To describe the surgical technique and assess the clinical efficacy and safety of modified endoscopic transnasal orbital apex decompression in the treatment of dysthyroid optic neuropathy. In this retrospective research, forty-two subjects (74 orbits) who underwent modified endoscopic transnasal orbital apex decompression for the treatment of dysthyroid optic neuropathy were enrolled. Preoperative and postoperative best-corrected visual acuity (BCVA), visual field mean deviation (MD), Hertel exophthalmometry, and new onset diplopia were assessed before and after the intervention. The Wilcoxon test was used for differential analysis. Linear mixed-models’ analyses were conducted to assess the potential predictors for BCVA change. Postoperatively, the mean BCVA improved from 0.70 ± 0.62 logMAR to 0.22 ± 0.33 logMAR. BCVA significantly improved in 69 eyes (93%), remained stable in 4 eyes (5%) and deteriorated in 1 eye (1%). MD of visual fields improved from −13.73 ± 9.22 dB to −7.23 ± 7.04 dB. Proptosis decreased from 19.57 ± 3.38 mm to 16.35 ± 3.01 mm. Preoperative BCVA, MD of visual fields and medical rectus diameter were independent factors associated with improvements in BCVA (P < 0.05) by linear mixed-models’ analyses. Eighteen patients (42.9%) developed new diplopia postoperatively. Modified endoscopic transnasal orbital apex decompression effectively restores vision in dysthyroid optic neuropathy.

中文翻译：

---

改良内窥镜经鼻眶后减压治疗甲状腺功能减退性视神经病变

描述外科技术，并评估改良的内窥镜经鼻眶眶尖减压治疗甲状腺功能减退性视神经病变的临床疗效和安全性。在这项回顾性研究中，招募了42例受试者（74眼眶），他们接受了改良的经鼻内镜鼻下眶尖减压治疗，以治疗甲状腺功能减退性视神经病变。术前和术后均评估术前和术后最佳矫正视力（BCVA），视野平均偏差（MD），Hertel检眼镜，新发复视。Wilcoxon检验用于差异分析。进行了线性混合模型的分析，以评估BCVA变化的潜在预测因子。术后，平均B​​CVA从0.70±0.62 logMAR提高到0.22±0.33 logMAR。BCVA在69眼（93％）中显着改善，在4眼（5％）中保持稳定，而在1眼（1％）中恶化。视野的MD从-13.73±9.22 dB改善到−7.23±7.04 dB。眼前凸从19.57±3.38毫米降低到16.35±3.01毫米。术前BCVA，视野的MD和直肌直径是与线性混合模型分析得出的BCVA改善相关的独立因素（P <0.05）。术后有18例患者（占42.9％）发展为新的复视。改良的内窥镜经鼻眶眶减压可有效恢复甲状腺功能异常的视神经病变的视力。通过线性混合模型的分析，视野的MD和直肌直径是与BCVA改善相关的独立因素（P <0.05）。术后有18例患者（占42.9％）发展为新的复视。改良的内窥镜经鼻眶眶减压可有效恢复甲状腺功能异常的视神经病变的视力。通过线性混合模型的分析，视野的MD和直肌直径是与BCVA改善相关的独立因素（P <0.05）。术后有18例患者（占42.9％）发展为新的复视。改良的内窥镜经鼻眶眶减压可有效恢复甲状腺功能异常的视神经病变的视力。