甲状腺眼病相关眼睑疾病的治疗策略

doi:10.3969/j.issn.2095-378X.2024.02.001

摘要/Abstract

摘要： 甲状腺眼病（TED）是与甲状腺疾病密切相关的一种器官特异自身免疫性疾病,位居成人眼眶疾病发病率首位。TED临床表现复杂,可引起单眼或双眼眼睑退缩、上睑下垂等眼睑位置异常,严重的眼睑退缩可导致暴露性角膜溃疡。针对TED患者的眼睑并发症,需根据TED的分期分级选择药物治疗或手术治疗,重建患者的眼表外观,实现解剖学和社交功能复位。

关键词: 甲状腺眼病, 眼睑疾病, 药物治疗, 手术治疗

Abstract: Thyroid eye disease （TED） is the most common orbital disease in adults, and it is an organ-specific autoimmune inflammation closely related to thyroid disease. The clinical manifestations of TED are complex, including abnormal eyelid position such as eyelid recession and ptosis in one or both eyes. Severe eyelid recession can lead to exposed corneal ulcers. For TED eyelid complications, drug or surgical treatment is performed according to disease progression to reconstruct the patient's ocular surface appearance and achieve anatomical and social function reduction.

Key words: Thyroid eye disease, Eyelid disease, Pharmacotherapy, Surgical treatment

中图分类号:

R777.1

王惠学, 易岚, 季佳利, 陈倩, 邱庆华. 甲状腺眼病相关眼睑疾病的治疗策略[J]. 外科研究与新技术（中英文）, 2024, 13(2): 91-95.

WANG Huixue, YI Lan, JI Jiali, CHEN Qian, QIU Qinghua. Treatment strategies for eyelid disease associated with thyroid eye disease[J]. Surgical Research and New Technique, 2024, 13(2): 91-95.

