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May 1981

Apical Optic Nerve Compression of Dysthyroid Optic Neuropathy on Computed Tomography

Author Affiliations

From the Departments of Ophthalmology (Drs Kennerdell and El-Hoshy), Radiology (Neuroradiology Division) (Dr Rosenbaum), and Neurology (Dr Kennerdell), University of Pittsburgh School of Medicine. Dr Rosenbaum is currently with the Department of Radiology, The Johns Hopkins University, Baltimore. Dr El-Hoshy is currently with the Department of Ophthalmology, University of Cairo.

Arch Ophthalmol. 1981;99(5):807-809. doi:10.1001/archopht.1981.03930010807002

• Computed assisted tomography (CT) of seven cases of dysthyroid optic neuropathy showed moderate to severe thickening of the extraocular muscles at the orbital apex, while CT of two control cases of dysthyroid orbitopathy without neuropathy showed minimal or fusiform thickening. The consequences include probable apical compression with optic nerve neuropathy either by direct pressure on the nerve or its blood supply. The management of these cases is either by oral administration of corticosteroids in high dosage with gradual tapering or radiation therapy to the orbital apex (approximately 3,000 rad over a ten-day period). If surgical decompression is to be attempted, it should be designed to decompress the optic nerve at the orbital apex.

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