Treatment of Adult Craniopharyngiomas

Neurosurgery ◽  
2012 ◽  
Vol 71 (3) ◽  
pp. 715-721 ◽  
Author(s):  
Young-Hoon Kim ◽  
Chae-Yong Kim ◽  
Jin Wook Kim ◽  
Yong Hwy Kim ◽  
Jung Ho Han ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Visual Impairment ◽  
Tumor Recurrence ◽  
Significant Risk ◽  
Tumor Control ◽  
Total Removal ◽  
Short Term ◽  
Visual Outcomes ◽  
Short And Long Term

Abstract BACKGROUND: Craniopharyngiomas (CRPs) often cause visual deterioration (VD) due to the close vicinity of the optic apparatus. OBJECTIVE: To evaluate longitudinal visual outcomes after surgery of CRP and determine the prognostic factors thereof. METHODS: One hundred forty-six adult patients who underwent surgery for newly diagnosed CRP were retrospectively reviewed. There were 87 male patients (60%), and the median age was 41 years (range, 18–75). The mean follow-up duration was 88.7 months (range, 24–307). A visual impairment score was used to assess the short-term (&lt;1 month) and long-term (&gt;2 years) visual outcomes. RESULTS: Gross total removal was performed in 53 patients (36%), and tumor recurrence occurred in 40 patients (27%). The average preoperative, short- and long-term visual impairment scores were 44.4, 38.5, and 38.1, respectively, on a 0- to 100-point scale (with 100 indicating the worst vision). Short- and long-term VD occurred in 28 (19%) and 39 patients (27%), respectively. Subtotal removal (STR) alone (P = .010; OR = 4.8), short-term VD (P &lt; .001; OR = 39.7), and tumor recurrence (P &lt; .001; OR = 28.2) were significant risk factors for long-term VD in the multivariate analysis. Patients undergoing STR alone had higher tumor recurrence rates in comparison with those who underwent gross total removal or STR with adjuvant therapy (P &lt; .001). CONCLUSION: Short-term VD secondary to the surgical insult and the recurrence of the tumor were strong predictors of long-term visual outcomes after surgical treatment for CRP. STR alone may be an ineffective strategy for achieving tumor control and optimal visual outcomes in patients with CRP.

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

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

Ophthalmology ◽  
1991 ◽  
Vol 98 (9) ◽  
pp. 1435-1442 ◽  
Author(s):  
Keith D. Carter ◽  
Bartley R. Frueh ◽  
Thomas P. Hessburg ◽  
David C. Musch
Keyword(s):  
Optic Neuropathy ◽  
Eye Disease ◽  
Orbital Decompression ◽  
Compressive Optic Neuropathy ◽  
Term Efficacy

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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