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Evaluation of retinal nerve fiber layer thickness profile in thyroid ophthalmopathy without optic nerve dysfunction

International Journal of Ophthalmology(English edition) 2016年第11期9卷 1634-1637页

作者： Kumari Mugdha Apjit Kaur Neha Sinha sandeep saxena Department of Ophthalmology King George's Medical University Lucknow 226003 India Sankara Eye Hospital Kanpur 208001 India

AIM： To evaluate retinal nerve fiber layer（RNFL）thickness profile in patients of thyroid ophthalmopathy with no clinical signs of optic nerve ***： A prospective, case-control, observational study conducted at a tertiary care centre. Inclusion criteria consisted of patients with eyelid retraction in association with any one of： biochemical thyroid dysfunction, exophthalmos, or extraocular muscle involvement; or thyroid dysfunction in association with either exophthalmos or extra-ocular muscle involvement;or a clinical activity score（CAS）〉3/7. Two measurements of RNFL thickness were done for each eye, by Cirrus HD-optical coherence tomography 6mo ***： Mean age of the sample was 38.75y（range13-70y） with 18 males and 22 females. Average RNFL thickness at first visit was 92.06 ±12.44 μm, significantly lower than control group（101.28±6.64 μm）（P =0.0001）.Thickness of inferior quadrant decreased from 118.2 ±21.27 μm to 115.0 ±22.27 μm after 6mo（P =0.02）. There was no correlation between the change in CAS and RNFL thickness. CONCLUSION： Decreased RNFL thickness is an important feature of thyroid orbitopathy, which is an inherent outcome of compressive optic neuropathy of any etiology. Subclinical RNFL damage continues in the absence of clinical activity of the disease. RNFL evaluation is essential in Grave＇s disease and active intervention may be warranted in the presence of significant damage.

关键词： thyroid ophthalmopathy retinal nerve fibrelayer optical coherence tomography

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Biologic response modifiers in retinal vasculitis

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World Journal of Immunology 2014年第2期4卷 122-129页

作者： sandeep saxena Khushboo Srivastav Retina Service Department of Ophthalmology King George's Medical University Lucknow 226003 India

Intraocular inflammation is an important cause of blindness both in the developing and developed world. Corticosteroids play a pivotal role in the treatment of intraocular inflammation. Lately, therapy by immunosuppression has taken the center stage for patients with severe intraocular inflammation. However, the side effects of immunosuppressive drugs are oncogenic, infectious, and hematological. Recently, biologic response modifiers specifically targeting suppression of the immune effector responses have revolutionized the treatment of intraocular inflammation. Anti-tumour necrosis factor agents are etanercept, infliximab, and adalimumab. Newer drugs include certolizumab and golimumab. Infliximab has been found to be superior to corticosteroids in treating retinal vasculitis. Anti-interlenkin therapies include rituximab, daclizumab, anakinra, tocilizumab and secukinumab. Rituximab has been proven to be quite effective. Other biologics used are interferons and abatacept. However, there are several limitations and side effects associated with their use.

关键词： Uveitis Immunotherapy Biologic response modifers Retinal vasculitis Non-infectious uveitis

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