Keratitis Eksposur Hingga Gangguan Penglihatan: Spektrum Dampak Keterlambatan Rujukan Pasien Tiroid Ke Dokter Mata: Laporan Kasus

Sabrina Indri Wardani, Elfa Ali Idrus, Arief Akhdestira Mustaram, Raden Angga Kartiwa

Abstract


Distiroid Eksoftalmus atau penyakit mata tiroid (Thyroid Eye Disease; TED) merupakan komplikasi penyakit Graves pada mata. Pasien dapat menunjukkan berbagai gejala, termasuk terganggunya fungsi penglihatan yang ireversibel dan keterbatasan aktivitas harian jika tidak diobati. Kami menyajikan seri kasus yang terdiri dari dua kasus TED. Kasus pertama adalah anak berusia 14 tahun dengan penyakit Graves yang rutin kontrol di unit endokrinologi, dengan keluhan eksoftalmus dan lagoftalmus bilateral, serta keterbatasan gerakan mata pada mata kiri. Penglihatan mata kiri menurun akibat infeksi. Kasus kedua adalah seorang pria berusia 32 tahun dengan TED dengan temuan keratitis eksposur, keratopati, dan prolaps iris. Mata kanan tidak memiliki persepsi cahaya dan mata kiri terancam prolaps isi bola mata. Pendekatan multidisiplin dan penilaian klinis yang komprehensif, termasuk pemeriksaan mata, pada pasien gangguan hormon tiroid wajib dilakukan untuk mencegah komplikasi yang tidak dapat dipulihkan.


Keywords


Eksoftalmus distiroid; Kebutaan; Keratitis Eksposur; Orbitopati Grave; Penyakit Mata Tiroid

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References


Allam, I. Y., Lazreg, S., Shafik Shaheen, M., Doheim, M. F., & Mohammed, M. A. (2021). Ocular Surface Changes in Patients with Thyroid Eye Disease: An Observational Clinical Study. Clin Ophthalmol, 15, 2481-2488. https://doi.org/10.2147/opth.S317708

Bartalena, L., Kahaly, G. J., Baldeschi, L., Dayan, C. M., Eckstein, A., Marcocci, C., Marinò, M., Vaidya, B., & Wiersinga, W. M. (2021). The 2021 European Group on Graves' Orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves' orbitopathy. Eur J Endocrinol, 185(4), G43-g67. https://doi.org/10.1530/eje-21-0479

Bartalena, L., & Tanda, M. L. (2022). Current concepts regarding Graves’ orbitopathy. Journal of Internal Medicine, 292(5), 692-716. https://doi.org/https://doi.org/10.1111/joim.13524

Boulakh, L., Nygaard, B., Bek, T., Faber, J., Heegaard, S., Toft, P. B., Poulsen, H. E., Toft-Petersen, A. P., Hesgaard, H. B., & Ellervik, C. (2022). Nationwide Incidence of Thyroid Eye Disease and Cumulative Incidence of Strabismus and Surgical Interventions in Denmark. JAMA Ophthalmology, 140(7), 667-673.

https://doi.org/10.1001/jamaophthalmol.2022.1002

Chahal, J. S., Heur, M., & Chiu, G. B. (2017). Prosthetic Replacement of the Ocular Surface Ecosystem Scleral Lens Therapy for Exposure Keratopathy. Eye & Contact Lens, 43(4), 240-244. https://doi.org/10.1097/icl.0000000000000265

Dell, J., Mussatto, C., Chu, R., Al-Sabbagh, M., Timoney, P., & Sokol, J. (2023). Effects of Smoking on Outcomes of Thyroid Eye Disease Treated with Teprotumumab: A Retrospective Cohort Study. Kansas Journal of Medicine, 16(1), 62-64.

https://doi.org/10.17161/kjm.vol16.18940

Devi, B., Das, R. K., & Phukan, S. (2016). Thyroid ophthalmopathy in an adolescent girl: a case report. International Journal of Research in Medical Sciences, 4, 3640-3643.

