Central retinal artery occlusion following surgery for thyroid eye disease: A case report.

Abstract

Rationale: Thyroid eye disease (TED) is the most common orbital disorder in adults and significantly affects patient health. Orbital decompression surgery is an important treatment option. Central retinal artery occlusion (CRAO) after orbital medial wall decompression is rare in patients with TED. Therefore, the earlier the identification and treatment, the more likely it is to reduce visual impairment.

Patient concerns: This paper examines a case of CRAO occurring postoperatively in a patient who underwent medial wall orbital decompression for TED.

Diagnoses: Central retinal artery occlusion.

Interventions: During the operation, the pupil was dilated, and eye massage and peribulbal injection of atropine were performed immediately. Fundus fluorescein angiography suggested the possibility of CRAO. Intravenous methylprednisolone 1000 mg, mannitol 50 g, ginkgo biloba extract 20 mL, nimodipine 20 mg tid, cobamamide 0.5 mg tid, and oral citicoline 0.2 g tid, along with periocular injection of atropine and hyperbaric oxygen therapy were also administered.

Outcomes: Fifteen days after onset, the patient's retinal edema and retinal blood perfusion greatly improved. The patient's visual acuity recovered from counting fingers to 0.6.

Lessons: Retinal vascular obstruction is a serious threat to vision; therefore, early detection and treatment are very important.