【摘要】 威胁视力的Graves眼病(Graves’ophthalmopathy,GO)包括甲状腺功能障碍性视神经病变(dysthyroid optic neuropathy,DON)和暴露性角膜炎,是GO的急症,严重者失明,需要紧急干预治疗。应早期识别及时诊断DON。大剂量糖皮质激素静脉冲击治疗仍是DON患者首选方案,无改善者行眶减压术。糖皮质激素联合球后放射治疗或其他免疫抑制剂旨在减少激素用量提高疗效仍需大样本随机对照的临床试验;新型生物制剂如IGF-1R单抗IL-6受体单抗在威胁视力的GO中的应用仍在探索中。更多还原

【Abstract】 Sight-threatening Graves’ ophthalmopathy(GO),including dysthyroid optic neuropathy(DON)and exposure keratitis,is an emergency severe situation of GO,which may lead to blindness and needs emergency intervention. DON should be carefully distinguished and diagnosed early. High-dose glucocorticoid for intravenous pulse therapy is still the first line treatment for DON patients. orbital decompression surgrey is performed for those without improvement. Strategy of glucocorticoid combined with retrobulbar radiotherapy or other immunosuppressive agents to reduce the dosage of corticosteroids and improve the effect still needs large sample randomized controlled clinical trials to verify is resuits. The application of new biological agents such as anti-IGF-1 receptor or IL-6 receptor monoclonal antibody in sight-threatening GO is still under exploration.更多还原