To assess all available data to compare the efficacy of glucocorticoids treatment and orbital decompression for dysthyroid optic neuropathy(DON).PubMed,EMBASE,the Cochrane Library databases as well as other sources we...To assess all available data to compare the efficacy of glucocorticoids treatment and orbital decompression for dysthyroid optic neuropathy(DON).PubMed,EMBASE,the Cochrane Library databases as well as other sources were searched by two independent reviewers followed by extensive hand-searching for the identification of relevant studies.The primary outcomes were the improvement in visual acuity and responder rate.Secondary outcomes were the proptosis reduction,change in diplopia,and clinical activity score(CAS).One randomized controlled trial,three retrospective case series and one prospective case series met the inclusion criteria.They were divided into intravenous high-dose glucocorticoids(ivGC)group and orbital decompression(OD)group.Both groups demonstrated improvement in visual acuity.In addition,the proportion of patients with improved vision in OD group was higher than that in ivGC group(P<0.001).Post-treatment proptosis reduction was also reported in both groups.Overall,weighted mean in proptosis reduction estimated at 1.64 and 5.45 mm in patients treated with ivGC and OD respectively.This study also presented results regarding pre-existing and new-onset diplopia.Apart from diplopia,a wide variety of minor and major complications were noted in 5 included studies.The most common complication in ivGC group and OD group was Cushing's syndrome and epistaxis respectively.The present systematic review shows that both glucocorticoids treatment and OD are effective in treating DON and OD may work better in improving visual acuity and reducing proptosis.However,high-quality,large-sample,controlled studies need to be performed in the future.展开更多
AIM:To describe the role of endoscopic transnasal canaliculorhinostomy(ETC)in refractory common canalicular obstruction(CCO)associated with an absent or unidentifiable lacrimal sac.METHODS:The records of patients with...AIM:To describe the role of endoscopic transnasal canaliculorhinostomy(ETC)in refractory common canalicular obstruction(CCO)associated with an absent or unidentifiable lacrimal sac.METHODS:The records of patients with refractory CCO who underwent ETC at the Eye Hospital of Wenzhou Medical University from October 2007 to December 2016 were retrospectively reviewed.RESULTS:Fifty-six patients(56 eyes)with refractory CCO were recruited into the study.Eight patients were excluded due to the presence of a residual lacrimal sac or failure to complete the follow-up duration.The anatomic and functional success rates were both 85.4%(41/48)at a mean follow-up of 18.6 mo.Five cases failed as a result of ostial synechia and two failed because of ostial obstruction by granulation.Postoperative complications included mild nasal bleeding in 5 cases,dried nasal feeling in 8 cases,and olfactory dysfunction in 4 cases.CONCLUSION:Although being surgically challenging,ETC has comparable findings to its external approach counterpart or conjunctivodacryocystorhinostomy(CDCR)with Jones tube.And it may prove to be a novel alternate surgical technique for patients with refractory CCO without identifiable lacrimal sac.展开更多
基金Supported by the Natural Science Foundation of China(No.81770926)the Natural Key Research and Development Program of China(No.2016YFC1101200)。
文摘To assess all available data to compare the efficacy of glucocorticoids treatment and orbital decompression for dysthyroid optic neuropathy(DON).PubMed,EMBASE,the Cochrane Library databases as well as other sources were searched by two independent reviewers followed by extensive hand-searching for the identification of relevant studies.The primary outcomes were the improvement in visual acuity and responder rate.Secondary outcomes were the proptosis reduction,change in diplopia,and clinical activity score(CAS).One randomized controlled trial,three retrospective case series and one prospective case series met the inclusion criteria.They were divided into intravenous high-dose glucocorticoids(ivGC)group and orbital decompression(OD)group.Both groups demonstrated improvement in visual acuity.In addition,the proportion of patients with improved vision in OD group was higher than that in ivGC group(P<0.001).Post-treatment proptosis reduction was also reported in both groups.Overall,weighted mean in proptosis reduction estimated at 1.64 and 5.45 mm in patients treated with ivGC and OD respectively.This study also presented results regarding pre-existing and new-onset diplopia.Apart from diplopia,a wide variety of minor and major complications were noted in 5 included studies.The most common complication in ivGC group and OD group was Cushing's syndrome and epistaxis respectively.The present systematic review shows that both glucocorticoids treatment and OD are effective in treating DON and OD may work better in improving visual acuity and reducing proptosis.However,high-quality,large-sample,controlled studies need to be performed in the future.
基金Supported by the Natural Key Research and Development Program of China(No.2016YFC1101200)the National Natural Science Foundation of China(No.81770926)。
文摘AIM:To describe the role of endoscopic transnasal canaliculorhinostomy(ETC)in refractory common canalicular obstruction(CCO)associated with an absent or unidentifiable lacrimal sac.METHODS:The records of patients with refractory CCO who underwent ETC at the Eye Hospital of Wenzhou Medical University from October 2007 to December 2016 were retrospectively reviewed.RESULTS:Fifty-six patients(56 eyes)with refractory CCO were recruited into the study.Eight patients were excluded due to the presence of a residual lacrimal sac or failure to complete the follow-up duration.The anatomic and functional success rates were both 85.4%(41/48)at a mean follow-up of 18.6 mo.Five cases failed as a result of ostial synechia and two failed because of ostial obstruction by granulation.Postoperative complications included mild nasal bleeding in 5 cases,dried nasal feeling in 8 cases,and olfactory dysfunction in 4 cases.CONCLUSION:Although being surgically challenging,ETC has comparable findings to its external approach counterpart or conjunctivodacryocystorhinostomy(CDCR)with Jones tube.And it may prove to be a novel alternate surgical technique for patients with refractory CCO without identifiable lacrimal sac.
