{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:18:14Z","timestamp":1784557094014,"version":"3.55.0"},"reference-count":11,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["etj.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Dysthyroid optic neuropathy (DON) is a rare, severe form of thyroid eye disease, in which decreased visual acuity is accompanied by characteristic MRI findings. The treatment of DON has always been a challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>In a patient in whom visual acuity deteriorated on the left eye, mannitol 20% 200 mL followed by furosemide 40 mg 6 h later, administered daily, were initiated on the day of admission. Visual function by ophthalmology methods, and orbital compartment volumes and water content by MRI were followed. Intravenous diuretics resulted in an immediate therapeutic response. Visual acuity improved from 20\/50 to 20\/25 after 2 days of treatment. MRI revealed decreasing water content of both the muscle and connective tissue compartments without any volume changes. Subsequently, corticosteroids and orbital irradiation were started. Orbital decompression surgery was not required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion\/conclusion<\/jats:title>\n                    <jats:p>Edematous swelling of orbital tissues is an established contributor of local pressure increase in thyroid eye disease. Diuretics reduce orbital pressure and, if confirmed by others, may be useful additions to the standard of care in sight-threatening DON.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/etj-22-0078","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T09:37:04Z","timestamp":1657100224000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":1,"title":["Non-surgical orbital decompression using diuresis in dysthyroid optic neuropathy: a case report"],"prefix":"10.1530","volume":"11","author":[{"given":"Annamaria","family":"Erdei","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Gazdag","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadett","family":"Ujhelyi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edit B","family":"Nagy","sequence":"additional","affiliation":[{"name":"Division of Radiology and Imaging Science, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ervin","family":"Berenyi","sequence":"additional","affiliation":[{"name":"Division of Radiology and Imaging Science, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eszter","family":"Berta","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zita","family":"Steiber","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandor","family":"Barna","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emese","family":"Mezosi","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, University of Pecs Medical School, Pecs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miklos","family":"Bodor","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9286-6471","authenticated-orcid":true,"given":"Endre V","family":"Nagy","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"European Thyroid Journal","first-page":"9","article-title":"The 2016 European Thyroid Association\/European Group on Graves\u2019 Orbitopathy Guidelines for the Management of Graves\u2019 Orbitopathy","volume":"5","author":"Bartalena","year":"2016","unstructured":"Bartalena LBaldeschi LBoboridis KEckstein AKahaly GJMarcocci CPerros PSalvi MWiersinga WM & European Group on Graves\u2019 Orbitopathy (EUGOGO). The 2016 European Thyroid Association\/European Group on Graves\u2019 Orbitopathy Guidelines for the Management of Graves\u2019 Orbitopathy. European Thyroid Journal201659\u201326. (https:\/\/doi.org\/10.1159\/000443828)"},{"key":"bib2","series-title":"Ophthalmology and Therapy","first-page":"541","article-title":"Practice patterns in orbital decompression surgery among American Society of Ophthalmic Plastic and Reconstructive Surgery Members","volume":"8","author":"DeParis","year":"2019","unstructured":"DeParis SWTian JRajaii F. Practice patterns in orbital decompression surgery among American Society of Ophthalmic Plastic and Reconstructive Surgery Members. Ophthalmology and Therapy20198541\u2013548. (https:\/\/doi.org\/10.1007\/s40123-019-00206-z)"},{"key":"bib3","series-title":"British Journal of Ophthalmology","first-page":"639","article-title":"Clinical criteria for the assessment of disease activity in Graves\u2019 ophthalmopathy: a novel approach","volume":"73","author":"Mourits","year":"1989","unstructured":"Mourits MPKoornneef LWiersinga WMPrummel MFBerghout Avan der Gaag R. Clinical criteria for the assessment of disease activity in Graves\u2019 ophthalmopathy: a novel approach. British Journal of