Orbital Fat Decompression for Thyroid Eye Disease

Prat, Marta Calsina; Braunstein, Alexandra; Glass, Lora R. Dagi; Kazim, Michael

doi:10.1097/iop.0000000000000260

Cited by 46 publications

(11 citation statements)

References 9 publications

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“… 16 – 18 Removal of orbital fat results in an exophthalmos reduction of approximately 3–4 mm. 19 – 22 In some cases, the average exophthalmos reduction following the fat decompression is 5.3 mm. 23 Exophthalmos regression as a result of endonasal endoscopic orbital decompression via the transethmoidal approach is 3.5–6 mm.…”

Section: Discussionmentioning

confidence: 99%

Orbital decompression in the system of treatment for complicated thyroid eye disease: case report and literature review

Ismailova¹,

Беловалова

Grusha

et al. 2018

IMCRJ

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Orbital decompression is a surgical procedure aimed at increasing the orbital volume and/or decreasing the volume of the orbital fat. The indications for orbital decompression are determined in the course of thorough eye examination. An important objective of examination of a patient with thyroid eye disease (TED) is determination of inflammation activity and severity. Orbital decompression is a surgical procedure that can be performed in both the active and nonactive stages of the disease. However, the indications for the surgery in these cases are different. Optic neuropathy and severe corneal disease are threatening complications that may lead to permanent visual loss and generally occur in the presence of active orbital inflammation. If treatment with high-dose corticosteroids has proven ineffective, an urgent surgical procedure consisting of orbital decompression and, in case of involvement of the cornea, eyelid and corneal surgery has to be performed. Owing to significant progress in technology, improvement of methods and accumulated experience over the past decade, the indications for bone orbital decompression have extended compared to the time when this procedure was used only in patients with extremely severe TED. The most common complication of the orbital decompression is the development or deterioration of previously existing binocular diplopia and strabismus. In addition, other parameters may change as well, including the position of the globe, the eyelids, the angle of deviation of the eye, and intraocular pressure. Thus, bone orbital decompression is a major step of a comprehensive, often multistage, system of rehabilitation of patients with severe refractory TED.

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Section: Discussionmentioning

confidence: 99%

Orbital decompression in the system of treatment for complicated thyroid eye disease: case report and literature review

Ismailova¹,

Беловалова

Grusha

et al. 2018

IMCRJ

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show abstract

“…Based on these findings, a decrease in orbital fat is needed to alleviate exophthalmos. Other studies have revealed the effectiveness of surgery (eg, orbital fat decompression) to accomplish this difference 17,18. Richter et al17 reported the effectiveness of transpalpebral decompression.…”

Section: Discussionmentioning

confidence: 99%

“…Another study also showed that exophthalmos values did not significantly improve after methylprednisolone pulse therapy 16. Therefore, decreasing the amount of orbital fat appears to be the most important factor in alleviating exophthalmos, and studies have shown that orbital fat-decompression surgery is effective for exophthalmos due to TAO 17,18. Another study showed that intravenous administration of teprotumumab, a human monoclonal antibody inhibitor of IGF1R, was effective for exophthalmos in patients with active TAO 19.…”

Section: Introductionmentioning

confidence: 99%

Treatment with bimatoprost for exophthalmos in patients with inactive thyroid-associated ophthalmopathy

Higashiyama

Ohji

2018

OPTH

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PurposeThis study was performed to observe changes prospectively in exophthalmos and orbital fat in patients with inactive thyroid-associated ophthalmopathy (TAO) treated with bimatoprost.MethodsIn this 12-month single-treatment pilot observational study, 13 patients with inactive-phase TAO were administered bimatoprost to treat exophthalmos due to TAO. Exophthalmos values and orbital tissue volumes were measured on MRI by technicians in a masked fashion.ResultsNine orbits of nine patients (eight women, one man) were treated with bimatoprost for 12 months. Mean exophthalmos values before and after treatment were 21.7±2.2 and 21.7±2.0 mm, respectively. The mean value after 12 months of treatment was not significantly different from before treatment (P=0.82). Mean orbital fat volume before and after 12 months of treatment was 17.2±2.5 and 17.0±3.0 cm3, respectively. The corresponding total extraocular muscle volume was 4.0±0.7 and 3.8±0.9 cm3, respectively. Mean volume in each tissue type after 12 months of treatment was not significantly different from before treatment (orbital fat, P=0.70; extraocular muscles, P=0.32).ConclusionTopical bimatoprost treatment did not reduce exophthalmos or orbital fat in this cohort of patients with inactive TAO.

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“…Осложнения внутренней декомпрессии орбиты разделяют на интраоперационные и послеоперационные [14,19].…”

Section: внутренняя декомпрессия орбитыunclassified

Surgical orbit decompression in patients with endocrine ophtalmopathy (review)

Kalandari

Левченко

2020

Nejrohirurgiâ (Mosk.)

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В статье представлены определение и эпидемиология эндокринной офтальмопатии, описаны основные клинические проявления этой патологии и принципы ее лечения. Особое внимание уделено перечислению всех возможных методов хирургической декомпрессии орбиты, как внутренней, так и наружной. Выполнен сравнительный анализ имеющихся способов орбитотомии, выделены их достоинства и недостатки. Рассмотрены основные предикторы эффективности декомпрессии орбиты, возможные осложнения и меры их профилактики. В работе также освещены методы лечения оптической нейропатии и прогнозирования результатов хирургической декомпрессии орбиты.

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Orbital Fat Decompression for Thyroid Eye Disease

Cited by 46 publications

References 9 publications

Orbital decompression in the system of treatment for complicated thyroid eye disease: case report and literature review

Orbital decompression in the system of treatment for complicated thyroid eye disease: case report and literature review

Treatment with bimatoprost for exophthalmos in patients with inactive thyroid-associated ophthalmopathy

Surgical orbit decompression in patients with endocrine ophtalmopathy (review)

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