title: Optic neuropathy of Graves disease: results of transantral orbital decompression and long-term follow-up in 215 patients.
abstract: 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.
authors.affiliation: Division of Endocrinology, Diabetes, Metabolism, Nutrition and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Cacia V
authors.initials: CV
authors.lastname: Soares-Welch
authors.forename: Vahab
authors.initials: V
authors.lastname: Fatourechi
authors.forename: George B
authors.initials: GB
authors.lastname: Bartley
authors.forename: Charles W
authors.initials: CW
authors.lastname: Beatty
authors.forename: Colum A
authors.initials: CA
authors.lastname: Gorman
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Bahn
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Bergstralh
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Schleck
authors.forename: James A
authors.initials: JA
authors.lastname: Garrity
mesh_terms: 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