Presión intraocular post-tratamiento de la oftalmopatía tiroidea

Abstract

To evaluate the change in the intraocular pressure (IOP) in subjects with thyroid-associated orbitopathy (TAO) treated with orbital decompression, extraocular muscle surgery or methylprednisolone pulse therapy. The charts of 31 subjects with TAO who visited in our department between 1998 and 2004 were analyzed. Subject age, gender, diagnosis and treatment for glaucoma, use of systemic steroids, procedure performed and pre-operative and post-operative IOP in the primary position and in upgaze, were all evaluated. Of the 20 eyes that underwent orbital decompression, the mean pre-operative IOP was 17.35 (3.86 SD) mmHg and 22.45 (6.36 SD) mmHg in upgaze. The post-operative IOP was 14.24 (3.43 SD) mmHg and 18.20 (4.74 SD) mmHg in upgaze. The mean pre-operative IOP in the 10 eyes who had strabismus surgery was 18.9 (3.07 SD) mmHg and 22.4 (6.14 SD) mmHg in upgaze. The post-operative IOP was 16.6 (3.50 SD) mmHg and 18.6 (3.33 SD) mmHg in upgaze. In the 12 patients treated with methylprednisolone pulse therapy, the mean pre-treatment IOP was 21.33 (6.42 SD) mmHg and 24.45 (8.15 SD) mmHg in upgaze. After the treatment the mean IOP was 17.33 (4.38 SD) mmHg and 20.08 (4.86 SD) mmHg in upgaze. In subjects with a pre-operative IOP>or=21 mmHg or in treatment for glaucoma we observed a greater reduction in IOP (p<0.005). We have observed a significant reduction in IOP in the three groups of patients after treatment for TAO, however no significant difference was found between the methods used.