Endocrine Abstracts

Aim: To estimate influence of radioiodine treatment of Graves’ disease (GD) on course of Graves’ ophthalmopathy (GO).

Material and methods: 9 patients with GD and mild or moderate GO were included to the study (3 (33%) men and 6 (67%) women); the anamnesis of smoking had 4 persons (44%). Diagnosis of GO was evaluated by determination of severity and activity of disease with CAS, presents of diplopia, orbital ultrasound. CAS before radioiodine treatment (RIT) and glucocorticoid pulse – therapy was 2.7±0.7 points. The thickness of rectal extraocular muscles were (right/left eyes): upper – 5.44±0.37/5.4±0.4 mm, low – 5.6±0.3/5.5±0.08 mm, lateral – 5.1±0.3/5.1±0.3 mm, medial – 5.2±0.5/5.2±0.5 mm.

5 (55.6%) patients were underwent of prevention intravenous pulse therapy with glucocorticoids in a mean doze of 4.4±2.3 gr. This therapy was spent 0.5–1.5 months prior to RIT. CAS in all patients after pulse therapy was 1.5±0.7 points. The median of activity of 131I was 10.4 mCu.

Results: Right after treatment periorbital edema was determined in 2 cases (22%), burning of cornea – 2 (22%). All symptoms were stopped within 10 days. We did not find significant changes of eye muscles thickness.

In 1.5 months after RIT 7 (77.8%) patients were without worsening of GO. There was increasing of CAS to 2.5 points in other cases, but all these patients were hypothyroid. Symptoms of activity were decreased without additional treatment after administration of L-T4. Diplopia was kept in 1 patient without worsening.

Conclusions: After RIT worsening of GO was observed only in hypothyroid patients. In all cases it was not required to special therapy. In some cases symptomatic therapy was appointed.