葛瑞夫茲氏眼病變

葛瑞夫茲氏眼病變是成人最常見的眼眶疾病之一，其發生比例佔葛瑞夫茲病病患者中25%～50%。雖然甲狀腺機能亢進大多都可有效的被治療，然而對於臨床醫師而言，葛瑞夫茲氏眼病變的最佳治療方法仍是一大挑戰。葛瑞夫茲氏眼病變的自然病程具有相當的多樣性。因此治療要根據臨床嚴重性和活動性加以評估。治療主要包含儘早控制甲狀腺功能、緩解症狀以及降低眼窩組織間的發炎。有吸菸的患者要積極衛教戒菸。大部分的患者皆為輕微眼病變，長期追蹤下來並不會更進一步惡化。抗甲狀腺藥物或甲狀腺切除手術不會影響葛瑞夫茲氏眼病變的病程，然而越來越多證據顯示放射線治療可能會使眼病變新產生或更加惡化。藥物方面，類固醇還是為主要第一線治療，尤其以針劑效果比口服還更有效。在某些臨床狀況下，放射線療法或減壓手術可為輔助治療。

關鍵字

葛瑞夫茲氏眼病變；抗甲促素受體抗體

並列摘要

Graves' ophthalmopathy (GO) is the most common orbital disease in adults and develops in 25% to 50% of patients with Graves' disease (GD). Although thyroid manifestations of GD can be effectively managed, the optimal treatment of GO has remained challenging. The natural history of GO is variable. Patients should be treated according to the severity and activity of their eye disease. Treatment should include control of thyroid function, relief of symptom and reduction of inflammation in the periorbital tissues. Smoker should be educated to quit smoking aggressively. Most patients have mild disease and do not have progression during follow-up. Anti-thyroid drugs and thyroidectomy do not have a negative influence on the course of GO. However, there is increasing evidence that radioiodine therapy can cause the development or worsening of GO. Glucocorticoids(GCs) are the preferred first-line treatment for moderate and severe GO. IV GCs is more effective than oral GCs. Radiation and surgical decompression can also be used in selected patients.

並列關鍵字

Graves' ophthalmopathy ； Anti-TSH receptor-antibody

國際替代計量

葛瑞夫茲氏眼病變

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