伊朗 Graves 眼病的临床特点

目的:研究分析伊朗 Graves 眼病患者的临床特点.方法:回顾分析 2003/2005 年确诊为 Graves 眼病的103例患者临床资料.结果:在103例 Graves 眼病患者中,48例(46.6%)为男性,55例(53.3%)为女性(男女比例为1.1).年龄18-73(平均45)岁,95例(92.2%)表现为甲状腺机能亢进,3例(2.9%)表现为原发性甲状腺机能减退,5例(4.8%)甲状腺机能正常.出现眼部症状的时间为2～95 (平均3.2)mo,而表现出甲状腺功能障碍的时间为6～180(平均39.4)mo.12例患者单眼发病,90例(87%)患者有眼睑退缩,80例(77.6%)患者表现出眼球突出,其中30例(29%)伴有局限性眼外肌运动障碍;CT扫描显示70例患者中有52例(74%)有眼外肌肥大.6例患者(5.8%)有视神经功能障碍,22例患者(21%)表现出Graves眼病相关的青光眼.其中7例(6.7%)为正常眼压青光眼.结论:本组病例中眼睑退缩是Graves眼病最常见的临床表现.未来需要更大范围的病例研究,以评价分析Graves眼病在伊朗人群中的发病率以及不同人种之间临床表现差异.

Clinical features of Graves' ophthalmopathy in Iran

AIM:To determine the clinical characteristics of a prospective study of patients with Graves' ophthalmopathy. METHODS:We reviewed clinical manifestations,and medical records of 103 patients in whom Graves' ophthalmopathy was diagnosed between 2003 and 2005. RESULTS:Among 103 patients with Graves' ophthalmopathy,48 (46.6%) male and 55 (53.3%) female (F:M=1.1),with mean age of 45 (range; 18-73) years,95 (92.2%) patients had Graves' hyperthyroidism,3 (2.9%) had primary hypothyroidism,and 5 (4.8%) were euthyroid. The mean duration of ocular symptoms was 13.2 (range 2-95) months) while the mean duration of dysthyroid symptoms was 39.4 (range 6-180) months. Unilaterality was occurred in 12 patients. Eyelid retraction was present in 90 patients (87%),whereas the approximate frequency of exophthalmos was 77.6% (80 patients); restrictive extraocular myopathy,29% (30 patients); evidence of extraocular enlargement on CT-scan in 52 patients of 70 patients (74%) that was evaluated,and optic nerve dysfunction,5.8% (6 patients). 22 (21%) patients had glaucoma associated with Graves' ophthalmopathy that 7 (6.7%) of them were normal-tension glaucoma. CONCLUSION:Eyelid retraction was the most common clinical sign of Graves' ophthalmopathy in our patients. Larger prospective studies are suggested to evaluate both the prevalence and possible racial difference in its clinical presentation in Iranian population.