Optic neuropathy of Graves disease: results of transantral orbital decompression and long-term follow-up in 215 patients.
OBJECTIVE
To review demographic characteristics, clinical features, and long-term outcomes of patients with optic neuropathy of Graves disease after transantral orbital decompression.


METHODS
Retrospective analysis of noncomparative interventional case series; long-term follow-up by questionnaire.


METHODS
Medical record data (preoperative and postoperative assessments) were collected from patients who had transantral orbital decompression to treat Graves optic neuropathy. Responses to two follow-up questionnaires concerning patient satisfaction were evaluated. Statistical analysis (reflected as P values) compared preoperative and early postoperative (< or =182 days) data.


RESULTS
Between November 1969 and May 1989, 215 patients underwent transantral orbital decompression for Graves optic neuropathy. In 205 eyes with visual acuity of 20/40 or worse before decompression, visual acuity improved by 3 Snellen lines or more in 110 (54%) (P <.001). Of 291 eyes with visual field defects preoperatively, 120 (41%) had resolution, and 126 (43%) had improvement postoperatively (P <.001). Proptosis was reduced in 350 eyes by 4.4 +/- 2.3 mm (mean +/- SD) (P <.001). In 104 eyes, disk edema resolved in 72 (69%) and improved in 28 (27%). Responses to questionnaires mailed in 1990 and 2000 showed that 76% and 88% of respondents, respectively, were subjectively satisfied with the results of orbital decompression.


CONCLUSIONS
Transantral orbital decompression appeared to be effective in treating optic neuropathy of Graves disease. Patient satisfaction was high at 10-year and 20-year follow-up.
Soares-Welch
Cacia V
CV
Division of Endocrinology, Diabetes, Metabolism, Nutrition and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Fatourechi
Vahab
V
Bartley
George B
GB
Beatty
Charles W
CW
Gorman
Colum A
CA
Bahn
Rebecca S
RS
Bergstralh
Erik J
EJ
Schleck
Cathy D
CD
Garrity
James A
JA
D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D009901:Optic Nerve Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014792:Visual Acuity; D014794:Visual Fields