回顾性分析不同方法治疗甲状腺相关性眼病眼压的变化

Intraocular pressure change after different treatments for thyroid-associated ophthalmopathy

目的:比较甲基强的松龙静脉冲击治疗及眼外肌手术治疗甲状腺相关性眼病(thyroid-associated ophthalmopathy,TAO)前后眼压(intraocular pressure,IOP)的变化。方法:回顾性分析收集2008-01/2010-12于我院眼科就诊的26例42眼TAO患者,患者行甲基强的松龙静脉冲击治疗或眼外肌手术,比较术前、术后第一眼位及上视时的眼压变化。结果:患者16例32眼采用甲强龙冲击治疗,治疗前平均眼压第一眼位时为21.13±4.10mmHg,向上注视时为23.75±5.67mmHg,治疗后分别为16.81±3.69mmHg(P<0.05),18.50±4.03mmHg(P<0.05);10例10眼采用眼外肌斜视手术,术前平均眼压第一眼位时为18.40±2.49mmHg,上视时为24.70±3.63mmHg,术后分别为17.30±1.55mmHg(P>0.05),18.60±2.20mmHg(P<0.01);术前眼压≥21mmHg的TAO患者眼压下降明显(P<0.05)。结论:两组患者用不同的方法治疗后眼压显著下降,但是眼外肌斜视手术前后眼压在第一眼位时的变化没有统计学差别。

AIM：To study the effect of methylprednisolone pulse therapy and extraocular muscle surgery on intraocular pressure（IOP） in patients with thyroid-associated ophthalmopathy（TAO）.METHODS：Twenty-six patients（42 eyes） with TAO who visited our department were given methylprednisolone pulse therapy or extraocular muscle surgery between Jan.2008 and Dec.2010 were analyzed retrospectively.Pre-operative and post-operative IOP in both primary gaze and up gaze were all studied.RESULTS：In the 16 patients treated with methylprednisolone pulse therapy,the mean pre-treatment IOP was 21.13±4.10mmHg in primary gaze and 23.75±5.67mmHg in upgaze.After treatment the mean IOP was 16.81±3.69mmHg（P0.05）and 18.5±4.03mmHg（P0.05）respectively.The mean pre-operative IOP in the 10 eyes who had extraocular muscle recession was 18.4±2.49 mmHg in primary gaze and 24.7±3.63mmHg in upgaze.The post-operative IOP was 17.3±1.55mmHg（P0.05）and 18.6±2.2mmHg（P0.01）respectively.In patients with a pre-operative IOP≥21mmHg were observed a greater reduction in IOP（P0.05）.CONCLUSION：We observed a significant reduction in IOP in the two groups of patients after treatment for TAO,however no significant difference was found in IOP in primary gaze after extraocular muscle surgery.