Clinical Features Of Neurological Lesions And Thyroid Shock Therapy In Patients With Thyroid Associated Ophthalmopathy

Purpose:To analyse the clinical features of the Dysthyroid Optic Neuropathy (DON) and investigate the efficacy of the methylprednisolone pulse therapy (MPT).Methods:27patients (43eyes) with DON was included in the study. Thyroid status and ophthalmic examination was performed on all the DON patients.22patients (35eyes) were treated with MPT, followed by the prednisone orally. The unresponsive patients were treated with radiotherapy or orbital decompression.Results:The study included21men and19women. The average years were51.2±1.8. Prior to treatment,88.37%of DON patients had best corrected visual acuity (BCVA) worse than0.8;79.07%were visual abnormal;48.84%had abnormal optic disc appearance;67.44%showed apical muscle crowding in Orbital imaging. Median clinical activity scores (CAS) decreased from5.0±0.2to3.5±0.2(P<0.001) at1weeks after MPT. Median BCVA improved from0.38±0.04to0.69±0.28(p<0.001) at2weeks after MPT. And the mean defects (MD) of visual field decreased from8.08±0.87dB to4.85±0.62dB (P<0.001) at1months after MPT.Conclusions:The pathogenesis of DON was associated with smoking, hypertension and diabetes and TRAb, TSH. MPT was effective in restoring visual function of DON patients. The BCVA and MD are sensitive indications in evaluating the effect of the MPT. The CAS at first2weeks was good prediction of unresponsiveness of MPT.