Sympathetic Overactivity in the Development of Eyelid Retraction in a Patient with Euthyroid Graves' Disease Evaluated by Accommodation

Endocrine Journal

NOBORU HAMADA⁴  HIROMI YOSHIDA⁴  JAEDUK YOSHIMURA NOH¹  YASUYUKI OKAMOTO⁴  KEI TSUMURA²  YOSHIKO NAKAMURA³ 

[1] Ito Hospital;Second Department of Internal Medicine, Osaka City University Medical School;NTT Osaka Central Health Administration Center;Sumire Hospital

关键词: Eyelid retraction;    Euthyroid Graves' disease;    Accommodation;    Sympathetic overactivity;    Guanethidine;   

DOI  :  10.1507/endocrj.47.623

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(13)Cited-By(2)It is known that measurement of accommodation is useful to evaluate the sympathetic activity of intraocular muscles. To find if sympathetic overactivity is involved in eyelid retraction in euthyroid Graves' disease, we measured accommodation in two patients with this disease, whose serum concentrations of free T3, free T4 and TSH were within reference ranges. Accommodation was measured with a computer-assisted infrared optometer with an iriscoder, and the results were expressed as the change in the eye's refractive power (in diopters) in response to the movement of a target beam. In patient 1, the accommodation amplitude was low, indicating sympathetic overactivity. This amplitude rose to near the reference range when timolol maleate drops were used, and the eyelid retraction disappeared when guanethidine drops were given. During the use of guanethidine drops, accommodation remained normal. In patient 2, who had normal accommodation, eyelid retraction did not change with guanethidine administration, but improved with intravenous methylprednisolone pulse therapy. These two cases suggested that even in euthyroid Graves' disease, eyelid retraction is caused by sympathetic overactivity, and pulse therapy with methylprednisolone may be effective for eyelid retraction when guanethidine drops are not effective.

【 授权许可】

Unknown