Optic Neuropathy in Thyroid Eye Disease: A Case Series
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In patients with thyroid disease, ocular involvement or thyroid ophthalmopathy is common, irrespective of theirthyroid status. A common feature of thyroid eye disease is eyelid retraction, which leads to a classical starry gaze(Kocher sign). Treatment with radioactive iodine (RAI) is a known therapy for hyperthyroidism. However, this treatmentmay lead to or worsen thyroid ophthalmopathy. We report a case series of two patients with thyrotoxicosis,who presented with an atypical and subtle occurrence of thyroid eye disease (TED) soon after RAI therapy. One ofthe patients was initially diagnosed and treated for dry eyes; however, over a period of time, the patient’s vision progressivelydeteriorated. Clinical and radiological investigations confirmed thyroid ophthalmopathy with low serumthyroid hormone levels. Both patients recovered well after immediate intensive intravenous steroid treatment. These cases highlight the importance of recognizing partial ptosis as one of the presenting signs of active TEDamong general practitioners and physicians.
Abstract
In patients with thyroid disease, ocular involvement or thyroid ophthalmopathy is common, irrespective of theirthyroid status. A common feature of thyroid eye disease is eyelid retraction, which leads to a classical starry gaze(Kocher sign). Treatment with radioactive iodine (RAI) is a known therapy for hyperthyroidism. However, this treatmentmay lead to or worsen thyroid ophthalmopathy. We report a case series of two patients with thyrotoxicosis,who presented with an atypical and subtle occurrence of thyroid eye disease (TED) soon after RAI therapy. One ofthe patients was initially diagnosed and treated for dry eyes; however, over a period of time, the patient’s vision progressivelydeteriorated. Clinical and radiological investigations confirmed thyroid ophthalmopathy with low serumthyroid hormone levels. Both patients recovered well after immediate intensive intravenous steroid treatment. These cases highlight the importance of recognizing partial ptosis as one of the presenting signs of active TEDamong general practitioners and physicians.
참고문헌 (11)
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