Endoscope-navigation-assisted orbital decompression for graves' orbitopathy. 2023

Shuo Zhang, and Yu Wu, and Yang Wang, and Rou Sun, and Jing Sun, and Xianqun Fan, and Yinwei Li, and Huifang Zhou
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

OBJECTIVE To compare the surgical outcomes of endoscope-navigation (EN)-assisted orbital decompression and non-EN-assisted orbital decompression for Graves' orbitopathy (GO) and to assess the potential clinical advantage of EN in orbital decompression surgery. METHODS This retrospective cohort study was performed on 227 orbits of 147 GO patients who underwent EN-assisted orbital decompression (185 orbits) or non-EN-assisted orbital decompression (42 orbits). Assessment included proptosis reduction, best-corrected visual acuity (BCVA), diplopia, ocular restriction and surgical complications. RESULTS The proptosis reduction in the EN group was 0.9 mm greater than that in the non-EN group in the entire cohort (p  =  0.004) and 1.0 mm greater than that in the non-EN group in the propensity score matching cohort (p  =  0.025) at 2 years postoperatively. In all, 78.2% of orbits with sight-threatening GO in the EN group and 52.6% of orbits in the non-EN group showed BCVA improvement (p  =  0.026). The proportion of patients with improvement in diplopia was significantly greater in the EN group than in the non-EN group (p  =  0.026). CONCLUSIONS EN offers anatomical localization and deep-seated tissue visualization in orbital decompression and significantly improves the surgical outcomes for GO.

UI MeSH Term Description Entries
D009915 Orbit Bony cavity that holds the eyeball and its associated tissues and appendages. Eye Socket,Eye Sockets,Orbits,Socket, Eye,Sockets, Eye
D004172 Diplopia A visual symptom in which a single object is perceived by the visual cortex as two objects rather than one. Disorders associated with this condition include REFRACTIVE ERRORS; STRABISMUS; OCULOMOTOR NERVE DISEASES; TROCHLEAR NERVE DISEASES; ABDUCENS NERVE DISEASES; and diseases of the BRAIN STEM and OCCIPITAL LOBE. Double Vision,Polyopsia,Diplopia, Cortical,Diplopia, Horizontal,Diplopia, Intermittent,Diplopia, Monocular,Diplopia, Refractive,Diplopia, Unilateral,Diplopia, Vertical,Cortical Diplopia,Cortical Diplopias,Diplopias,Diplopias, Cortical,Diplopias, Horizontal,Diplopias, Intermittent,Diplopias, Monocular,Diplopias, Refractive,Diplopias, Unilateral,Diplopias, Vertical,Horizontal Diplopia,Horizontal Diplopias,Intermittent Diplopia,Intermittent Diplopias,Monocular Diplopia,Monocular Diplopias,Polyopsias,Refractive Diplopia,Refractive Diplopias,Unilateral Diplopia,Unilateral Diplopias,Vertical Diplopia,Vertical Diplopias,Vision, Double
D005094 Exophthalmos Abnormal protrusion of both eyes; may be caused by endocrine gland malfunction, malignancy, injury, or paralysis of the extrinsic muscles of the eye. Proptosis,Proptoses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D049970 Graves Ophthalmopathy An autoimmune disorder of the EYE, occurring in patients with Graves disease. Subtypes include congestive (inflammation of the orbital connective tissue), myopathic (swelling and dysfunction of the extraocular muscles), and mixed congestive-myopathic ophthalmopathy. Graves Eye Disease,Ophthalmopathy, Infiltrative,Ophthalmopathy, Thyroid-Associated,Thyroid Eye Disease,Thyroid-Associated Ophthalmopathy,Congestive Ophthalmopathy,Dysthyroid Ophthalmopathy,Edematous Ophthalmopathy,Graves Orbitopathy,Myopathic Ophthalmopathy,Ophthalmopathies, Thyroid-Associated,Thyroid-Associated Ophthalmopathies,Congestive Ophthalmopathies,Disease, Graves Eye,Disease, Thyroid Eye,Dysthyroid Ophthalmopathies,Edematous Ophthalmopathies,Eye Disease, Graves,Eye Disease, Thyroid,Infiltrative Ophthalmopathies,Infiltrative Ophthalmopathy,Myopathic Ophthalmopathies,Ophthalmopathy, Congestive,Ophthalmopathy, Dysthyroid,Ophthalmopathy, Edematous,Ophthalmopathy, Graves,Ophthalmopathy, Myopathic,Ophthalmopathy, Thyroid Associated,Orbitopathy, Graves,Thyroid Associated Ophthalmopathies,Thyroid Associated Ophthalmopathy,Thyroid Eye Diseases
D019299 Decompression, Surgical A surgical operation for the relief of pressure in a body compartment or on a body part. (From Dorland, 28th ed) Surgical Decompression,Decompressions, Surgical,Surgical Decompressions
D019723 Endoscopes Instruments for the visual examination of interior structures of the body. There are rigid endoscopes and flexible fiberoptic endoscopes for various types of viewing in ENDOSCOPY. Endoscope

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