甲状腺相关眼病合并眼压升高106例临床分析

目的 观察甲状腺相关眼病(Thymid—associated Ophthalmopathy，TAO)合并眼压升高的临床特征和影响因素。方法 对1994年～2001年间收治的339例(597眼)TAO患者中106例(188眼)眼压升高患者的临床资料进行分析。结果 本组TAO患者眼压升高的发生率为31．3％，男性略高于女性。眼压升高的发生与TAO患者眼肌肥大对眼球壁的压迫、眶内结缔组织增生及眼肌肥大和水肿致眶压增高、以及TAO病变的严重程度有关，与TAO病程无明显关系。甲强龙冲击和开眶减压手术控制TAO病情和眶压后，绝大部分患者眼压可以控制。结论 TAO眼压升高有其独自的临床特点，应与原发性青光眼鉴别。积极有效的TAO治疗措施可使绝大部分患者的眼压得到控制。

Clinical analysis of l06 cases with intraocular pression in thyroid-assocated ophthalmopathy

Objective To summarize the clinic manifestation of thyroid-associated ophthalmopathy(TAO)with intraocular pression,and to analyze the contributing factors.Methods 106 cases(188 eyes)of ocular hypertension in 339 cases(597 eyes)with TAO were collected from 1994 to 2001 and their clinic manifestations were summarized and analyzed.Results It was demonstrated that the incidence of ocular hypertension in TAO was 31.3%,and was more frequently found in the male than in the female.The elevated of intraocular pression in TAO was found to be partially raleted to the eyeball compression by enlarged extraocular muscles,the elevated of intraorbital pression as result of the proliferation of intraorbital connective tissue and the enlarged and swelling of extraocular muscles.It was also related to the severity of TAO,not to the course of TAO.The ocular hypertension in most cases can be controlled with reducing of intraorbital pression by methylprednisolone or orbital decompression.Conclusions Specific clinical features was found in TAO patients with ocular hypertension.It should be differentiated with primary glaucoma.The intraocular pression in most cases can be controlled by prompt and effective treatment of TAO.