BACKGROUND To investigate preoperative clinical factors and visual outcomes of Japanese patients with dysthyroid optic neuropathy (DON) after urgent orbital decompression. METHODS This retrospective, observational case series study investigated 44 patients who exhibited several preoperative clinical factors that might be associated with the need for urgent orbital decompression due to DON. Additionally, the visual acuity of DON patients was compared between the patients preoperatively and at 1 and 6 months postoperatively. RESULTS All 44 patients received steroid and with or without radiation therapy, with 27 patients able to avoid undergoing urgent surgery. However, the remaining 17 patients required urgent orbital decompression following a lack of response to the therapy. None of the patients who initially avoided surgery required additional surgery for DON. Factors significantly associated with the need for urgent orbital decompression surgery included: female gender, older age, long disease duration, unilateral significant DON, history of resistance to pulsed steroid therapy, unstable thyroid function, high TRAb (Thyrotrophin receptor antibody)value, poor visual acuity, presence of central diplopia, and presence of corneal problems (P < 0.05 each). The results also showed that postoperative visual outcomes of surgery for DON were acceptable. CONCLUSION This study revealed several preoperative clinical factors for DON that appear to be associated with the need for urgent orbital decompression surgery in Japanese patients.

中文翻译：

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眼眶减压伴甲状腺功能异常性视神经病变后的术前临床因素和视觉效果。

背景技术探讨日本急诊眼眶减压术后甲状腺功能异常视神经病变（DON）患者的术前临床因素和视觉效果。方法这项回顾性观察病例系列研究调查了44例表现出几种术前临床因素的患者，这些因素可能与DON引起的眼眶紧急减压有关。另外，比较了术前和术后1个月和6个月之间DON患者的视力。结果所有44例患者均接受了激素治疗，并接受或不接受放射治疗，其中27例患者可以避免接受紧急手术。然而，其余17例患者对治疗反应欠佳，需要紧急进行眼眶减压。最初避免手术的患者均不需要为DON进行额外的手术。与紧急眼眶减压手术的需要显着相关的因素包括：女性，年龄，疾病持续时间长，单侧显着的DON，对脉冲类固醇治疗的抵抗史，甲状腺功能不稳定，TRAb（促甲状腺激素受体抗体）值高，视力差敏锐度，中枢性复视的存在和角膜问题的存在（每个P <0.05）。结果还表明，DON手术的术后视觉效果是可以接受的。结论这项研究揭示了DON的一些术前临床因素，这些因素似乎与日本患者急需眼眶减压手术有关。与紧急眼眶减压手术的需要显着相关的因素包括：女性，年龄，疾病持续时间长，单侧显着的DON，对脉冲类固醇治疗的抵抗史，甲状腺功能不稳定，TRAb（促甲状腺激素受体抗体）值高，视力差敏锐度，中枢性复视的存在和角膜问题的存在（每个P <0.05）。结果还表明，DON手术的术后视觉效果是可以接受的。结论这项研究揭示了DON的一些术前临床因素，这些因素似乎与日本患者急需眼眶减压手术有关。与紧急眼眶减压手术的需要显着相关的因素包括：女性，年龄，疾病持续时间长，单侧显着的DON，对脉冲类固醇治疗的抵抗史，甲状腺功能不稳定，TRAb（促甲状腺激素受体抗体）值高，视力差敏锐度，中枢性复视的存在和角膜问题的存在（每个P <0.05）。结果还表明，DON手术的术后视觉效果是可以接受的。结论这项研究揭示了DON的一些术前临床因素，这些因素似乎与日本患者急需眼眶减压手术有关。TRAb（促甲状腺激素受体抗体）值高，视力差，中枢性复视和角膜问题（每个P <0.05）。结果还表明，DON手术的术后视觉效果是可以接受的。结论这项研究揭示了DON的一些术前临床因素，这些因素似乎与日本患者急需眼眶减压手术有关。TRAb（促甲状腺激素受体抗体）值高，视力差，中枢性复视和角膜问题（每个P <0.05）。结果还表明，DON手术的术后视觉效果是可以接受的。结论这项研究揭示了DON的一些术前临床因素，这些因素似乎与日本患者急需眼眶减压手术有关。