Long-term follow-up of Graves ophthalmopathy in an incidence cohort
Long-term follow-up of Graves ophthalmopathy in an incidence cohort
复制标题
DOI：
10.1016/s0161-6420(96)30579-4
复制
发表时间：
1996-06-01
期刊：
影响因子：
13.7
通讯作者：
Gorman, CA
中科院分区：
文献类型：
--
作者：
Bartley, GB;Fatourechi, V;Gorman, CA
目的：为了提供长期随访数据的发病率队列中的120 patients.Methods：数据从一个全面的审查，每个病人的社区医疗记录，随访调查，或both.Results：最初的眼科检查和最近的随访之间的中位间隔为9.8年（范围，64天至17.4年）。96例患者（80.0%）的随访时间超过5年，而59例患者（49.2%）的随访时间超过10年。2只眼发生视神经病变导致的持续性视力丧失，最终视力分别为20/30和20/60。自作者所在机构进行末次眼科检查以来，没有患者报告Graves眼病导致的视力恶化。2例患者（2.2%）有恒定复视，但均可用眼镜（棱镜）矫正。近三分之一的受访者在前4周内有眼部不适; 72%的患者最常见的原因是干眼症。在被调查者中，60.5%的人认为他们的眼睛外观没有恢复到甲状腺疾病发生前的样子，51.6%的人认为他们的眼睛出现了异常，37.9%的人对他们的眼睛外观不满意。虽然治疗后很少有患者因Graves眼病而出现长期功能障碍，但超过三分之一的患者对最终外观不满意。精神障碍的心理、美学、经济和社会后遗症需要通过正式的结果研究进一步定义。
Purpose: To provide long-term follow-up data on patients with Graves ophthalmopathy in an incidence cohort of 120 patients.Methods: Data were obtained from a comprehensive review of each patient's community medical record, a follow-up survey, or both.Results: The median interval between the initial ophthalmic examination and most recent follow-up was 9.8 years (range, 64 days to 17.4 years). Follow-up of more than 5 years was available for 96 patients (80.0%), whereas follow-up exceeding 10 years was achieved for 59 patients (49.2%). Persistent visual loss from optic neuropathy occurred in two eyes, with final visual acuities of 20/30 and 20/60, respectively. None of the patients reported deterioration of vision attributable to Graves ophthalmopathy in the interval since their last ophthalmic examination at the authors' institution. Two patients (2.2%) had constant diplopia, but it was correctable with spectacles (prisms) in each case. Nearly one third of respondents had had ocular discomfort during the preceding 4 weeks; the most frequent cause in 72% of patients was dry eyes. Among the respondents to the survey, 60.5% believed that the appearance of their eyes had not returned to what it had been before the development of thyroid disease, 51.6% thought that their eyes appeared abnormal, and 37.9% were dissatisfied with the appearance of their eyes.Conclusions. Although with treatment few patients have long-term functional impairment from Graves ophthalmopathy, more than one third of patients are dissatisfied with their ultimate appearance. The psychologic, aesthetic, economic, and social sequelae of the disorder require further definition by formal outcomes studies.