参考文献

[1] Bartalena L, Piantanida E, Gallo D, et al. Epidemiology, natural history, risk factors, and prevention of Graves' orbitopathy[J]. Front Endocrinol (Lausanne), 2020, 11(5): 615993.
[2] Baudouin C, Aragona P, Messmer EM, et al. Role of hyperosmolarity in the pathogenesis and management of dry eye disease: proceedings of the OCEAN group meeting[J]. Ocul Surf, 2013, 11(4): 246-258.
[3] Baudouin C, Cochener B, Pisella PJ, et al. Randomized, phase Ⅲ study comparing osmoprotective carboxymethylcellulose with sodium hyaluronate in dry eye disease[J]. Eur J Ophthalmol, 2012, 22(5): 751-761.
[4] Vogel R, Crockett RS, Oden N, et al.Demonstration of efficacy in the treatment of dry eye disease with 0.18% sodium hyaluronate ophthalmic solution (vismed, rejena)[J]. Am J Ophthalmol, 2010, 149(4):594-601.
[5] Coulter I, Frewin S, Krassas GE, et al. Psychological implications of Graves′ orbitopathy[J]. Eur J Endocrinol, 2007, 157(2): 127-131.
[6] Kashkouli MB, Alemzadeh SA, Aghaei H, et al. Subjective versus objective dry eye disease in patients with moderate-severe thyroid eye disease[J]. Ocul Surf, 2018, 16(4): 458-462.
[7] Nowak M, Marek B, Kos-Kudła B, et al. [Tear film profile in patients with active thyroid orbithopathy][J]. Klin Oczna, 2005, 107(7-9): 479-482.
[8] Kishazi E, Dor M, Eperon S, et al. Differential profiling of lacrimal cytokines in patients suffering from thyroid-associated orbitopathy[J]. Sci Rep, 2018, 8(1): 10792.
[9] Huang D, Xu N, Song Y, et al. Inflammatory cytokine profiles in the tears of thyroid-associated ophthalmopathy[J]. Graefes Arch Clin Exp Ophthalmol, 2012, 250(4): 619-625.
[10] Ma JYW, Sze YH, Bian JF, et al. Critical role of mass spectrometry proteomics in tear biomarker discovery for multifactorial ocular diseases (Review)[J]. Int J Mol Med, 2021, 47(5):212-232.
[11] Hsu SL, Lee PY, Chang CH, et al. Immunological impression cytology of the conjunctival epithelium in patients with thyroid orbitopathy-related dry eye[J]. Genet Mol Res, 2016, 15(3):118-132.
[12] Matheis N, Grus FH, Breitenfeld M, et al. Proteomics differentiate between thyroid-associated orbitopathy and dry eye syndrome[J]. Invest Ophthalmol Vis Sci, 2015, 56(4): 2649-2656.
[13] Rouen PA, White ML.Dry eye disease: prevalence, assessment, and management[J]. Home Healthc Now, 2018, 36(2): 74-83.
[14] Singh VK, Sharma P, Vaksh UKS, et al. Current approaches for the regeneration and reconstruction of ocular surface in dry eye[J]. Front Med (Lausanne), 2022, 9(5): 885780.
[15] Thorne AW, Rootman DB.Influence of surgical approach for decompression on lower eyelid position in thyroid eye disease[J]. Orbit, 2020, 39(2): 84-86.
[16] Kim JS, Blizzard S, Woodward JA, et al. Prostaglandin-associated periorbitopathy in children and young adults with glaucoma[J]. Ophthalmol Glaucoma, 2020, 3(4): 288-294.
[17] Chin YH, Ng CH, Lee MH, et al. Prevalence of thyroid eye disease in Graves' disease: a meta-analysis and systematic review[J]. Clin Endocrinol (Oxf), 2020, 93(4): 363-374.
[18] Lee DC, Young SM, Kim YD, et al. Course of upper eyelid retraction in thyroid eye disease[J]. Br J Ophthalmol, 2020, 104(2): 254-259.
[19] Scott AB.Injection treatment of endocrine orbital myopathy[J]. Doc Ophthalmol, 1984, 58(1): 141-145.
[20] Uddin JM, Davies PD.Treatment of upper eyelid retraction associated with thyroid eye disease with subconjunctival botulinum toxin injection[J]. Ophthalmology, 2002, 109(6): 1183-1187.
[21] Morgenstern KE, Evanchan J, Foster JA, et al. Botulinum toxin type a for dysthyroid upper eyelid retraction[J]. Ophthalmic Plast Reconstr Surg, 2004, 20(3): 181-185.
[22] Hassan Hussien M, Abd El-Wahed Hassan E, El-Haddad NSEM. Comparison between hyaluronic acid filler and botulinum toxin type A in the treatment of thyroid upper eyelid retraction[J]. Ther Adv Ophthalmol, 2020, 12:2515841420979113.
[23] Nava Castañeda A, Tovilla Canales JL, Garnica Hayashi L,et al.Management of upper eyelid retraction associated with dysthyroid orbitopathy during the acute inflammatory phase with botulinum toxin type A[J]. J Fr Ophtalmol, 2017, 40(4):279-284.
[24] Kandasamy S, Agrawal S, Pushker N, et al. Correlation of levator-Muller's complex thickness on ultrasound biomicroscopy to botulinum toxin A injection in thyroid-related upper eyelid retraction[J]. J Ultrasound Med, 2023, 42(2): 399-408.
[25] Dawson E, Ali N, Lee JP.Botulinum toxin injection into the superior rectus for treatment of strabismus[J]. Strabismus, 2012, 20(1): 24-25.
[26] Issaho DC, Carvalho FRS, Tabuse MKU, et al.The use of botulinum toxin to treat infantile esotropia: a systematic review with meta-analysis[J]. Invest Ophthalmol Vis Sci, 2017, 58(12): 5468-5476.
[27] Yang HK, Kim DH, Hwang JM.Botulinum toxin injection without electromyographic guidance in consecutive esotropia[J]. PLoS One, 2020, 15(11): e0241588.
[28] Young SM, Kim YD, Lang SS, et al. Transconjunctival triamcinolone injection for upper lid retraction in thyroid eye disease—a new injection method[J]. Ophthalmic Plast Reconstr Surg, 2018, 34(6): 587-593.
[29] Xu DD, Chen Y, Xu HY, et al. Long-term effect of triamcinolone acetonide in the treatment of upper lid retraction with thyroid associated ophthalmopathy[J]. Int J Ophthalmol, 2018, 11(8): 1290-1295.
[30] Tu X, Dong Y, Zhang H, et al. Corticosteroids for Graves' ophthalmopathy: systematic review and meta-analysis[J]. Biomed Res Int, 2018, 18(4): 4845894.
[31] Joos ZP, Sullivan TJ.Peri-levator palpebrae superioris triamcinolone injection for the treatment of thyroid eye disease-associated upper eyelid retraction[J]. Clin Exp Ophthalmol, 2017, 45(6): 651-652.
[32] Li D, Sun F.Observations on the efficacy of two methods for the treatment of upper eyelid retraction in thyroid-associated ophthalmopathy[J]. Biomed Res Int, 2021, 1(3): 9514279.
[33] Hassan Hussien M, Abd El-Wahed Hassan E, El-Haddad N. Comparison between hyaluronic acid filler and botulinum toxin type A in the treatment of thyroid upper eyelid retraction[J]. Ther Adv Ophthalmol, 2020, 12(2): 25158414-20979113.
[34] Li Q, Ye H, Ding Y, et al. Clinical characteristics of moderate-to-severe thyroid associated ophthalmopathy in 354 Chinese cases[J]. PLoS One, 2017, 12(5): e0176064.
[35] Hintschich C.Eyelid surgery in Graves' orbitopathy[J]. Klin Monbl Augenheilkd, 2021, 238(1): 33-40.
[36] Henderson JW.A surgical procedure for retraction of eyelids in endocrine exophthalmos (a moving picture)[J]. Trans Am Ophthalmol Soc, 1965, 63(1): 70-74.
[37] Gildener-Leapman JR, Sheps I, Stein R, et al. The sutureless mullerectomy[J]. Ophthalmic Plast Reconstr Surg, 2019, 35(3): 290-293.
[38] Sun J, Liu X, Zhang Y, et al. Bovine acellular dermal matrix for levator lengthening in thyroid-related upper-eyelid retraction[J]. Med Sci Monit, 2018, 4(2): 2728-2734.
[39] Lee J, Lee H, Park M, et al. Modified full thickness graded blepharotomy for upper eyelid retraction associated with thyroid eye disease in East Asians[J]. Ann Plast Surg, 2016, 77(6): 592-596.
[40] Vasanthapuram VH, Naik MN.Blepharoptosis in thyroid eye disease: etiopathogenesis, clinical features and correlation with thyroid eye disease[J]. Int Ophthalmol, 2022, 42(1): 13-18.
[41] Brogan K, Farrugia ME, Crofts K.Ptosis surgery in patients with myasthenia gravis: a useful adjunct to medical therapy[J]. Semin Ophthalmol, 2018, 33(3): 429-434.