[Effectiveness of treatment for thyroid orbitopathy in patients hospitalized at the Endocrinology Department of Pomeranian Medical University].
The aim of the present study is the assessment of efficacy of systemic corticosteroid treatment combined with orbital radiotherapy in patients with thyroid ophthalmopathy.


METHODS
101 patients hospitalized in the Endocrinology Department of the Pomeranian Medical University in the years 1999-2002.


METHODS
During first stage of treatment 3 to 6-7 intravenous pulses of methylprednisolone (SoluMedrol Pharmacia & Upjohn) in a dose of 1.0 g/day in consecutive 3 days were administered in combination with radiotherapy of the retroorbital spaces. Ten daily doses of 200 cGy using X-ray to each retroorbital space were given between the 2-nd to 4-th SoluMedrol pulse. Prednisone (Encorton Polfa) at an initial dose of 60 mg/day was used during the second stage of therapy.


RESULTS
Donaldson's ophthalmopathy index scored for each eye separately decreased significantly after both stages of treatment (right eye: 6.35 (before treatment); 2.25 (after first stage), 1.2 (after second stage), p<0.05; left eye: 6.1 (before treatment); 2.1 (after first stage); 1.15 (after second stage), p<0.05). The clinical picture of Graves ophthalmopahty after the end of therapy in most of patients was significantly improved. Persistent diplopia was found in 16/101 patients. Two of them were referred for surgical correction of abnormal eyeball fixation, the rest were using prismatic glasses. Until now, no recurrence of thyroid eye disease in treated patients was observed.


CONCLUSIONS
Combined therapy is an effective method of treatment of Graves' ophtahlmopathy in terms of both rapid regression of inflammatory changes in orbital soft tissues and in prevention of recurrence of the disease.
Kulig
Grzegorz
G
Klinika Endokrynologii, Nadciśnienia Tetniczego i Chorób Przemiany Materii Pomorskiej Akademii Medycznej w Szczecinie.
Kaźmierczyk-Puchalska
Agnieszka
A
Krzyzanowska-Swiniarska
Barbara
B
Pilarska
Krystyna
K
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D006111:Graves Disease / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D020551:Pulse Therapy, Drug; D011829:Radiation Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone