Modified endoscopic transnasal orbital apex decompression in dysthyroid optic neuropathy

Eye and Vision

Andy D. Kim¹  Michael T. M. Wang¹  Yunhai Tu²  Wencan Wu²  Mingna Xu²  Zhaoqi Pan² 

[1] Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland;The Eye Hospital of Wenzhou Medical University;

关键词: Endoscopic transnasal orbital decompression;    Dysthyroid optic neuropathy;    Thyroid-associated ophthalmopathy;    Visual acuity;    Visual field;   

DOI  :  10.1186/s40662-021-00238-2

来源: DOAJ

【 摘 要 】

Abstract 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 ± 3.38 mm to 16.35 ± 3.01 mm. 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.

【 授权许可】

Unknown