Radiotherapy for thyroid orbitopathy. Effects on extraocular muscle balance

Area of Science:

• Ophthalmology
• Endocrinology
• Radiation Oncology

Background:

• Graves' orbitopathy frequently causes restrictive ophthalmopathy and strabismus, impacting patient quality of life.
• Motility disturbances are a common and challenging complication of thyroid eye disease.

Purpose of the Study:

• To evaluate the efficacy of radiotherapy in managing restrictive ophthalmopathy and strabismus associated with Graves' orbitopathy.
• To assess the functional outcomes of radiotherapy for motility disturbances in thyroid eye disease.

Main Methods:

• A prospective study involving 33 patients with thyroid orbitopathy and motility disturbances.
• Quantitative measurements of ocular restrictions and deviations were performed before and at 1 and 6 months post-radiotherapy.
• Serial assessments included maximal ductions and ocular deviations in primary and reading gazes.

Main Results:

• Statistically significant improvements were observed in gaze restriction, particularly supraduction.
• Significant improvements in both vertical and horizontal strabismus were noted after radiotherapy.
• While motility disturbances improved, functional gains for restrictive ophthalmopathy and strabismus were limited.

Conclusions:

• Radiotherapy can lead to statistically significant improvements in motility disturbances in Graves' orbitopathy.
• The functional improvement of restrictive ophthalmopathy and strabismus after radiotherapy alone is often suboptimal.
• Radiotherapy's utility may be limited as a standalone treatment for diplopia in this patient population.