甲状腺眼症に対するステロイドパルス療法と放射線療法が奏効した3例

Three cases of thyroid ophthalmopathy treated by pulsed systemic corticosteroid and radiation

　両眼の眼球突出，眼球運動障害，視力低下のある甲状腺眼症3例を治療した。1例に甲状腺機能亢進があり，他の2例は甲状腺機能が正常であった。甲状腺刺激抗体の高値が2例にあった。MRI画像で全例に顕著な外眼筋肥大があり，T2強調像では2例で外眼筋内のT2緩和時間が延長していた。2例にステロイドパルス療法と放射線療法，1例に放射線療法のみを行った。全症例で，視力，中心フリッカー値，外眼筋の肥大が改善した。甲状腺眼症では，甲状腺機能障害の有無にかかわらず，ステロイドパルス療法と放射線療法が有効であることを示す症例群である。

We treated three cases of thyroid ophthalmopathy with bilateral proptosis, dysfunction of eye movement and visual loss. One case had hyperthyroidism and the other two had euthyroidism. Two cases showed elevated titers of serum thyroid-stimulating antibody. Magnetic resonance imaging (MRI) showed thickening of extraocular muscles in all cases. Two cases showed increased T2 relaxation times in the extraocular muscles. Two cases were treated by pulsed systemic corticosteroid and radiation. One case was treated by radiation only. All the cases showed remarkable improvements in visual acuity, critical fusion frequency and thickening of extraocular muscles. These cases illustrate that combined treatment with systemic corticosteroid and radiation may be effective for thyroid ophthalmopathy regardless of the presence of thyroid dysfunction.