Intraocular Pressure in Endocrinological Patients with Exophthalmos

Manor, Riri S.; Kurz, O; Lewitus, Z

doi:10.1159/000307046

Cited by 32 publications

(13 citation statements)

References 9 publications

(9 reference statements)

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“…Mechanisms for elevation of IOP include congestive orbitopathy with secondary elevation of episcleral venous pressure, 18 increased retrobulbar pressure, 19 contraction of extra-ocular muscles with increased pressure on the globe, 20,21 increased mucopolysaccharide deposition within the trabecular meshwork, genetic predisposition, and rarely angle closure glaucoma. 4,22 The primary association of primary open-angle glaucoma (POAG) and thyroid dysfunction has been disputed, with a prevalence of between 0 and 6.5%. Most reports, however, have not found a significant association between thyroid dysfunction and POAG (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the extent of IOP elevation may correlate with the degree of proptosis. [2][3][4][5] It is well recognised that IOP will decrease following both fat and bony orbital decompression; [6][7][8][9] however, changes in refractive status have been less well investigated. The purpose of this study was to investigate the effect of a varying degree of orbital decompression on both refractive status and IOP in both primary and secondary (up and downgaze) positions.…”

Section: Introductionmentioning

confidence: 99%

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The effect of orbital decompression surgery on refraction and intraocular pressure in patients with thyroid orbitopathy

Norris

Ross

Kazim

et al. 2012

Eye

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Purpose To investigate the effect of orbital decompression surgery in thyroid orbitopathy (TO) on both refractive status and intraocular pressure (IOP). Patients and methods A prospective, multicentre, consecutive audit of patients undergoing thyroid decompression surgery. Indications for surgery included cosmetically unacceptable proptosis or corneal exposure. Exclusion criteria included the following: previous orbital surgery, glaucoma, corneal disease, steroid use in the preceding 12 months, or an acute optic neuropathy. Automated refraction, keratometry, pachymetry, Hertel exophthalmometry, and IOP were recorded at 1 month pre-and 3 months postoperatively. IOP using the Tono-Pen (mean of three readings) was measured in the primary, upgaze, and downgaze positions. Results Data were collected from 52 orbits of 33 patients (East Grinstead, New York, and Adelaide). There was no significant difference between pre-and postoperative data for sphere, cylinder, or central corneal thickness (CCT). The mean spherical equivalent was À0.43±1.49 D pre-operatively and À0.28±1.52 D postoperatively. The steepest meridian of corneal curvature was 93.1 degrees pre-and 94.2 degrees postoperatively, with no significant difference. Mean IOP significantly decreased when measuring by Goldmann applanation tonometry (GAT) (2.28 mm Hg, *P ¼ 0.001) and Tono-Pen (3.06 mm Hg, *P ¼ o0.0001). IOP measured in upgaze was significantly greater than that in the primary position. Regression analysis between change in IOP and either Hertel exophthalmometry or the number of orbital walls decompressed was non-significant (*Student's t-test). Conclusion Patients with TO undergoing orbital decompression had, on average, with-the-rule astigmatism not affected by orbital decompression surgery. IOP was significantly reduced by decompression surgery although no relationship between IOP and the degree of decompression was observed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of orbital decompression surgery on refraction and intraocular pressure in patients with thyroid orbitopathy

Norris

Ross

Kazim

et al. 2012

Eye

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“…As IOP is influenced by several hormones [5], it appears reasonable that thyroid hormones might also affect IOP. Hertel [6]first reported an elevation of IOP after hypothyroidism induced in rabbits, but experimental studies failed to demonstrate this result [7].…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism and Primary Open-Angle Glaucoma

et al. 2000

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Objective: To test if there is an association between hypothyroidism and primary open-angle glaucoma (POAG) and the utility of routine study of thyroid function in these patients. Methods: The study was conducted in a case-control fashion. Seventy-five consecutive patients with a previous diagnosis of POAG and 75 control patients were prospectively evaluated for hypothyroidism. The levels of thyroid-stimulating hormone and free thyroxin were measured. Results: Hypothyroidism was revealed in only 2 patients with previous diagnosis of POAG (2.67%) and 3 patients of the control group (4%). Conclusions: As we have not been able to demonstrate the previously reported relationship between hypothyroidism and POAG, we cannot recommend the systematic screening for hypothyroidism in patients with POAG.

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“…The prevalence of ocular hypertension (OHT) in subjects with Graves’ orbitopathy (GO) is estimated to be between 5 and 24% [1,2,3,4]. It can be due to increased muscle, adipose and connective tissue volume, mucopolysaccharide precipitation in the trabecular meshwork, and increased episcleral venous pressure in the limited intraorbital space [5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Retinal Nerve Fiber Layer with Optic Nerve Tracking Optical Coherence Tomography in Thyroid-Associated Orbitopathy

Forte

Bonavolontà

Vassallo³

2009

Ophthalmologica

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Aims: To evaluate retinal nerve fiber layer (RNFL) thickness in eyes with Graves’ orbitopathy (GO), in eyes with ocular hypertension (OHT) and in a control group of healthy eyes. Methods: Observational, controlled cross-sectional study. We evaluated all patients with primary open-angle glaucoma (POAG) and all patients with GO and intraocular pressure >23 mm Hg in primary position examined from March 2006 to June 2007. Forty apparently healthy patients (80 eyes) were enrolled as a control group. Complete ophthalmic evaluation, visual field (VF) examination with the Humphrey Visual Field Analyzer and RNFL thickness measurement with optic nerve tracking optical coherence tomography (ONT-OCT; OCT/SLO, OTI, Toronto, Ont., Canada) were performed. Results: Among 116 eyes with POAG [58 patients, 32 males, 26 females, mean age 62 (46–71) years], RNFL was reduced in 87 eyes (75%, p = 0.05) when compared with the control group, and a good correlation was found between RNFL thickness and VF abnormalities (Spearman’s ρ 0.822; p = 0.001). Among 60 eyes [30 patients, 12 males, 18 females, mean age 56 (50–69) years] with GO and OHT, nonglaucomatous diffuse abnormalities of the VF were detected in 44 eyes (73.3%, p = 0.03), while RNFL thinning was present in 14 eyes (9 patients, 23.3%, p = 0.03). No correlation was found between RNFL thickness and VF abnormalities (Spearman’s ρ 0.365; p = 0.02). No significant differences in RNFL pattern were present between the group with GO, OHT and RNFL thinning and the group with POAG. Conclusions: In patients with GO and OHT, evaluation of RNFL thickness with ONT-OCT may represent an objective diagnostic technique for detecting optic neuropathy.

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Intraocular Pressure in Endocrinological Patients with Exophthalmos

Cited by 32 publications

References 9 publications

The effect of orbital decompression surgery on refraction and intraocular pressure in patients with thyroid orbitopathy

The effect of orbital decompression surgery on refraction and intraocular pressure in patients with thyroid orbitopathy

Hypothyroidism and Primary Open-Angle Glaucoma

Evaluation of Retinal Nerve Fiber Layer with Optic Nerve Tracking Optical Coherence Tomography in Thyroid-Associated Orbitopathy

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