Antioxidant agents in the treatment of Graves' ophthalmopathy

To report the effect of antioxidant agents in the treatment of mild and moderately severe Graves' ophthalmopathy.

Prospective, nonrandomized, comparative study performed at a referral center. A series of 11 patients with mild or moderately severe, active, newly diagnosed Graves' ophthalmopathy were included in the study. Allopurinol (300 mg daily) orally and nicotinamide (300 mg daily) orally were used for 3 months. A complete ophthalmologic examination was performed before and 1 and 3 months after initiation of treatment. The response to treatment was estimated separately for each component of the disease and overall by its effect on a total eye score. Eleven patients with mild or moderately severe, active, newly diagnosed Graves' ophthalmopathy who received placebo were also examined at the same time points. Patients in each group were recruited consecutively. Although nonsmoking was not an exclusion criterion, all patients were cigarette smokers.

Nine (82%) of 11 patients treated with oral antioxidants showed improvement of mild to moderately severe Graves' ophthalmopathy versus three (27%) of 11 patients in the control group (P <.05). Soft tissue inflammation was the component of the disease that responded more to treatment. No side effects of antioxidant treatment were recorded. Patients' satisfaction was high.

This pilot study presents encouraging results in the treatment of mild and moderately severe Graves' ophthalmopathy with antioxidant agents. To evaluate these preliminary results, randomized prospec-tive studies are needed.