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中华眼科医学杂志(电子版) ›› 2020, Vol. 10 ›› Issue (06) : 380 -384. doi: 10.3877/cma.j.issn.2095-2007.2020.06.011

综述

甲状腺相关眼病继发性高眼压和青光眼发病机制与治疗的研究进展
马铭绅1, 范懿1, 李月月2, 苏帆2, 杨新吉2,†()   
  1. 1. 010050　呼和浩特，内蒙古医科大学2019级硕士研究生
    2. 100039　北京，中国人民解放军总医院眼科学部　眼眶病研究所
  • 收稿日期:2020-06-02 出版日期:2020-12-28
  • 通信作者: 杨新吉
  • 基金资助:
    首都卫生发展科研专项项目(首发2020-2-5131)

The mechanism and treatment of high intraocular pressure and glaucoma caused by thyroid-associated ophthalmopathy

Mingshen Ma1, Yi Fan1, Yueyue Li2, Fan Su2, Xinji Yang2,†()   

  1. 1. Master′s degree 2019, Inner Mongolia Medical University, Hohhot 010050, China
    2. Department of Ophthalmology, Chinese People′s Liberation Army General Hospital, Beijing 100039, China
  • Received:2020-06-02 Published:2020-12-28
  • Corresponding author: Xinji Yang
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马铭绅, 范懿, 李月月, 苏帆, 杨新吉. 甲状腺相关眼病继发性高眼压和青光眼发病机制与治疗的研究进展[J]. 中华眼科医学杂志(电子版), 2020, 10(06): 380-384.

Mingshen Ma, Yi Fan, Yueyue Li, Fan Su, Xinji Yang. The mechanism and treatment of high intraocular pressure and glaucoma caused by thyroid-associated ophthalmopathy[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2020, 10(06): 380-384.

甲状腺相关眼病(TAO)，又称Graves眼病，常伴有眼眶病变。TAO的临床表现通常有眼睑后退、眼球突出、复视、眼外肌水肿及眼外肌纤维化。在眼肌变性、眶压增加、糖皮质激素药物的应用及其他各种因素的共同作用下，部分TAO患者会罹患高眼压(OHT)，甚至继发青光眼。与原发性青光眼不同，继发于TAO的OHT和青光眼，在积极治疗TAO之后就会得到缓解。TAO的治疗方法包括药物治疗、放射治疗及手术治疗。本文中笔者就TAO继发性OHT和青光眼的发生机制及其治疗进行综述，以期为临床诊断和治疗TAO所致的OHT和青光眼提供指导。

关键词: 甲状腺相关眼病, 促甲状腺激素受体, 继发性高眼压, 继发性青光眼, 眼眶减压术

The occurrence of thyroid-associated ophthalmopathy (TAO), known as Grave′s ophthalmopathy, often accompanied orbital lesions. It is often as the major clinical manifestation that eyelid retraction, eyeball protrusion, double vision, extraocular muscle edema, and fibrosis. Due to various factors such as ocular muscle degeneration, increased orbital pressure, and the use of hormonal drugs, a considerable number of patients with TAO have elevated ocular hypertension (OHT) and glaucoma. Unlike primary glaucoma, secondary OHT and open angle glaucoma caused by TAO can be controlled after removing TAO. The drug therapy, radiation therapy, and surgical procedure were major treatment methods. The mechanism and treatment of high intraocular pressure and glaucoma caused by TAO was reviewed, which to provide data for better clinical diagnosis and treatment of secondary OHT and glaucoma.

Key words: Thyroid-associated ophthalmopathy, Thyroid stimulating hormone receptor, Secondary high intraocular pressure, Secondary glaucoma, Orbital decompression
图3 患者术前及术后电子计算机断层扫描的冠状位成像　图3A和图3B分别示患者眼外观和眼磁共振成像T1冠状位图像。患者双眼眼睑肿胀，睑裂闭合不全，眼压及眶压均明显升高；图3C和图3D示患者术后6个月复诊时患者眼睑及结膜肿胀消退，电子计算机断层扫描成像示双眼眶骨壁减压术后外观
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