Endocrine Abstracts

Graves’ ophthalmopathy is an autoimmune disorder with orbital tissue inflammation. Decompression surgery is considered when conservative treatment fails. Indications for this operation are optic neuropathy, severe inflammation with pain and proptosis.

The aim of the present study is to describe the long-term results of decompression surgery in patients with thyroid-associated ophthalmopathy (TAO. This study includes retrospective analysis and clinical re-examination of TAO patients with comparison to healthy controls. The study protocol was approved by the Ethics Committee of University Central Hospital.

Seventy-eight patients who had undergone orbital decompression by transantral or endonasal technique between the years 1985 and 2000 were invited for re-examination. For comparison, 79 randomly selected healthy age- and sex-matched controls underwent a similar examination. Patients’ median age was 54 years (range 22–77) and median follow-up time was 5.2 years (IQR 3.0–8.0). In comparison to the patients’ preoperative state, proptosis was reduced 4.7 (2.6) mm (mean (S.D.)) in the right and 4.4 (2.9) mm in the left globe (P<0.0001) but did not reach the level of controls’ globe (P<0.0001). In the right and left eye of patients, visual acuity improved in 44 to 55%, remained stable in 27 to 36%, and worsened in 18 to 20%, but remained significantly worse than in controls (P=0.02–0.001).

Diplopia was the most frequent complaint (n=39, 50%) in patients. Sensory disturbances were significantly more frequent in patients (P<0.0001). Among patients and controls, maxillary sinusitis and facial neuralgias were equally common. Although overall satisfaction with present eye status measured by VAS was lower (median 7, IQR 5 to 8) for the patients than the controls (median 8, IQR 7 to 9) (P<0.0001), the majority of the patients (91%) considered the operation helpful.

Orbital decompression seems an effective and safe treatment. Regardless of technique used, patient satisfaction with decompression surgery was high.