علاج اعتلال حجاج غريفز مع مرض العين الدرقي المهدد للبصر واعتلال العصب البصري الدرقي

References

doi: 10.1089/thy.2022.0251

• Patients with DON and/or corneal breakdown and/or globe subluxation require urgent management.
• DON may result from compression of the optic nerve by enlarged EOM at the apex of the orbit, or infrequently (<5%), due to stretch of the nerve because of proptosis.
• Patients with DON require urgent treatment with IVGC therapy, with close monitoring of response and early (after two weeks) consideration for decompression surgery if baseline visual function is not restored and maintained with medical therapy.
• Although the optimal dose and schedule of GC are not established, the recommended use of large doses of IVMP daily for 3 consecutive or alternate days is based on the experience of treating patients with optic neuritis from other etiologies.
• IVGC has been reported to be effective in approximately 40% of DON patients, generating improvements in visual acuity and avoiding subsequent orbital decompression.
• Visual deterioration 2 weeks after initiating therapy is also predictive of poor response to IVGC.