title: The Effect of Systemic Steroids and Orbital Radiation for Active Graves Orbitopathy on Postdecompression Extraocular Muscle Volume.
abstract: OBJECTIVE
  To evaluate the effect of orbital radiation prior to surgery on the clinical course and extraocular muscle (EOM) radiologic volume changes after decompression in Graves orbitopathy (GO).
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  The medical records of patients treated with orbital decompression for GO and who underwent postoperative orbital computed tomography were reviewed. Only patients who underwent rehabilitative decompression in the inactive phase and who received systemic corticosteroids alone (ST group) or combined orbital radiation and systemic corticosteroids (SRT group) in the active inflammatory phase of the disease were selected. The main outcome measure was the comparison of preoperative and postoperative EOM volumes. Secondary outcome measures were changes in proptosis and diplopia after decompression.
  
  
  RESULTS
  Thirty-seven of 114 patients were selected for this study. There were no differences between the ST group (n = 22, 42 eyes) and SRT group (n = 15, 30 eyes) in terms of demographics or predecompression characteristics. After decompression surgery, the total EOM volume significantly increased by 15% in the ST group, but radiated EOMs in the SRT group did not expand, resulting in decreased induction of postoperative diplopia. The percentages of patients showing increased diplopia after decompression differed significantly between the groups (ST group, 40.9% vs SRT group, 13.3%, P = .04). However, there was no difference in exophthalmos reduction after decompression between the 2 groups.
  
  
  CONCLUSIONS
  Orbital radiation prior to orbital decompression can reduce both the postoperative increase in EOM volume and deterioration in diplopia.
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, KonYang University College of Medicine, Daejon, South Korea.
authors.forename: Ka Hyun
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Woo
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jinna
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Ki Chang
authors.initials: KC
authors.lastname: Keum
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: yoonjs@yuhs.ac.
authors.forename: Jin Sook
authors.initials: JS
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D049970:Graves Ophthalmopathy / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000000981:diagnostic imaging*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D009915:Orbit / Q000000981:diagnostic imaging / Q000528:radiation effects*; D009929:Organ Size; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids