The aftermath of orbital radiotherapy for Graves' ophthalmopathy

Colum A. Gorman, James A. Garrity, Vahab Fatourechi, Rebecca S. Bahn, Ivy A Petersen, Scott L. Stafford, John D. Earle, Glenn S. Forbes, Robert W. Kline, Helmut Buettner, Dennis M. Robertson, Erik J. Bergstralh, Kenneth P. Offord, Diana M. Rademacher, Nancy M. Stanley, George B. Bartley

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Objective: To determine whether long-term improvement could be observed after orbital radiotherapy for Graves' disease; in addition, to evaluate ancillary treatments needed for those who have received radiotherapy, to search for late-emerging adverse consequences of radiotherapy, and to relate orbital changes to serum levels of thyroid-stimulating immunoglobulin (TSI). Design: Three-year follow-up of noncomparative interventional case series. Participants. Forty-two patients. Intervention. All patients had received orbital radiotherapy within 6 months of study entry. Twelve months after study entry, patients were free to select any additional treatment for their ophthalmopathy. Main Outcome Measures. Need for surgery, steroid therapy, volume of extraocular muscles and fat, proptosis, area of diplopia fields and range of extraocular muscle motion, volume changes after decompression and correlations of eye findings with serum TSI levels, retinal status. Results: Half of the patients elected to have a surgical procedure on their eyes or orbits. Among patients who were not decompressed, we found only slight improvement in some of the main outcome measures. TSI did not positively correlate with baseline status or with any observed change in major outcome measures. After orbital decompression, the volumes of both muscle and fat increase, but bony orbital volume increases more and proptosis diminishes. Retinal microvascular abnormalities consistent with radiation retinopathy developed de novo in five eyes of three patients within 3 years of radiation therapy. Conclusions: In this 3-year uncontrolled follow-up phase, limited evidence for a clinically significant improvement was observed, which may be the result of treatment or of natural remission. In either case, the changes are of little clinical significance. Because it is neither effective nor innocuous, radiotherapy does not seem to be indicated for treatment of mild to moderate ophthalmopathy.

Original languageEnglish (US)
Pages (from-to)2100-2107
Number of pages8
JournalOphthalmology
Volume109
Issue number11
DOIs
StatePublished - Nov 1 2002

Fingerprint

Graves Ophthalmopathy
Radiotherapy
Thyroid-Stimulating Immunoglobulins
Oculomotor Muscles
Exophthalmos
Outcome Assessment (Health Care)
Decompression
Fats
Therapeutics
Diplopia
Graves Disease
Orbit
Serum
Steroids
Radiation
Muscles

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Gorman, C. A., Garrity, J. A., Fatourechi, V., Bahn, R. S., Petersen, I. A., Stafford, S. L., ... Bartley, G. B. (2002). The aftermath of orbital radiotherapy for Graves' ophthalmopathy. Ophthalmology, 109(11), 2100-2107. https://doi.org/10.1016/S0161-6420(02)01293-9

The aftermath of orbital radiotherapy for Graves' ophthalmopathy. / Gorman, Colum A.; Garrity, James A.; Fatourechi, Vahab; Bahn, Rebecca S.; Petersen, Ivy A; Stafford, Scott L.; Earle, John D.; Forbes, Glenn S.; Kline, Robert W.; Buettner, Helmut; Robertson, Dennis M.; Bergstralh, Erik J.; Offord, Kenneth P.; Rademacher, Diana M.; Stanley, Nancy M.; Bartley, George B.

In: Ophthalmology, Vol. 109, No. 11, 01.11.2002, p. 2100-2107.

