Abstract
Introduction. Graves’ disease is a common autoimmune inflammatory condition of the thyroid. About
one in four of affected patients also develop orbital symptoms like proptosis and diplopia - called Graves’
Ophthalmopathy (GO). Orbital decompression surgery is a therapeutic option for these patients with
varying success.
Case Description. year old male known to have Graves’ disease diagnosed at the age of 52 years and
has been on thiamazoli since diagnosis. He presented to the hospital complaining for double vision, eye
tearing, eyelid oedema, redness, impaired vision for the last few months. Patient was a smoker for 35 years,
continued to smoke during therapy as well. Ultrasonography of the thyroid showed enlarged both lobes of
the thyroid, there was multiple, different sized nodes classified as TIRADS2 and TIRADS3 on the chronic
thyroiditis structure. Thyroid was with a non-homogeneous structure, highly enhaced vascularization as in
chronic autoimmune thyroiditis. Radiological examination showed bilaterally hypertrophied and enlarged
extraocular muscles, compressed extraconal and intraconal fat tissue which leaded to compression on the
optic nerves bilaterally at the tip level. Also severe proptosis bilaterally was spotted on the CT scan. Since
systemic glucocorticoid therapy didn’t help to stop the progress of the disease, a decision was made in
favour of orbital decompression surgery as a therapeutic option. Surgery of both eyes was performed within
two weeks.
Summary. CT is the most commonly utilized imaging technique for evaluating GO. Objective measures
of appearance change include proptosis and fat prolapse. Imaging studies may be particularly helpful when
decompressive surgery is planned. Awareness of this clinical presentation is important, as early detection
and treatment can prevent visual complications.
Conclusions. Graves’ Ophthalmopathy is a variant and therapeutically challenging disease. Orbital
decompression surgery proved to be effective in saving the patients eyesight and improving quality of life.
one in four of affected patients also develop orbital symptoms like proptosis and diplopia - called Graves’
Ophthalmopathy (GO). Orbital decompression surgery is a therapeutic option for these patients with
varying success.
Case Description. year old male known to have Graves’ disease diagnosed at the age of 52 years and
has been on thiamazoli since diagnosis. He presented to the hospital complaining for double vision, eye
tearing, eyelid oedema, redness, impaired vision for the last few months. Patient was a smoker for 35 years,
continued to smoke during therapy as well. Ultrasonography of the thyroid showed enlarged both lobes of
the thyroid, there was multiple, different sized nodes classified as TIRADS2 and TIRADS3 on the chronic
thyroiditis structure. Thyroid was with a non-homogeneous structure, highly enhaced vascularization as in
chronic autoimmune thyroiditis. Radiological examination showed bilaterally hypertrophied and enlarged
extraocular muscles, compressed extraconal and intraconal fat tissue which leaded to compression on the
optic nerves bilaterally at the tip level. Also severe proptosis bilaterally was spotted on the CT scan. Since
systemic glucocorticoid therapy didn’t help to stop the progress of the disease, a decision was made in
favour of orbital decompression surgery as a therapeutic option. Surgery of both eyes was performed within
two weeks.
Summary. CT is the most commonly utilized imaging technique for evaluating GO. Objective measures
of appearance change include proptosis and fat prolapse. Imaging studies may be particularly helpful when
decompressive surgery is planned. Awareness of this clinical presentation is important, as early detection
and treatment can prevent visual complications.
Conclusions. Graves’ Ophthalmopathy is a variant and therapeutically challenging disease. Orbital
decompression surgery proved to be effective in saving the patients eyesight and improving quality of life.
| Original language | English |
|---|---|
| Pages (from-to) | 899 |
| Number of pages | 1 |
| Journal | Medicina (Kaunas) |
| Volume | 59 |
| Issue number | Suppl.2 |
| Publication status | Published - 2023 |
| Event | RSU Research Week 2023: Research Week 2023 Rīga Stradiņš University - Riga Stradins University, Riga, Latvia Duration: 27 Mar 2023 → 31 Mar 2023 https://rw2023.rsu.lv/general-information https://rw2023.rsu.lv |
Keywords*
- Graves’ diseas
- Ophthalmopathy
- Decompression
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)