Long Term Prognosis Of Severe Visual Impairment in Dysthyroid Optic Neuropathy After Orbital Decompression Surgery
Author: Bercin Tarlan
Base Hospital / Institution: Gazi University
Rapid fire oral presentation
Abstract ID: 24-503
Purpose
To evaluate the long-term prognosis of severe visual loss in dysthyroid optic neuropathy (DON) after orbital decompression surgery.
Methods
In this cross-sectional study, we enrolled patients with severe visual loss (BCVA less than 0.1) caused by DON who had undergone orbital decompression surgery between 2003 and 2023. We reviewed and analyzed ophthalmic examination findings, demographic and clinical profiles, as well as the types and outcomes of surgical interventions.The primary outcome measure was visual acuity, and clinical outcome measures included the mean deviation on the Humphrey visual field, Ishihara color plate testing.
Results
Fifty-eight eyes of 34 patients with a mean age of 58±6.1 years and male-to-female ratio of 22(64.7%)/12 (35.2%) were included. The follow-up duration ranged from 14 to 108 months, with a median duration of 28 months.The duration of visual loss from the onset of GO, ranged from 4 to 9 months, with a median duration of 5.8 months. The mean duration from the diagnosis of DON to the surgery was 3.9±1.2 weeks. The surgical method was fat, medial, and lateral wall decompressions in 46 (79.3%) eyes; and fat, medial, lateral and inferior wall (three-wall) decompressions in 12 (20.6%) eyes. The mean BCVA in logMAR unit was significantly improved at 1 and, 12 months after treatment compared to baseline values in patients (p < 0.001). The mean preoperative logMAR BCVA 1.9±0.78 increased to postoperative logMAR BCVA 0.35±0.25, (p < 0.001) after surgery at one-month follow-up and at one-year follow-up, the mean BCVA in LogMAR units was 0.32±0.22 (p < 0.001). 24 (41.3%) eyes required other surgeries and steroid treatment within the 1-year follow-up and no recurrence of DON was observed in any of the patients.
Conclusion
Considering the close observation of the patient and the timing of the surgery, the prognosis of patients with severe vision loss caused by DON is an important issue in the management of these patients. Orbital decompression surgery is an effective treatment modality for the management of sight threatening GO that is not responding to the previous steroid treatment.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Onur | Konuk | Gazi University |
