[Development of endocrine orbitopathy in pregnancy]

A report is given on an endocrine orbitopathy in a 24-year-old female in which the disease deteriorated from the 3rd month of pregnancy, with a severe restriction of motility, exophthalmia (Hertel exophthalmometer both eyes 28 mm), severe visual field defects and a decrease of visual acuity to 20/200 both eyes. Therefore--despite of certain restraints of the pharmacologic therapy during pregnancy--glucocorticoid-treatment was started. After delivery, the condition deteriorated, despite of a higher steroid dose. Therefore, a retrobulbar irradiation was begun on the 12th day post partum (telecobalt 10 Gy). From that time on all signs improved over the next months (visual acuity 20/25; exophthalmometer both eyes 20 mm, normal visual field). In the literature, endocrine orbitopathy (Graves' ophthalmopathy) during pregnancy has been mentioned sporadically, but to our knowledge such a severe case, as reported here, has not been described before.