CHANGES IN THE PROMINENCE OF THE EYES IN VARIOUS THYROID STATES<sup>1</sup>

Dobyns, Brown M.; Haines, Samuel F.

doi:10.1210/jcem-6-9-633

Cited by 20 publications

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“…The effect of thyroid surgery on the ophthalmolopathy of Graves' disease has been a contentious issue. It has been claimed by some that thyroidectomy aggravates ophthalmopathy [1][2][3][4][5][6][7][8] and that overt ocular involvement should, therefore, be regarded as a contraindication to thyroid surgery. Others have contended that thyroid ablation by total thyroidectomy or radioiodine treatment may actually prevent or ameliorate ophthalmopathy [%14].…”

mentioning

confidence: 99%

The effect of subtotal thyroidectomy on Graves' ophthalmopathy

Levitt¹,

Edis²,

Agnello³

et al. 1988

World j. surg.

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Nineteen unselected patients undergoing subtotal thyroidectomy (STT) for Graves' disease were submitted to thorough ophthalmologic assessment before and after (mean, 10 mo) thyroid surgery. All clinical examinations were performed by the same observer and findings were scored according to the American Thyroid Association (“NOSPECS”) classification. Orbital computed tomography (CT) scans were performed in all patients prior to surgery and again at follow‐up if the initial scan was abnormal or if there was evidence of clinical deterioration; all CT scans were viewed by the same individual. There was evidence of infiltrative ophthalmopathy at some stage in the course of observation in 17 (89%) of the 19 patients. No predictable ocular response to STT was apparent. Ophthalmic status was noted to improve in 6 patients, to remain unchanged in 7 patients, and to progressively deteriorate in 6 patients. This unpredictable pattern was seen irrespective of the severity of preexisting ocular involvement. The absence of any consistent or predictable ocular response to STT strongly suggests that thyroidectomy does not influence the natural course of Graves' ophthalmopathy. We believe that the presence of evolving or stable ophthalmopathy, even if severe, should not be regarded as a contraindication to STT in Graves' disease.

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confidence: 99%

The effect of subtotal thyroidectomy on Graves' ophthalmopathy

Levitt¹,

Edis²,

Agnello³

et al. 1988

World j. surg.

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“…In support of this conclusion, he cites reports of Soley [35] and Dobyns [11] and D obyns and H aines [10]. G reig el al.…”

Section: Resultsmentioning

confidence: 82%

“…Though it is established that TSH is decreased rather than increased in untreated thyrotoxic exophthalmos [30] and hence cannot be the cause of the exophthalmos, the minimal increases in proptosis described by D obyns and H aines [10] and others [14,15,17] which follow upon treatment of the hyperthyroidism could result from actual or impending hypothyroidism. Also, the fact that malignant exophthalmos can occur in spontaneous thyroid hypofunction in which TSH is increased [30] raises the possibility that in certain individuals malignant exophthalmos could have resulted from TSH excesses.…”

Section: Resultsmentioning

confidence: 99%

Prophylaxis against Exophthalmos or its Progression in Newly-Treated Thyrotoxicosis

Danowski¹,

Lukes²,

Sabeh³

et al. 1971

Horm Res Paediatr

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Exophthalmos usually did not appear nor did pre-existent exophthalmos progress in thyrotoxic patients treated with desiccated thyroid in full replacement dosages, 2½ to 3 grains per day, simultaneously with thyroid blocking agent therapy, ¹³¹I administration, or thyroidectomy. Indeed, in most patients so treated, exophthalmos present prior to therapy of the hyperthyroidism decreased or disappeared. Our observations are consonant with the hypothesis that full replacement dosages of thyroid hormones started at essentially the same time that treatment of the thyrotoxic state is initiated may provide prophylaxis against the appearance or the progression of the exophthalmos which follows treatment of thyrotoxicosis. We do not intend to suggest, however, that exophthalmos which appears, progresses, or enters a malignant phase after successful treatment of hyperthyroidism at some time in the past is benefited by such treatment.

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“…In no case was enophthalmos noted. Dobyns and Haines (1946), who investigated thirteen cases of myxoedema using the Hertel exophthalmometer, found that treatment with thyroid hormone tended to cause a slight backward displacement of the eyeball of 1 to 2*75 mm. This was attributed to loss of fluid from the orbital tissues.…”

Section: Discussionmentioning

confidence: 99%

Myxoedema With Enophthalmos

Schen¹

1960

British Journal of Ophthalmology

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CHANGES IN THE PROMINENCE OF THE EYES IN VARIOUS THYROID STATES¹

Cited by 20 publications

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The effect of subtotal thyroidectomy on Graves' ophthalmopathy

The effect of subtotal thyroidectomy on Graves' ophthalmopathy

Prophylaxis against Exophthalmos or its Progression in Newly-Treated Thyrotoxicosis

Myxoedema With Enophthalmos

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CHANGES IN THE PROMINENCE OF THE EYES IN VARIOUS THYROID STATES1

Cited by 20 publications

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The effect of subtotal thyroidectomy on Graves' ophthalmopathy

The effect of subtotal thyroidectomy on Graves' ophthalmopathy

Prophylaxis against Exophthalmos or its Progression in Newly-Treated Thyrotoxicosis

Myxoedema With Enophthalmos

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CHANGES IN THE PROMINENCE OF THE EYES IN VARIOUS THYROID STATES¹