J Korean Soc Pediatr Endocrinol Search


Ann Pediatr Endocrinol Metab > Accepted Articles
DOI: https://doi.org/10.6065/apem.2346118.059    [Accepted] Published online January 29, 2024.
Orbital apex syndrome in pediatric thyroid eye disease: A case report and literature review
Hyun ji Jang, Ha young Jo 
Department of Pediatrics, Pusan National University Hospital, Busan, Korea
Address for correspondence:  Ha young Jo
Email: gocaki_@naver.com
Received: May 24, 2023   Revised: July 31, 2023   Accepted: August 14, 2023
Thyroid eye disease is an autoimmune disorder with clinical manifestations including lid retraction, proptosis, decreased visual acuity, and strabismus, and an incidence rate of 0.79 to 6.5 cases per 100,000 children. While reports are rare, the symptoms of thyroid eye disease in children have been found to be similar to those in adults, although typically milder. A 17-year-old girl presented with diplopia and hypoesthesia of the left forehead. Other clinical symptoms included mildly reduced visual acuity, restricted ocular movement, ptosis, and lid edema of the left eye. On the basis of blood tests, including a thyroid function test, Graves’ disease was diagnosed, and a complication of Graves’ disease was conjectured to have caused orbital apex syndrome due to thyroid eye disease, characterized by the involvement of cranial nerves II, III, IV, and VI, and the ophthalmic division of cranial nerve V. Following steroid pulse therapy, ophthalmic symptoms improved, and the patient is currently taking the antithyroid agent methimazole. To the best of our knowledge, this is the first report to describe orbital apex syndrome in pediatric thyroid eye disease, and the presented data will contribute to the future analysis of the clinical features of atypical pediatric thyroid eye disease.
Keywords: Thyroid eye disease; Graves Ophthalmopathy; Graves’ disease; Strabismus; Pediatric


Browse all articles >

Editorial Office
501-107, 30 Seocho-daero 74-gil, Seocho-gu, Seoul 06622, Republic of Korea
Tel: +82-2-3471-4268    Fax: +82-2-3471-4269    E-mail: editor@e-apem.org                

Copyright © 2024 by Korean Society of Pediatric Endocrinology.

Developed in M2PI

Close layer
prev next