[Therapeutic options in thyroid ophthalmopathy].

Area of Science:

• Ophthalmology
• Endocrinology
• Neurology

Background:

• Graves disease frequently causes thyroid myopathy, leading to hyperthyroidism, hypothyroidism, or euthyroidism.
• Thyroid myopathy is a primary cause of acquired double vision in adult populations.
• This study investigates the progression of thyroid myopathy following both non-surgical and surgical interventions.

Observation:

• Fifteen patients with thyroid myopathy underwent analysis of their clinical progression.
• Treatments included conservative systemic corticosteroids, orbital anti-inflammatory therapy, and retrobulbar corticosteroid injections.
• Surgical interventions were performed on three patients experiencing restrictive strabismus and diplopia; two required orbital decompression for malignant exophthalmia.

Findings:

• Conservative treatment for thyroid myopathy is effective only during the acute phase.
• Surgical treatment is indicated for established muscular fibrosis and restrictive strabismus.
• Optimal surgical timing for restrictive strabismus is approximately six months post-stable ocular deviation.

Implications:

• Early conservative management is crucial for acute thyroid myopathy.
• Surgical strategies must consider the presence of fibrosis and the timing of ocular deviation.
• Adjustable surgical techniques offer the most suitable approach for correcting restrictive strabismus in thyroid myopathy.