Open Access
CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 02): S190
DOI: 10.1055/s-0042-1746520
Poster
Endoscopy

Orbital decompression in patients with Graves‘ orbitopathy and dysthyroid optic neuropathy- A comparison of pre- and postoperative visual acuity and proptosis

Authors

  • Friederike Kaster

    1   Universitätsklinikum Essen, Essen

  • Kerstin Stähr

    1   Universitätsklinikum Essen, Essen

  • Stephan Lang

    1   Universitätsklinikum Essen, Essen

  • Stefan Mattheis

    1   Universitätsklinikum Essen, Essen
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    Introduction Many medical indications for orbital decompression exist in patients with Graves‘ orbitopathy (GO) of which the dysthyroid optic neuropathie (DON) is rather severe and has to be urgently treated. The neuropathy of the optic nerve is commonly caused by swelling of the extraocular muscle tissue resulting in a compression of the optic nerve in the area of the apex orbitae or by stretching of the optic nerve caused by proptosis. Most common symptoms include decreased color saturation and central scotoma.

    Material and methods From 2011 until 2021, we examined 165 patients with GO and DON before and after orbital decompression. The patients received either balanced (medial and lateral orbital wall) or medial orbital decompression. Visual acuity (Snellen) and proptosis (Hertel-index) were tested prior to and then 6 weeks post surgery.

    Results The majority of patients (99%) showed signs of significant (p<0,001) improvement or stabilisation in visual acuity (snellen). A minority of patients showed a measurable loss of vision. Proptosis showed to be significantly decreased in comparison of pre- and postoperative examination (average of 5mm).

    Conclusion Orbital decompression performed on patients with DON could prevent the progress of neuropathy in the optic nerve and in possibly most common cases could even cause a recovery of the visual acuity and is therefore medically proposed for patients with DON. An improvement of proptosis is futhermore helpful to reduce stigmata of Graves‘ orbitopathy and causes a relief of symptoms such as occular dryness, corneal damage and photosensitivity.


     

    Conflict of Interest

    The author declares that there is no conflict of interest.

    Publikationsverlauf

    Artikel online veröffentlicht:
    24. Mai 2022

    © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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