Evaluation of retinal nerve fiber layer thickness profile in thyroid ophthalmopathy without optic nerve dysfunction  

作　　者：Kumari Mugdha Apjit Kaur Neha Sinha Sandeep Saxena 

机构地区：[1]Department of Ophthalmology, King George's Medical University, Lucknow 226003, India [2]Sankara Eye Hospital, Kanpur 208001, India

出　　处：《International Journal of Ophthalmology(English edition)》2016年第11期1634-1637,共4页国际眼科杂志（英文版）

摘　　要：AIM： To evaluate retinal nerve fiber layer（RNFL）thickness profile in patients of thyroid ophthalmopathy with no clinical signs of optic nerve dysfunction.METHODS： A prospective, case-control, observational study conducted at a tertiary care centre. Inclusion criteria consisted of patients with eyelid retraction in association with any one of： biochemical thyroid dysfunction, exophthalmos, or extraocular muscle involvement; or thyroid dysfunction in association with either exophthalmos or extra-ocular muscle involvement;or a clinical activity score（CAS）〉3/7. Two measurements of RNFL thickness were done for each eye, by Cirrus HD-optical coherence tomography 6mo apart.RESULTS： Mean age of the sample was 38.75y（range13-70y） with 18 males and 22 females. Average RNFL thickness at first visit was 92.06 ±12.44 μm, significantly lower than control group（101.28±6.64 μm）（P =0.0001）.Thickness of inferior quadrant decreased from 118.2 ±21.27 μm to 115.0 ±22.27 μm after 6mo（P =0.02）. There was no correlation between the change in CAS and RNFL thickness. CONCLUSION： Decreased RNFL thickness is an important feature of thyroid orbitopathy, which is an inherent outcome of compressive optic neuropathy of any etiology. Subclinical RNFL damage continues in the absence of clinical activity of the disease. RNFL evaluation is essential in Grave＇s disease and active intervention may be warranted in the presence of significant damage.AIM： To evaluate retinal nerve fiber layer（RNFL）thickness profile in patients of thyroid ophthalmopathy with no clinical signs of optic nerve dysfunction.METHODS： A prospective, case-control, observational study conducted at a tertiary care centre. Inclusion criteria consisted of patients with eyelid retraction in association with any one of： biochemical thyroid dysfunction, exophthalmos, or extraocular muscle involvement; or thyroid dysfunction in association with either exophthalmos or extra-ocular muscle involvement;or a clinical activity score（CAS）〉3/7. Two measurements of RNFL thickness were done for each eye, by Cirrus HD-optical coherence tomography 6mo apart.RESULTS： Mean age of the sample was 38.75y（range13-70y） with 18 males and 22 females. Average RNFL thickness at first visit was 92.06 ±12.44 μm, significantly lower than control group（101.28±6.64 μm）（P =0.0001）.Thickness of inferior quadrant decreased from 118.2 ±21.27 μm to 115.0 ±22.27 μm after 6mo（P =0.02）. There was no correlation between the change in CAS and RNFL thickness. CONCLUSION： Decreased RNFL thickness is an important feature of thyroid orbitopathy, which is an inherent outcome of compressive optic neuropathy of any etiology. Subclinical RNFL damage continues in the absence of clinical activity of the disease. RNFL evaluation is essential in Grave＇s disease and active intervention may be warranted in the presence of significant damage.

关 键 词：thyroid ophthalmopathy retinal nerve fibrelayer optical coherence tomography 

分 类 号：R581[医药卫生—内分泌] R771.3[医药卫生—内科学]