Assessment of eye position and double vision before and after the treatment for thyroid associated ophthalmopathy

• Published in: JAPANESE ORTHOPTIC JOURNAL Vol. 36; pp. 113 - 117
• Main Authors: Shibata, Takuya, Hamada, Mizue, Taguchi, Akiko, Ishii, Yuko, Wakakura, Masato, Inouye, Jiro
• Format: Journal Article
• Language: English
• Published: JAPANESE ASSOCIATION OF CERTIFIED ORTHOPTISTS 2007
• Subjects: Assessment methods of subjective symptom; Double vision; Thyroid associated ophthalmopathy
• ISSN: 0387-5172; 1883-9215
• DOI: 10.4263/jorthoptic.36.113

Purpose: Quantitaive assessment by MRI is often used during treatment of thyroid associated ophthalmopathy (TAO). However, this assessments are not always identical to subjective symptoms of the patients. We retrospectively compared the data from major amblyoscopy and Hess screen chart and subjective symptoms of double vision in patients with TAO. And we assessed if these are the correlation between quantitative eye position and subjective symptoms of double vision before and after the treatment. Methods: Twenty nine patients with TAO received methylprednisolone pulse treatment together with irradiation between August, 1999 and November, 2004, are retrospectively reviewed. Subjective symptom of double vision at each 9 direction was scored from mainus to +++. Subjective angles of eye position measured by major amblyoscope were categorized into horizontal deviation and vertical+torsional deviations, and Hess deviation were measured at the upper 15 degrees, primarty and lower 15 degrees before and after 3, 6, 12 months and the final visit after 1 year of the treatment. For statistical analysis, paired t-test was used. Results: The subjective score of double vision and subjective deviations measured by major amblyoscope decreased significantly with time after the treatment. I the latter, vertical+torsional deviations decreased significantly than horizontal deviations. In Although deviation at the primary and upper 15 degrees in Hess decresed, it was not highly significant so as seen in measurements by the major amblyoscopy. Scored subjective symptoms of double vision appear to be troughly correlated to the measurements by major amblyoscope and Hess screen. Conclusions: The present methods using major amblyoscope and Hess screen chart which are almost comparable to subjective symptoms of double vision are considered to be a useful manner for assessments of treatment of patients with TAO.