Ophthalmology198973639\u2013644. (https:\/\/doi.org\/10.1136\/bjo.73.8.639)"},{"key":"bib4","series-title":"American Journal of Roentgenology","first-page":"1005","article-title":"Using morphologic parameters of extraocular muscles for diagnosis and follow-up of Graves\u2019 ophthalmopathy: diameters, areas, or volumes?","volume":"179","author":"Szucs-Farkas","year":"2002","unstructured":"Szucs-Farkas ZToth JBalazs EGaluska LBurman KDKaranyi ZLeovey ANagy EV. Using morphologic parameters of extraocular muscles for diagnosis and follow-up of Graves\u2019 ophthalmopathy: diameters, areas, or volumes?American Journal of Roentgenology20021791005\u20131010. (https:\/\/doi.org\/10.2214\/ajr.179.4.1791005)"},{"key":"bib5","series-title":"Eye","first-page":"506","article-title":"The STIR sequence MRI in the assessment of extraocular muscles in thyroid eye disease","volume":"8","author":"Hoh","year":"1994","unstructured":"Hoh HBLaitt RDWakeley CKabala JGoddard PPotts MJHarrad RA. The STIR sequence MRI in the assessment of extraocular muscles in thyroid eye disease. Eye19948506\u2013510. (https:\/\/doi.org\/10.1038\/eye.1994.126)"},{"key":"bib6","series-title":"Thyroid","first-page":"897","article-title":"Therapeutic outcomes of high-dose intravenous steroids in the treatment of dysthyroid optic neuropathy","volume":"24","author":"Curr\u00f2","year":"2014","unstructured":"Curr\u00f2 NCovelli DVannucchi GCampi IPirola GSimonetta SDazzi DGuastella CPignataro LBeck-Peccoz PTherapeutic outcomes of high-dose intravenous steroids in the treatment of dysthyroid optic neuropathy. Thyroid201424897\u2013905. (https:\/\/doi.org\/10.1089\/thy.2013.0445)"},{"key":"bib7","series-title":"Clinical Endocrinology","first-page":"323","article-title":"Surgical or medical decompression as a first-line treatment of optic neuropathy in Graves\u2019 ophthalmopathy? A randomized controlled trial","volume":"63","author":"Wakelkamp","year":"2005","unstructured":"Wakelkamp IMBaldeschi LSaeed PMourits MPPrummel MFWiersinga WM. Surgical or medical decompression as a first-line treatment of optic neuropathy in Graves\u2019 ophthalmopathy? A randomized controlled trial. Clinical Endocrinology200563323\u2013328. (https:\/\/doi.org\/10.1111\/j.1365-2265.2005.02345.x)"},{"issue":"4S Supplement 1","key":"bib8","series-title":"Ophthalmic Plastic and Reconstructive Surgery","article-title":"Dysthyroid optic neuropathy","volume":"34","author":"Saeed","year":"2018","unstructured":"Saeed PTavakoli Rad SBisschop PHLT. Dysthyroid optic neuropathy. Ophthalmic Plastic and Reconstructive Surgery201834 (4S Supplement 1) S60\u2013S67. (https:\/\/doi.org\/10.1097\/IOP.0000000000001146)"},{"key":"bib9","series-title":"Radiology","first-page":"759","article-title":"Graves ophthalmopathy: MR imaging of the orbits","volume":"172","author":"Hosten","year":"1989","unstructured":"Hosten NSander BCordes MSchubert CJSch\u00f6rner WFelix R. Graves ophthalmopathy: MR imaging of the orbits. Radiology1989172759\u2013762. (https:\/\/doi.org\/10.1148\/radiology.172.3.2772184)"},{"key":"bib10","series-title":"Structural Chemistry","first-page":"697","article-title":"Molecular structure of hyaluronan: an introduction","volume":"19","author":"Hargittai","year":"2008","unstructured":"Hargittai IHargittai M. Molecular structure of hyaluronan: an introduction. Structural Chemistry200819697\u2013717. (https:\/\/doi.org\/10.1007\/s11224-008-9370-3)"},{"key":"bib11","series-title":"New England Journal of Medicine","first-page":"1748","article-title":"Teprotumumab for thyroid-associated ophthalmopathy","volume":"376","author":"Smith","year":"2017","unstructured":"Smith TJKahaly GJEzra DGFleming JCDailey RATang RAHarris GJAntonelli ASalvi MGoldberg RATeprotumumab for thyroid-associated ophthalmopathy. New England Journal of Medicine20173761748\u20131761. (https:\/\/doi.org\/10.1056\/NEJMoa1614949)"}],"container-title":["European Thyroid Journal"],"original-title":[],"link":[{"URL":"https:\/\/etj.bioscientifica.com\/view\/journals\/etj\/11\/5\/ETJ-22-0078.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/etj.bioscientifica.com\/downloadpdf\/journals\/etj\/11\/5\/ETJ-22-0078.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/etj.bioscientifica.com\/downloadpdf\/journals\/etj\/11\/5\/ETJ-22-0078.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:51:37Z","timestamp":1784555497000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/etj\/article\/2821"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,1]]},"references-count":11,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.1530\/etj-22-0078","relation":{},"ISSN":["2235-0802"],"issn-type":[{"value":"2235-0802","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,1]]}}}