Investigation of Eye Hydrodynamics in Patients with Different Clinical Forms of Endocrinous Ophthalmopathy

A. M. Nykoliuk

Abstract


Ocular hydrodynamic disorders in patients with thyroid ophthalmopathy (TO) can occur due to the compression of the eye globe by the orbital tissues or aqueous humor outflow obstruction. The investigation of the parameters of ocular hydrodynamics will allow us to diagnose its disorders and monitor the course of the disease in patients with TO.

The objective of the research was to investigate the parameters of eye hydrodynamics in patients with different clinical forms of TO.

Material and methods. The investigation of the parameters of eye hydrodynamics was performed in 119 patients with TO at the age of 16-68 years. Clinical form of TO was established according to the classification of A. F. Brovkina. In all cases eye disease was bilateral (238 eyes): thyrotoxic exophthalmos was observed in 42 patients, initial congestive exophthalmos was found in 31 patients, 31 patients developed advanced congestive exophthalmos, and 15 patients suffered from endocrine myopathy. All patients underwent Maklakov applanation tonometry with direct and lateral directions of gaze, Nesterov’s tonography with calculation of P0, C, F and Becker’s coefficient.

Results. It was established, that mild form of TO (thyrotoxic exophthalmos) did not cause hydrodynamic disorders, while more severe clinical forms of the disease (congestive exophthalmos, endocrine myopathy) were characterized by periodic or persistent increase in the intraocular pressure in average by 16% due to decrease in the aqueous humor outflow by 19.5- 22% in significant number (43-56%) of patients.

Conclusion. Mild forms of TO do not result in hydrodynamic disorders. More severe clinical forms of TO (congestive exophthalmos, endocrine myopathy) can lead to temporary or persistent ophthalmohypertension due to the aqueous humor outflow obstruction.


Keywords


thyroid ophthalmopathy; ocular hydrodynamics; congestive exophthalmos; intraocular pressure

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References


Brovkina AF. Endocrine ophthalmopathy. GEOTAR-Media. Moscow. 2008;184.

Sandul GA. Complex characteristics of main variants of clinical course of endocrine ophthalmopathy [dissertation]. St. Petersburg. 2006;22.

Gamblin GT, Harper DG, Galentine P, et al. Prevalence of increased intraocular pressure in Graves’ disease - evidence of frequent subclinical ophthalmopathy. N. Engl. J. Med.1983;308:420-424.




Copyright (c) 2017 A. M. Nykoliuk

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