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WGA Rescources

Abstract #6801 Published in IGR 4-1

Intraocular high pressure in thyroid-associated orbitopathy: physiopathological mechanisms, diagnosis, and management: three case reports

Ayed HB; Hamedani M; Bok C; Barraco P; Oubaaz A; Morax S
Journal Français d'Ophtalmologie 2002; 25: 15-22


PURPOSE: To determine the mechanisms and treatment of ocular hypertension in patients with thyroid-associated orbitopathy and to differentiate this from glaucomatous damage. DESIGN: Three case reports. METHODS: A retrospective review of the clinical findings, course, and treatment of these three patients. RESULTS: Elevated intraocular pressure (IOP) in thyroid-associated orbitopathy observed in the three cases may involve different physiopathological ,abnormalities such as disturbances of the venous circulation, compression by infiltrative muscles, and long corticosteroid use. In the first two cases, defects demonstrated in the perimetry were consistent with glaucomatous damage. In the third case, visual field abnormalities may be compatible with a glaucomatous disease, but all defects resolved after therapy. Treatment was very difficult in the three cases, combining antiglaucomatous medication, steroids, orbital radiotherapy, orbital decompression, and extraocular muscle surgery. IOP was controlled in all cases. CONCLUSIONS: Elevated IOP in thyroid-associated orbitopathy can be distinguished from glaucomatous disease by its physiopathological mechanisms, clinical course, visual field defects, and treatment. The management of this hypertension is closely related to the treatment of dysthyroid orbitopathy.LA: French

Dr. H.B. Ayed, Service d'Ophtalmologie/Chirurgie Plastique Reconstructive Ophtalmologie, Fondation A. de Rothschild, 25 a 29, rue Manin, 75940 Paris Cedex 19, France. morax-oph@fo-rothschild.fr


Classification:

9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)



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