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Management of patients with dysthyroid optic neuropathy treated with intravenous corticosteroids and/or orbital decompression surgery

PURPOSE: To assess the characteristics and long-term outcomes of adult patients with dysthyroid optic neuropathy (DON) who underwent orbital decompression surgery and/or received intravenous (IV) methylprednisolone. METHODS: Retrospective chart review of 98 eyes of 49 patients who were diagnosed and...

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Autores principales: Rezar-Dreindl, Sandra, Papp, Andrea, Baumann, Arnulf, Neumayer, Thomas, Eibenberger, Katharina, Stifter, Eva, Schmidt-Erfurth, Ursula
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9581819/
https://www.ncbi.nlm.nih.gov/pubmed/35731314
http://dx.doi.org/10.1007/s00417-022-05732-4
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author Rezar-Dreindl, Sandra
Papp, Andrea
Baumann, Arnulf
Neumayer, Thomas
Eibenberger, Katharina
Stifter, Eva
Schmidt-Erfurth, Ursula
author_facet Rezar-Dreindl, Sandra
Papp, Andrea
Baumann, Arnulf
Neumayer, Thomas
Eibenberger, Katharina
Stifter, Eva
Schmidt-Erfurth, Ursula
author_sort Rezar-Dreindl, Sandra
collection PubMed
description PURPOSE: To assess the characteristics and long-term outcomes of adult patients with dysthyroid optic neuropathy (DON) who underwent orbital decompression surgery and/or received intravenous (IV) methylprednisolone. METHODS: Retrospective chart review of 98 eyes of 49 patients who were diagnosed and treated with bilateral DON between 2007 and 2018 at the Department of Ophthalmology and Optometry and Oral and Maxillofacial Surgery of the Medical University of Vienna. RESULTS: The mean follow-up period was 4.1 ± 2.7 years. The most common presenting symptoms were eyelid and periorbital swelling (45%) representing active inflammation. Upgaze restriction was the most common clinical finding (73%). At time of diagnosis, the mean clinical activity score was 4 ± 1/4 ± 1 (right/left eye, respectively). Sixty-three percent (31/49) of the patients were treated both with IV methylprednisolone and underwent orbital decompression surgery, 22% (11/49) were treated with IV methylprednisolone alone and 14% (7/49) underwent surgical decompression only. Seventy-one percent (30/42) of the patients underwent 3-wall decompression. The mean reduction of proptosis in patients treated with both IV methylprednisolone and orbital decompression surgery was 4/5 mm. Mean of reduction in proptosis in patients receiving IV methylprednisolone only was 1/0 mm and in patients with surgical decompression only was 5/5 mm. Mean VA was 0.1 ± 0.5/0.1 ± 0.5 logMAR at baseline and 0.05 ± 0.7/0.05 ± 0.7 at final follow-up. In 92% (45/49), VA was preserved or improved at final follow-up. CONCLUSIONS: The majority of patients with DON were treated both with IV corticosteroids and 3-wall decompression surgery. Vision could be successfully preserved in most cases and reduction of proptosis was achieved, especially after orbital decompression surgery. [Image: see text]
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spelling pubmed-95818192022-10-21 Management of patients with dysthyroid optic neuropathy treated with intravenous corticosteroids and/or orbital decompression surgery Rezar-Dreindl, Sandra Papp, Andrea Baumann, Arnulf Neumayer, Thomas Eibenberger, Katharina Stifter, Eva Schmidt-Erfurth, Ursula Graefes Arch Clin Exp Ophthalmol Oculoplastics and Orbit PURPOSE: To assess the characteristics and long-term outcomes of adult patients with dysthyroid optic neuropathy (DON) who underwent orbital decompression surgery and/or received intravenous (IV) methylprednisolone. METHODS: Retrospective chart review of 98 eyes of 49 patients who were diagnosed and treated with bilateral DON between 2007 and 2018 at the Department of Ophthalmology and Optometry and Oral and Maxillofacial Surgery of the Medical University of Vienna. RESULTS: The mean follow-up period was 4.1 ± 2.7 years. The most common presenting symptoms were eyelid and periorbital swelling (45%) representing active inflammation. Upgaze restriction was the most common clinical finding (73%). At time of diagnosis, the mean clinical activity score was 4 ± 1/4 ± 1 (right/left eye, respectively). Sixty-three percent (31/49) of the patients were treated both with IV methylprednisolone and underwent orbital decompression surgery, 22% (11/49) were treated with IV methylprednisolone alone and 14% (7/49) underwent surgical decompression only. Seventy-one percent (30/42) of the patients underwent 3-wall decompression. The mean reduction of proptosis in patients treated with both IV methylprednisolone and orbital decompression surgery was 4/5 mm. Mean of reduction in proptosis in patients receiving IV methylprednisolone only was 1/0 mm and in patients with surgical decompression only was 5/5 mm. Mean VA was 0.1 ± 0.5/0.1 ± 0.5 logMAR at baseline and 0.05 ± 0.7/0.05 ± 0.7 at final follow-up. In 92% (45/49), VA was preserved or improved at final follow-up. CONCLUSIONS: The majority of patients with DON were treated both with IV corticosteroids and 3-wall decompression surgery. Vision could be successfully preserved in most cases and reduction of proptosis was achieved, especially after orbital decompression surgery. [Image: see text] Springer Berlin Heidelberg 2022-06-22 2022 /pmc/articles/PMC9581819/ /pubmed/35731314 http://dx.doi.org/10.1007/s00417-022-05732-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Oculoplastics and Orbit
Rezar-Dreindl, Sandra
Papp, Andrea
Baumann, Arnulf
Neumayer, Thomas
Eibenberger, Katharina
Stifter, Eva
Schmidt-Erfurth, Ursula
Management of patients with dysthyroid optic neuropathy treated with intravenous corticosteroids and/or orbital decompression surgery
title Management of patients with dysthyroid optic neuropathy treated with intravenous corticosteroids and/or orbital decompression surgery
title_full Management of patients with dysthyroid optic neuropathy treated with intravenous corticosteroids and/or orbital decompression surgery
title_fullStr Management of patients with dysthyroid optic neuropathy treated with intravenous corticosteroids and/or orbital decompression surgery
title_full_unstemmed Management of patients with dysthyroid optic neuropathy treated with intravenous corticosteroids and/or orbital decompression surgery
title_short Management of patients with dysthyroid optic neuropathy treated with intravenous corticosteroids and/or orbital decompression surgery
title_sort management of patients with dysthyroid optic neuropathy treated with intravenous corticosteroids and/or orbital decompression surgery
topic Oculoplastics and Orbit
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9581819/
https://www.ncbi.nlm.nih.gov/pubmed/35731314
http://dx.doi.org/10.1007/s00417-022-05732-4
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