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(131)I and thyroid-associated ophthalmopathy
A K Rasmussen1, B Nygaard, U Feldt-Rasmussen
1Medical Department of Endocrinology, Rigshospitalet, University of Copenhagen, Denmark. aakr@rh.dk
Objective:
Radioiodine ((131)I) used to obtain euthyroidism in thyrotoxic patients is suspected of having a worsening or provoking effect on thyroid-associated ophthalmopathy (TAO), an autoimmune disease closely related to Graves' disease.
Design:
This review summarises the existing literature and describes risk factors influencing the course of TAO including thyroid function, cigarette smoking and treatment of Graves' hyperthyroidism (especially (131)I therapy).
Conclusion:
It is recommended that patients who may be at a greater risk of worsening ophthalmopathy are considered when choosing the modality of therapy of hyperthyroidism and also in deciding whether prophylactic systemic glucocorticoid treatment is indicated.