Publication
Pterional Orbit Decompression in Grave Disease with Dysthyroid Optic Neuropathy
Journal Paper/Review - Jan 19, 2021
Kuechlin Sebastian, Lagrèze Wolf A, Scheiwe Christian, Beck Juergen, Metzger Mark, Boehringer Daniel, Reich Michael, Gruber Markus, Joachimsen Lutz, Naseri Yashar, Steiert Christine, Grauvogel Juergen
Units
PubMed
Doi
Citation
Type
Journal
Publication Date
Issn Electronic
Pages
Brief description/objective
OBJECTIVE
The choice of surgical technique in sight-threatening Grave orbitopathy remains controversial. Available data are mostly derived from mixed cohorts with multiple surgical indications and techniques. The authors assessed predictors for visual outcome after standardized pterional orbital decompression for dysthyroid optic neuropathy.
METHODS
Retrospective analysis of 62 pterional orbital decompressions performed on 40 patients with dysthyroid optic neuropathy.
RESULTS
Visual acuity improved by an average of 3.8 lines in eyes with preoperative visual impairment (95% confidence interval [CI]: 1.8-5.8 lines, P < 0.001) and remained stable in eyes without prior visual impairment (95% CI -1.3 to 1 line, P = 0.81). Proptosis was reduced by an average of 3.1 mm (95% CI 1.8-4.3 mm, P < 0.001). Higher degrees of proptosis were predictive of worse visual outcomes (P = 0.017). New-onset diplopia developed in 2 patients, while previous diplopia resolved after surgery in 6 patients.
CONCLUSIONS
This cohort is the largest series of pterional orbit decompressions and the first to focus exclusively on dysthyroid neuropathy. Complication rates were low. Decompression surgery was highly effective at restoring and maintaining visual acuity in patients with dysthyroid optic neuropathy.