Spontaneous resolution of euthyroid optic neuropathy

Kitaguchi, Yoshiyuki; K, Ishihara; Nishida, Kohji

doi:10.1016/j.jcjo.2018.10.014

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…In both cases, vision loss was improved, restoring the initial visual acuity and visual field. In the first case corticosteroid therapy was administered ( 35 ), while the second case was only observed ( 37 ). A conservatory strategy can be rational in cases where disease severity has already peaked and clinical activity score is low; the authors concluded that the spontaneous remission of optic neuropathy can be correlated with normal thyroid function and with the absence of thyroid antibodies ( 37 ).…”

Section: Clinical Characteristics Of Egdmentioning

confidence: 99%

“…The efficiency of pulse corticosteroid treatment is assessed by visual acuity recovery, which was described especially in cases with unilateral involvement ( 36 ). Atypical presentation of euthyroid optic neuropathy with bilateral involvement and severe deterioration in visual acuity revealed a slight amelioration after the intravenous corticosteroid therapy ( 37 ).…”

Section: Treatmentmentioning

confidence: 99%

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A systematic review of euthyroid Graves' disease (Review)

et al. 2021

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Euthyroid Graves' Disease (EGD) is a challenging pathology, due to its atypical clinical manifestations and the absence of abnormal thyroid function. Typically, thyroid ophthalmopathy is associated with elevated thyroid hormone levels and with the presence of thyrotropin receptor antibodies (TRAb) but a low percentage of patients remain euthyroid without developing hyperthyroidism during long-term follow-up periods. Although it is considered a different pathology, it shares a lot of similarities with Graves' disease, rendering the diagnosis more difficult. It is also important to note that ophthalmopathy may be the first clinical manifestation of Graves' disease and that thyroid function examinations do not present abnormalities over a long period. Treatment choices for euthyroid disease do not differ from those described in Graves' ophthalmopathy. However, it is considered that since euthyroid patients develop milder ophthalmic symptoms and their clinical activity score is lower, they tend to have better responses to treatment. Moreover, atypical sight-threatening cases such as exposure keratopathy and dysthyroid optic neuropathy with variable responses to therapy also exist. Disease management consists of a favorable collaboration between ophthalmologists and endocrinologists because patients with EGD can develop thyroid abnormalities over time. In conclusion, the diagnosis of EGD is difficult, clinical manifestations and evolution are variables depending on several factors, including the heterogeneity of TRAb. This review aimed to identify the characteristics of this disease by reviewing the clinical studies and case reports published in previous years.

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Section: Clinical Characteristics Of Egdmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

A systematic review of euthyroid Graves' disease (Review)

et al. 2021

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Euthyroid graves’ ophthalmopathy in a Chinese population: A cross-sectional follow-up study

Lai,

Ali Abdulla Aljufairi,

Sebastian

et al. 2024

European Journal of Ophthalmology

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Objectives A subtype of patients with thyroid eye disease (TED) were found to be euthyroid without prior thyroid dysfunction or treatment, known as Euthyroid Graves’ Ophthalmopathy (EGO). We report the prevalence, clinical and serological phenotypes of EGO in a Chinese population. Methods A cross-sectional follow-up study. Ethnic Chinese TED patients were managed at the Thyroid Eye Clinic(TEC), Prince of Wales Hospital and TEC, the Chinese University of Hong Kong between September 2007 and July 2021. Results A total of 66 (5%) patients among the 1266 ethnic Han Chinese TED cohort were diagnosed as EGO, and 6 (9%)of them become dysthyroid over an average of 74-month follow-up. EGO patients were associated with a longer duration between onset of the symptoms to our first consultation ( P < 0.0001), a higher male-to-female ratio ( P = 0.0045) and a higher age of disease onset ( P = 0.0092). Family history of thyroid disease was more common in TED patients ( P = 0.0216) than in EGO patients. EGO patients were more likely to present unilaterally ( P < 0.0001), and they have a larger difference in MRD1 ( P < 0.0001), and extraocular motility ( P < 0.0001) between the 2 eyes when compared to the TED patients. Notably, the extraocular motility restriction of the worst eye was more affected in EGO patients ( P = 0.0113). The percentages of patients who received IVMP, ORT and emergency or elective surgeries(decompression or squint operation) between EGO and TED were similar. Conclusions Understanding the important clinical phenotypes of EGO may help the clinician to make the correct diagnosis. Further study to compare EGO and TED is warranted.

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Spontaneous resolution of euthyroid optic neuropathy

Abstract: Trans-lamina cribrosa pressure difference and open-angle glaucoma. The central India eye and medical study.

Cited by 2 publications

References 17 publications

A systematic review of euthyroid Graves' disease (Review)

A systematic review of euthyroid Graves' disease (Review)

Euthyroid graves’ ophthalmopathy in a Chinese population: A cross-sectional follow-up study

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