在患有甲状腺眼病的患者中经过轨道辐射后没有视网膜病变 - 一项随访研究
Sara Makhoul1,2, Janos K Aranyosi1, Emese Csiki3
1Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Frontiers in endocrinology
|December 26, 2025
概括
对于甲状腺眼病 (TED) 的轨道放射治疗 (ORT) 对于糖尿病患者来说似乎是安全的,最近的一项研究中没有观察到视网膜病变. 具有3D规划的先进线性加速器将风险降到最低,但眼科监测仍然至关重要.
科学领域:
- 眼科医生 眼科 眼科
- 辐射瘤学 辐射瘤学
- 内分泌学 在内分泌学.
背景情况:
- 甲状腺眼病 (TED) 是一种自身免疫轨道疾病.
- 轨道放射疗法 (ORT) 是对中度至重度活跃TED的治疗方法.
- 由于潜在的视网膜病变诱导,糖尿病是ORT的相对禁忌.
研究的目的:
- 评估ORT后糖尿病患者视网膜病变的风险,使用具有3D计划的现代线性加速器.
- 在糖尿病和先进辐射技术的背景下评估ORT的安全性.
主要方法:
- 在2004-2020年期间接受ORT的97名TED患者的回顾性分析.
- 所有患者都接受了基于3D的LINAC放射治疗 (总剂量为20 Gy).
- 眼科随访包括眼底检查,视力敏度和视网膜病变评估;19名患者患有糖尿病.
主要成果:
- 在ORT后,没有患者出现放射诱导的视网膜病变.
- 随访期间的中位数为60个月.
- 在ORT之前,先前存在的糖尿病视网膜病变不存在,血糖控制一般良好.
结论:
- 使用3D规划线性加速器的ORT似乎在没有先前存在的视网膜病变的控制良好的糖尿病患者中具有可忽略的视网膜病变风险.
- 即使使用先进的技术和良好的血糖控制,也建议进行眼科监测.
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