Dolman, P. J. (2018). Grading Severity and Activity in Thyroid Eye Disease. Ophthalmic Plast Reconstr Surg, 34(4S Suppl 1), S34-s40. https://doi.org/10.1097/iop.0000000000001150

Hodgson, N. M., & Rajaii, F. (2020). Current Understanding of the Progression and Management of Thyroid Associated Orbitopathy: A Systematic Review. Ophthalmology and Therapy, 9(1), 21-33. https://doi.org/10.1007/s40123-019-00226-9

Jain, A. P., Jaru-Ampornpan, P., & Douglas, R. S. (2021). Thyroid eye disease: Redefining its management—A review. Clinical & Experimental Ophthalmology, 49(2), 203-211. https://doi.org/https://doi.org/10.1111/ceo.13899

Kim, Y., Chung, J. K., & Lee, S. H. (2019). Thyroid Abnormality and Dry Eye Syndrome: a Cross-sectional Study from the Republic of Korea. jkos, 60(8), 725-730.

https://doi.org/10.3341/jkos.2019.60.8.725

Kumar, J., & Batham, S. (2016). Ocular Manifestations in Thyroid Eye Disorder: A Cross-Sectional Study. Int J Clin Med, 7(12).

Liaboe, C. A., Clark, T. J. E., Simmons, B. A., Carter, K., & Shriver, E. (2016, January 17, 2020). Thyroid Eye Disease: An Introductory Tutorial and Overview of Disease. EyeRounds.org. Retrieved 30 August 2019 from http://eyerounds.org/patients/thyroid-eye-disease.htm

Nivean, P. D., Madhivanan, N., Kumaramanikavel, G., Berendschot, T. T. J. M., Webers, C. A. B., & Paridaens, D. (2024). Understanding the clinical and molecular basis of thyroid orbitopathy: a review of recent evidence. Hormones, 23(1), 25-34. https://doi.org/10.1007/s42000-023-00498-8

Novaes, P., Diniz Grisolia, A. B., & Smith, T. J. (2016). Update on thyroid-associated Ophthalmopathy with a special emphasis on the ocular surface. Clin Diabetes Endocrinol, 2, 19. https://doi.org/10.1186/s40842-016-0037-5

Sabita, P., Ajit, T., Narayan, S. D., Kumar, S. A., & Niranjan, A. (2016). Ocular manifestations in thyroid eye disorder: a cross-sectional study from Nepal. International Journal of Clinical Medicine, 7(12), 814-823.

Takahashi, Y., Lee, P. A. L., Vaidya, A., Kono, S., & Kakizaki, H. (2021). Tear film break-up patterns in thyroid eye disease. Sci Rep, 11(1), 5288. https://doi.org/10.1038/s41598-021-84661-4

Ueland, H. O., Neset, M. T., Methlie, P., Ueland, G. Å., Pakdel, F., & Rødahl, E. (2023). Molecular Biomarkers in Thyroid Eye Disease: A Literature Review. Ophthalmic Plastic & Reconstructive Surgery, 39(6S). https://journals.lww.com/op-

rs/fulltext/2023/12001/molecular_biomarkers_in_thyroid_eye_diseas

e__a.4.aspx

Weisenthal, R. W., Daly, M. K., de Freitas, D., Feder, R. S., Orlin, S. E., Tu, E. Y., Van Meter, W. S., & Verdier, D. D. (2020-2021). External disease and cornea. In C. J. Rapuano, J. T. Stout, & C. A. McCannel (Eds.), Basic and Clinical Science Course (pp. 36-41; 79-80). American Academy of Ophthalmology. https://books.google.co.id/books?id=f1GUMwEACAAJ

Yokoi, N., & Georgiev, G. A. (2018). Tear Film–Oriented Diagnosis and Tear Film–Oriented Therapy for Dry Eye Based on Tear Film Dynamics. Invest Ophthalmol Vis Sci, 59(14), DES13-DES22. https://doi.org/10.1167/iovs.17-23700




DOI: https://doi.org/10.33024/jmm.v9i2.19602

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