Predicting visual acuity recovery in orbital decompression surgery for dysthyroid optic neuropathy.

IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM
Forrest W Fearington, Lazaro R Peraza, Gabriel A Hernandez-Herrera, Andrew S Awadallah, Janalee K Stokken, Lilly H Wagner, Elizabeth A Bradley, Marius N Stan, Erick D Bothun, Andrea A Tooley
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引用次数: 0

Abstract

Background: Patients with thyroid eye disease may develop dysthyroid optic neuropathy (DON), which is commonly treated via orbital decompression surgery. This study aims to identify preoperative factors that can predict postoperative best corrected visual acuity (BCVA) in patients with DON and to classify recovery rates based on these prognostic factors.

Methods: We retrospectively assessed thirty-two patients (51 orbits) diagnosed with DON who underwent orbital decompression.

Results: Univariate and multivariate mixed effects analysis revealed that preoperative BCVA was the strongest predictor of postoperative BCVA (p < 0.0001). Other significant prognostic factors were extraocular muscle hypertrophy (p = 0.01), visual field mean deviation (p = 0.009), retinal nerve fiber layer thickness (p = 0.01), and afferent pupillary defect (p < 0.0001). We then stratified outcomes by the strongest prognostic factor, preoperative BCVA, which demonstrated that 17 of 19 (89.5%) orbits with preoperative BCVA < logMAR 0.20 (20/32 Snellen) achieved acceptable final vision (defined as better than logMAR 0.40 or 20/50 Snellen), compared to 16 of 20 (80%) orbits with preoperative BCVA logMAR 0.20-0.60 (20/32-20/80 Snellen), and only 3 of 11 (27.3%) orbits with preoperative BCVA > logMAR 0.60 (20/80 Snellen). Patients with preoperative BCVA of logMAR 0.60 (20/80 Snellen) or better had > 80% chance of recovering with acceptable final vision after surgery, compared to a < 30% chance for patients with preoperative BCVA worse than logMAR 0.60 (20/80 Snellen).

Conclusions: These results highlight preoperative BCVA as the strongest predictor of DON outcome and suggest that earlier intervention prior to substantial BCVA deterioration may yield better results.

Level of evidence: 3: Retrospectively Registered.

预测甲状腺功能障碍视神经病变眶减压术后视力恢复。
背景:甲状腺眼病患者可发展为甲状腺功能障碍视神经病变(DON),通常通过眼眶减压手术治疗。本研究旨在确定可以预测DON患者术后最佳矫正视力(BCVA)的术前因素,并根据这些预后因素对恢复率进行分类。方法:回顾性分析32例(51个眶)诊断为DON并行眶减压术的患者。结果:单因素和多因素混合效应分析显示,术前BCVA是术后BCVA的最强预测因子(p logMAR 0.60 (20/80 Snellen))。术前BCVA为logMAR 0.60 (20/80 Snellen)或更高的患者术后恢复可接受最终视力的机会为bb80 %。结论:这些结果强调术前BCVA是DON预后的最强预测因子,并提示在BCVA严重恶化之前的早期干预可能会产生更好的结果。证据等级:3:回顾性注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Thyroid Research
Thyroid Research Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
3.10
自引率
4.50%
发文量
21
审稿时长
8 weeks
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