Modified endoscopic transnasal orbital apex decompression in dysthyroid optic neuropathy  

作　　者：Yunhai Tu Mingna Xu Andy D.Kim Michael T.M.Wang Zhaoqi Pan Wencan Wu 

机构地区：[1]The Eye Hospital of Wenzhou Medical University,No.270 Xueyuan Xi Road,Wenzhou,Zhejiang 325027,P.R.China [2]Department of Ophthalmology,New Zealand National Eye Centre,The University of Auckland,Auckland,New Zealand

出　　处：《Eye and Vision》2021年第1期183-191,共9页眼视光学杂志（英文）

基　　金：supported by the Natural Key Research and Development Program of China(2016YFC1101200).

摘　　要：Background:To describe the surgical technique and assess the clinical efficacy and safety of modified endoscopic transnasal orbital apex decompression in the treatment of dysthyroid optic neuropathy.Methods:In this retrospective research,forty-two subjects(74 orbits)who underwent modified endoscopic transnasal orbital apex decompression for the treatment of dysthyroid optic neuropathy were enrolled.Preoperative and postoperative best-corrected visual acuity(BCVA),visual field mean deviation(MD),Hertel exophthalmometry,and new onset diplopia were assessed before and after the intervention.The Wilcoxon test was used for differential analysis.Linear mixed-models’analyses were conducted to assess the potential predictors for BCVA change.Results:Postoperatively,the mean BCVA improved from 0.70±0.62 logMAR to 0.22±0.33 logMAR.BCVA significantly improved in 69 eyes(93%),remained stable in 4 eyes(5%)and deteriorated in 1 eye(1%).MD of visual fields improved from−13.73±9.22 dB to−7.23±7.04 dB.Proptosis decreased from 19.57±3.38mm to 16.35±3.01mm.Preoperative BCVA,MD of visual fields and medical rectus diameter were independent factors associated with improvements in BCVA(P<0.05)by linear mixed-models’analyses.Eighteen patients(42.9%)developed new diplopia postoperatively.Conclusion:Modified endoscopic transnasal orbital apex decompression effectively restores vision in dysthyroid optic neuropathy.

关 键 词：Endoscopic transnasal orbital decompression Dysthyroid optic neuropathy Thyroid-associated ophthalmopathy Visual acuity Visual field 

分 类 号：R581[医药卫生—内分泌] R774.6[医药卫生—内科学]