| 목적 : To investigate the change of thyroid stimulating immunoglobulin (TSI) levels after orbital fat decompression in patients with Graves’ orbitopathy (GO). 방법 : Data of 24 patients were eligible for analysis. 22 (91.7%) patients showed a decrease of TSI levels after surgery. Pre-operative TSI levels (mean 436.84 SRR%) significantly decreased after surgery (mean 292.29 SRR%) (paired t-test, p<0.001). In active GO (n= 11), pre-operative TSI level (p=0.001) and the decrease amount of TSI level post-operatively (p=0.004) were higher than those in inactive GO. In patients with myopathy score >2 (n= 13), pre-operative TSI level (p=0.004) and the decrease amount of TSI level post-operatively (p=0.087) were higher than those in patients with myopathy score <2결과 : Retrospective, observational case series. Patients who underwent orbital fat decompression either due to active GO (congestive uncontrolled inflammation or optic neuropathy) or inactive GO (cosmetically disfiguring proptosis) were included. Ophthalmic manifestations (modified NOSPECS [lid retraction, soft tissue inflammation, myopathy, proptosis, corneal and optic nerve involvement], clinical activity score [CAS]), TSI level before and after the surgery, and operative records (amount of fat removal, bone decompression) were reviewed. 결론 : Removal of Graves’ orbital fat tissues with its antigenic components may result in the reduction of antibodies to TSH receptor, thus supporting the concept that continued antibody production depends on the persistence of autoantigen in the body. The decrease amount of TSI was predominant in patients with active GO phase such as congestive uncontrolled inflammation or optic neuropathy. |