Research output: Contribution to journalArticle

Gorman, CA, Garrity, JA, Fatourechi, V, Bahn, RS, Petersen, IA, Stafford, SL, Earle, JD, Forbes, GS, Kline, RW, Buettner, H, Robertson, DM, Bergstralh, EJ, Offord, KP, Rademacher, DM, Stanley, NM & Bartley, GB 2002, 'The aftermath of orbital radiotherapy for Graves' ophthalmopathy', Ophthalmology, vol. 109, no. 11, pp. 2100-2107. https://doi.org/10.1016/S0161-6420(02)01293-9
Gorman, Colum A. ; Garrity, James A. ; Fatourechi, Vahab ; Bahn, Rebecca S. ; Petersen, Ivy A ; Stafford, Scott L. ; Earle, John D. ; Forbes, Glenn S. ; Kline, Robert W. ; Buettner, Helmut ; Robertson, Dennis M. ; Bergstralh, Erik J. ; Offord, Kenneth P. ; Rademacher, Diana M. ; Stanley, Nancy M. ; Bartley, George B. / The aftermath of orbital radiotherapy for Graves' ophthalmopathy. In: Ophthalmology. 2002 ; Vol. 109, No. 11. pp. 2100-2107.
@article{f9784cc1126648f5ae2b651b247deb92,
title = "The aftermath of orbital radiotherapy for Graves' ophthalmopathy",
abstract = "Objective: To determine whether long-term improvement could be observed after orbital radiotherapy for Graves' disease; in addition, to evaluate ancillary treatments needed for those who have received radiotherapy, to search for late-emerging adverse consequences of radiotherapy, and to relate orbital changes to serum levels of thyroid-stimulating immunoglobulin (TSI). Design: Three-year follow-up of noncomparative interventional case series. Participants. Forty-two patients. Intervention. All patients had received orbital radiotherapy within 6 months of study entry. Twelve months after study entry, patients were free to select any additional treatment for their ophthalmopathy. Main Outcome Measures. Need for surgery, steroid therapy, volume of extraocular muscles and fat, proptosis, area of diplopia fields and range of extraocular muscle motion, volume changes after decompression and correlations of eye findings with serum TSI levels, retinal status. Results: Half of the patients elected to have a surgical procedure on their eyes or orbits. Among patients who were not decompressed, we found only slight improvement in some of the main outcome measures. TSI did not positively correlate with baseline status or with any observed change in major outcome measures. After orbital decompression, the volumes of both muscle and fat increase, but bony orbital volume increases more and proptosis diminishes. Retinal microvascular abnormalities consistent with radiation retinopathy developed de novo in five eyes of three patients within 3 years of radiation therapy. Conclusions: In this 3-year uncontrolled follow-up phase, limited evidence for a clinically significant improvement was observed, which may be the result of treatment or of natural remission. In either case, the changes are of little clinical significance. Because it is neither effective nor innocuous, radiotherapy does not seem to be indicated for treatment of mild to moderate ophthalmopathy.",
author = "Gorman, {Colum A.} and Garrity, {James A.} and Vahab Fatourechi and Bahn, {Rebecca S.} and Petersen, {Ivy A} and Stafford, {Scott L.} and Earle, {John D.} and Forbes, {Glenn S.} and Kline, {Robert W.} and Helmut Buettner and Robertson, {Dennis M.} and Bergstralh, {Erik J.} and Offord, {Kenneth P.} and Rademacher, {Diana M.} and Stanley, {Nancy M.} and Bartley, {George B.}",
year = "2002",
month = "11",
day = "1",
doi = "10.1016/S0161-6420(02)01293-9",
language = "English (US)",
volume = "109",
pages = "2100--2107",
journal = "Ophthalmology",
issn = "0161-6420",
publisher = "Elsevier Inc.",
number = "11",

}

TY - JOUR

T1 - The aftermath of orbital radiotherapy for Graves' ophthalmopathy

AU - Gorman, Colum A.

AU - Garrity, James A.

AU - Fatourechi, Vahab

AU - Bahn, Rebecca S.

AU - Petersen, Ivy A

AU - Stafford, Scott L.

AU - Earle, John D.

AU - Forbes, Glenn S.

