Clinical Results of Combined Systemic Steroid and Retroorbital Radiotherapy Treatment in Active Thyroid Associated Ophthalmopathy

Authors : Bilge BATU OTO, Didem COLPAN OKSUZ, Seda SERT, Omer Erol UZEL, Ahmet Murat SARİCİ

Pages : 149-155

Doi:10.5798/dicletip.1313177

View : 34 | Download : 35

Publication Date : 2023-06-12

Article Type : Research Paper

Abstract :Objective: The aim of this study is to evaluate the efficacy of a different steroid dosage protocol which consists of intravenous pulse methylprednisolone combined with retroorbital radiotherapy in the treatment of active thyroid associated ophthalmopathy. Methods: The medical records of 29 patients who were treated with a standard protocol and who were followed-up for at least 6 months were retrospectively analyzed. The treatment protocol consisted of intravenous pulse methylprednisolone 1gram/day for 3 consecutive days, followed by retroorbital radiotherapy. Oral prednisolone which was tapered over a 3-month course was given as a maintenance dose. Results: 58 eyes of 29 patients were included in the study. Twelve patients were female insert ignore into journalissuearticles values(41%); and 17 were male insert ignore into journalissuearticles values(59%); with a mean age of 47.7 ± 12.6 years. The clinical activity score was 4.8 ± 1.3 and 2.8 ± 1.2, before and after treatment, respectively insert ignore into journalissuearticles values(P <0.05);. 14 eyes insert ignore into journalissuearticles values(31%); had an improvement in best corrected visual acuity. In 28 eyes with had proptosis, proptosis regressed after treatment. Among 21 patients with diplopia, 13 insert ignore into journalissuearticles values(61%); patients reported an improvement in diplopia after treatment insert ignore into journalissuearticles values(P <0.05);. None of our patients had any adverse event due to systemic steroid and retroorbital radiotherapy. Conclusions: Pulse intravenously applied methylprednisolone for 3 days as 1 gram/day, combined with retroorbital radiotherapy proved to be effective in control of moderate to severe and active thyroid associated ophthalmopathy. In the 6-month follow-up significant decrease in clinical activity score and improvement in diplopia was observed in addition to improvement in best corrected visual acuity.
Keywords : Orbital radiotherapy, Thyroid ophthalmopathy, Graves disease