Hopp til innhold
NHI.no
Annonse

Utstående øyne (eksoftalmus): Diagnosen

Diagnosen stilles på grunnlag av det man ser. At øynene er mer fremstående, at øyespalten - avstanden mellom øvre og nedre øyelokk - er videre enn normalt. Dette kombinert med eventuelle ubehag som du kan berette om - både fra øynene og mer generelt - og påvisning av forhøyet tyroksin, gir diagnosen. Som ledd i den videre utredningen kan det være aktuelt å gjøre en CT-undersøkelse.

Annonse

Generelle symptomer ved høyt stoffskifte kan være skjelving, hjertebank, svetting, økt appetitt, vekttap, løs mage, uro og nervøsitet.

Dette dokumentet er basert på det profesjonelle dokumentet Øyeforandringer ved hypertyreose . Referanselisten for dette dokumentet vises nedenfor

  1. Cawood T, Moriarty P, O'Shea D. Recent developments in thyroid eye disease. BMJ 2004; 329: 385-90. PubMed
  2. Rødahl E, Kloster R, Eidal K. Endokrin eksoftalmus. Norsk kvalitetshåndbok i oftalmologi. Nov 2016. legeforeningen.no
  3. Tanda ML, Piantanida E, Liparulo L, et al. Prevalence and natural history of Graves' orbitopathy in a large series of patients with newly diagnosed graves' hyperthyroidism seen at a single center. J Clin Endocrinol Metab 2013; 98:1443. PubMed
  4. Bartalena L, Pinchera A, Marcocci C. Management of Graves' ophthalmopathy: reality and perspectives. Endocr Rev 2000; 21: 168-99. PubMed
  5. Vestergaard P. Smoking and thyroid disorders - a meta-analysis. Eur J Endocrinol 2002; 146: 153-61. PubMed
  6. Khong JJ, Finch S, De Silva C, et al. Risk Factors for Graves' Orbitopathy; the Australian Thyroid-Associated Orbitopathy Research (ATOR) Study. J Clin Endocrinol Metab 2016; 101:2711. PubMed
  7. Davies TF, Burch HB. Clinical features and diagnosis of Graves' orbitopathy (ophthalmopathy). UpToDate, last updated Feb 27, 2018. UpToDate
  8. Lin LK, Andreoli CM, Hatton MP, Rubin PA. Recognizing the protruding eye. Orbit. 2008. 27(5):350-5.
  9. Marcocci C, Kahaly GJ, Krassas GE, et al. Selenium and the course of mild Graves' orbitopathy. N Engl J Med 2011; 364: 1920-31. New England Journal of Medicine
  10. Eckstein A, Quadbeck B, Mueller G, Rettenmeier AW, Hoermann R, Mann K, et al. Impact of smoking on the response to treatment of thyroid associated ophthalmopathy. Br J Ophthalmol 2003; 87: 773-6. British Journal of Ophthalmology
  11. Salvi M, Campi I. Medical Treatment of Graves' Orbitopathy. Horm Metab Res 2015; 47:779. PubMed
  12. Hart RH, Perros P. Glucocorticoids in the medical management of Graves' ophtalmopathy. Minerva Endocrinol 2003; 28: 223-31. PubMed
  13. Aktaran S, Akarsu E, Erbagci I, Araz M, Okumus S, Kartal M. Comparison of intravenous methylprednisolone therapy vs. oral methylprednisolone therapy in patients with Graves` ophthalmopathy. Int J Clin Pract 2007; 61: 45-51. PubMed
  14. Wiersinga WM, Smit T, Schuster-Uittenhoeve AL, van der Gaag R, Koornneef L. Therapeutic outcome of prednisone medication and of orbital irradiation in patients with Graves’ ophthalmopathy. Ophthalmologica 1988; 197(2): 75-84. PubMed
  15. Mourits MP, van Kempen-Harteveld ML, Garcia MB, Koppeschaar HP, Tick L, Terwee CB. Radiotherapy for Graves' orbitopathy: randomised placebo-controlled study. Lancet 2000; 355: 1505-9. PubMed
  16. Gorman CA, Garrity JA, Fatourechi V, Bahn RS, Petersen IA, Stafford SL, et al. A prospective, randomized, double-blind, placebo-controlled study of orbital radiotherapy for Graves' ophthalmopathy. Ophthalmology 2001; 108: 1523-34. PubMed
  17. Prummel MF, Terwee CB, Gerding MN, Baldeschi L, Mourits MP, Blank L, et al. A randomized controlled trial of orbital radiotherapy versus sham irradiation in patients with mild Graves' ophthalmopathy. J Clin Endocrinol Metab 2004; 89(1): 15-20. PubMed
  18. Perros P, Neoh C, Dickinson J. Thyroid eye disease. Clinical review. BMJ 2009; 338: b560. BMJ (DOI)
  19. Terwee C, Wakelkamp I, Tan S, Dekker F, Prummel MF, Wiersinga W. Long-term effects of Graves’ ophthalmopathy on health-related quality of life. Eur J Endocrinol 2002; 146(6): 751-7. PubMed
Annonse
Annonse