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


Oto B., ÇOLPAN ÖKSÜZ D., sert s., UZEL Ö. E., Sarici A. M.

Dicle Tıp Dergisi, cilt.50, sa.2, ss.149-155, 2023 (TRDizin) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 50 Sayı: 2
  • Basım Tarihi: 2023
  • Doi Numarası: 10.5798/dicletip.1313177
  • Dergi Adı: Dicle Tıp Dergisi
  • Derginin Tarandığı İndeksler: TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.149-155
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

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 (41%) and 17 were male (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 (P <0.05). 14 eyes (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 (61%) patients reported an improvement in diplopia after treatment (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.