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Long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus

OBJECTIVE: Thyroid-associated orbitopathy (TAO) is the most frequent cause of extraocular muscle enlargement, with consecutive restrictive strabismus. The main muscles involved are inferior and medial rectus, resulting in horizontal esotropia and/or vertical strabismus. Surgery may either establish...

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Autores principales: Savino, Gustavo, Mattei, Roberta, Salerni, Annabella, Fossataro, Claudia, Pafundi, Pia Clara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9684631/
https://www.ncbi.nlm.nih.gov/pubmed/36440235
http://dx.doi.org/10.3389/fendo.2022.1030422
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author Savino, Gustavo
Mattei, Roberta
Salerni, Annabella
Fossataro, Claudia
Pafundi, Pia Clara
author_facet Savino, Gustavo
Mattei, Roberta
Salerni, Annabella
Fossataro, Claudia
Pafundi, Pia Clara
author_sort Savino, Gustavo
collection PubMed
description OBJECTIVE: Thyroid-associated orbitopathy (TAO) is the most frequent cause of extraocular muscle enlargement, with consecutive restrictive strabismus. The main muscles involved are inferior and medial rectus, resulting in horizontal esotropia and/or vertical strabismus. Surgery may either establish or improve binocular single vision. The aim of the present study is to describe long-term follow-up of patients who underwent horizontal or vertical TAO strabismus surgery. METHODS: This observational retrospective study included 29 patients suffering from either vertical or horizontal TAO strabismus and diplopia, of whom 11 underwent bilateral medial recti muscle recession (Group A) and 18 underwent unilateral inferior rectus muscle recession (Group B). The endpoint of the study was the assessment of changes in deviation angle and diplopia across four time points (baseline, 7 days, 6 months, and 24 months) in each group. RESULTS: In Group A, the horizontal deviation angle significantly decreased 7 days after intervention (p < 0.001), without modifications overtime. In Group B, both deviation angles in primary and down-gaze position significantly decreased from baseline, both 7 days after surgery (p < 0.001) and at 6 months (p = 0.040). An overcorrection, with an inversion of vertical deviation angle, was observed across the different time points. CONCLUSIONS: Horizontal TAO strabismus correction leads to significant improvements of deviation angle and diplopia, with a stable undercorrection overtime. Inferior rectus recession leads to more unstable results, with a trend towards overcorrection limited to the first 6 months after surgery.
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spelling pubmed-96846312022-11-25 Long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus Savino, Gustavo Mattei, Roberta Salerni, Annabella Fossataro, Claudia Pafundi, Pia Clara Front Endocrinol (Lausanne) Endocrinology OBJECTIVE: Thyroid-associated orbitopathy (TAO) is the most frequent cause of extraocular muscle enlargement, with consecutive restrictive strabismus. The main muscles involved are inferior and medial rectus, resulting in horizontal esotropia and/or vertical strabismus. Surgery may either establish or improve binocular single vision. The aim of the present study is to describe long-term follow-up of patients who underwent horizontal or vertical TAO strabismus surgery. METHODS: This observational retrospective study included 29 patients suffering from either vertical or horizontal TAO strabismus and diplopia, of whom 11 underwent bilateral medial recti muscle recession (Group A) and 18 underwent unilateral inferior rectus muscle recession (Group B). The endpoint of the study was the assessment of changes in deviation angle and diplopia across four time points (baseline, 7 days, 6 months, and 24 months) in each group. RESULTS: In Group A, the horizontal deviation angle significantly decreased 7 days after intervention (p < 0.001), without modifications overtime. In Group B, both deviation angles in primary and down-gaze position significantly decreased from baseline, both 7 days after surgery (p < 0.001) and at 6 months (p = 0.040). An overcorrection, with an inversion of vertical deviation angle, was observed across the different time points. CONCLUSIONS: Horizontal TAO strabismus correction leads to significant improvements of deviation angle and diplopia, with a stable undercorrection overtime. Inferior rectus recession leads to more unstable results, with a trend towards overcorrection limited to the first 6 months after surgery. Frontiers Media S.A. 2022-11-10 /pmc/articles/PMC9684631/ /pubmed/36440235 http://dx.doi.org/10.3389/fendo.2022.1030422 Text en Copyright © 2022 Savino, Mattei, Salerni, Fossataro and Pafundi https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Savino, Gustavo
Mattei, Roberta
Salerni, Annabella
Fossataro, Claudia
Pafundi, Pia Clara
Long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus
title Long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus
title_full Long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus
title_fullStr Long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus
title_full_unstemmed Long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus
title_short Long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus
title_sort long-term follow-up of surgical treatment of thyroid-associated orbitopathy restrictive strabismus
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9684631/
https://www.ncbi.nlm.nih.gov/pubmed/36440235
http://dx.doi.org/10.3389/fendo.2022.1030422
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