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[Deterioration of endocrine ophthalmology after radioiodine therapy in Graves' disease?]
A Weigand1, B Hinzpeter, H Schicha
1Klinik und Poliklinik für Nuklearmedizin der Universität zu Köln.
Aim:
Our goal was to show the development of EO in RITH and compare it with the outcome of surgery or thyreostatic therapy.
Methods:
In this study 103 cases of an RITH at 82 patients were performed. The EO findings were measured before RITH and several times afterwards by the same experienced researcher according to the following criteria: 1. subjective complaints, 2. NOSPECS-classification, 3. exophthalmometry, 4. by photo. The observation period was at least 12 months. The measured dosage to the thyroid gland was on average 210 +/- 80 Gy. In 57 cases no EO and in 46 cases an EO of grades I to IV before therapy occurred.
Results:
In 11 cases there was an improvement and in 8 cases a worsening of the EO. In 84 cases the EO findings remained unchanged. Our data pointed towards the fact that with an achieved dosage to the thyroid of less than 200 Gy, a pretherapeutic thyroid gland volume greater than 55 ml, or implementation of RITH with preexisting EO without accompaning cortison therapy can worsen the EO findings.
Conclusion:
In comparison to surgical or thyreostatic therapy there was no increased risk of EO during or subsequent to RITH under cortison.