AU - Kline, Robert W.

AU - Buettner, Helmut

AU - Robertson, Dennis M.

AU - Bergstralh, Erik J.

AU - Offord, Kenneth P.

AU - Rademacher, Diana M.

AU - Stanley, Nancy M.

AU - Bartley, George B.

PY - 2002/11/1

Y1 - 2002/11/1

N2 - Objective: To determine whether long-term improvement could be observed after orbital radiotherapy for Graves' disease; in addition, to evaluate ancillary treatments needed for those who have received radiotherapy, to search for late-emerging adverse consequences of radiotherapy, and to relate orbital changes to serum levels of thyroid-stimulating immunoglobulin (TSI). Design: Three-year follow-up of noncomparative interventional case series. Participants. Forty-two patients. Intervention. All patients had received orbital radiotherapy within 6 months of study entry. Twelve months after study entry, patients were free to select any additional treatment for their ophthalmopathy. Main Outcome Measures. Need for surgery, steroid therapy, volume of extraocular muscles and fat, proptosis, area of diplopia fields and range of extraocular muscle motion, volume changes after decompression and correlations of eye findings with serum TSI levels, retinal status. Results: Half of the patients elected to have a surgical procedure on their eyes or orbits. Among patients who were not decompressed, we found only slight improvement in some of the main outcome measures. TSI did not positively correlate with baseline status or with any observed change in major outcome measures. After orbital decompression, the volumes of both muscle and fat increase, but bony orbital volume increases more and proptosis diminishes. Retinal microvascular abnormalities consistent with radiation retinopathy developed de novo in five eyes of three patients within 3 years of radiation therapy. Conclusions: In this 3-year uncontrolled follow-up phase, limited evidence for a clinically significant improvement was observed, which may be the result of treatment or of natural remission. In either case, the changes are of little clinical significance. Because it is neither effective nor innocuous, radiotherapy does not seem to be indicated for treatment of mild to moderate ophthalmopathy.

AB - Objective: To determine whether long-term improvement could be observed after orbital radiotherapy for Graves' disease; in addition, to evaluate ancillary treatments needed for those who have received radiotherapy, to search for late-emerging adverse consequences of radiotherapy, and to relate orbital changes to serum levels of thyroid-stimulating immunoglobulin (TSI). Design: Three-year follow-up of noncomparative interventional case series. Participants. Forty-two patients. Intervention. All patients had received orbital radiotherapy within 6 months of study entry. Twelve months after study entry, patients were free to select any additional treatment for their ophthalmopathy. Main Outcome Measures. Need for surgery, steroid therapy, volume of extraocular muscles and fat, proptosis, area of diplopia fields and range of extraocular muscle motion, volume changes after decompression and correlations of eye findings with serum TSI levels, retinal status. Results: Half of the patients elected to have a surgical procedure on their eyes or orbits. Among patients who were not decompressed, we found only slight improvement in some of the main outcome measures. TSI did not positively correlate with baseline status or with any observed change in major outcome measures. After orbital decompression, the volumes of both muscle and fat increase, but bony orbital volume increases more and proptosis diminishes. Retinal microvascular abnormalities consistent with radiation retinopathy developed de novo in five eyes of three patients within 3 years of radiation therapy. Conclusions: In this 3-year uncontrolled follow-up phase, limited evidence for a clinically significant improvement was observed, which may be the result of treatment or of natural remission. In either case, the changes are of little clinical significance. Because it is neither effective nor innocuous, radiotherapy does not seem to be indicated for treatment of mild to moderate ophthalmopathy.

UR - http://www.scopus.com/inward/record.url?scp=0036841646&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036841646&partnerID=8YFLogxK

U2 - 10.1016/S0161-6420(02)01293-9

DO - 10.1016/S0161-6420(02)01293-9

M3 - Article

VL - 109

SP - 2100

EP - 2107

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

IS - 11

ER -