title: Thyroid associated orbitopathy.
abstract: Thyroid-associated orbitopathy (TAO) is a self-limiting auto-immune condition usually associated with Grave's disease. It is characterised by ocular pain, eyelid swelling, chemosis, proptosis and keratopathy. As the mechanism for ophthamoplegia and optic neuropathy is the orbital swelling leading to mechanical restriction of ocular muscles and compression of optic nerve, one expects proptosis rather than ptosis in TAO. We describe a case of a young adult woman who presented with acute onset restriction of movement along with partial ptosis and severe diminution of vision in left eye. The MRI of orbit revealed significant swelling of recti along with signal alteration consistent with TAO. The radio-isotope thyroid scan revealed thyroiditis, and thyroid peroxidase (TPO) antibody was significantly high; hence, the diagnosis of Hashimoto thyroiditis was considered. A course of intravenous methylprednisolone followed by oral steroid was administered, which produced marked improvement in vision and extraocular movement.
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India. drrajeshverma32@yahoo.com
authors.forename: Rajesh
authors.initials: R
authors.lastname: Verma
authors.forename: Mani
authors.initials: M
authors.lastname: Gupta
authors.forename: Vinod Kumar
authors.initials: VK
authors.lastname: Mehta
mesh_terms: D000328:Adult; D005260:Female; D006111:Graves Disease / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use*; D009916:Orbital Diseases / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D008775:Methylprednisolone