Association between radioiodine therapy for Graves' hyperthyroidism and thyroid-associated ophthalmopathy

被引：10

作者：

El-Kaissi S. ^{[1
]}

Bowden J. ^{[1
]}

Henry M.J. ^{[1
]}

Yeo M. ^{[1
]}

Champion B.L. ^{[2
]}

Brotchie P. ^{[3
]}

Nicholson G.C. ^{[1
]}

Wall J.R. ^{[2
]}

机构：

[1] Department of Clinical and Biomedical Sciences, Barwon Health, University of Melbourne, Geelong, VIC 3220, Ryrie Street

[2] Department of Medicine, Nepean Clinical School, University of Sydney, Sydney, NSW, Derby Street

[3] Department of Radiology, Barwon Health, Geelong Hospital, Geelong, VIC, Ryrie Street

来源：

International Ophthalmology | 2010年 / 30卷 / 4期

基金：

英国医学研究理事会;

关键词：

Carbimazole; Graves' disease; Magnetic resonance imaging; Ophthalmopathy; Radioactive iodine;

D O I：

10.1007/s10792-010-9368-x

中图分类号：

学科分类号：

摘要：

To investigate the role of radioactive iodine (RAI) in the onset and progression of thyroid-associated ophthalmopathy (TAO). Forty-six Graves' disease patients with mild or no ophthalmopathy were prospectively treated with carbimazole (CBZ) (n = 22) or RAI (n = 24). Treatment effects were evaluated clinically over 12 months, and with orbital MRI-measured extra-ocular muscle (EOM) volumes at baseline and at 6 months. The diagnosisof TAO was based on the clinical activity score (CAS) system. There were 11/22 CBZ and 10/24 RAI patients with active ophthalmopathy at baseline. Despite greater mean TSH levels post-RAI (P = 0.003), there was no increase in the likelihood of developing active ophthalmopathy (OR 0.95; 95% CI 0.56-1.61, P = 0.9) or EOM dysfunction (OR 0.52; 95% CI 0.26-1.06, P = 0.074). The increased mean palpebral aperture post-RAI (P = 0.023) and greater mean proptosis in the CBZ group (P = 0.005) were not confirmed when the absolute values of these measurements were examined. There was no association between the treatment received and MRImeasured EOM volumes. In this study, RAI therapy for Graves' disease did not increase the risk of progression or development of ophthalmopathy in patients with mild or no eye disease at baseline. © Springer Science+Business Media B.V. 2010.

引用

页码：397 / 405

页数：8

共 26 条

[1]

Burch H.B., Wartofsky L., Graves' ophthalmopathy: Current concepts regarding pathogenesis and management, Endocr Rev, 14, pp. 747-793, (1993)

[2]

Tallstedt L., Lundell G., Torring O., Et al., Occurrence of ophthalmopathy after treatment for Graves' hyperthyroidism, N Engl J Med, 326, pp. 1733-1738, (1992)

[3]

Bartalena L., Marcocci C., Bogazzi F., Manetti L., Tanda M.L., Dell'Unto E., Bruno-Bossio G., Nardi M., Bartolomei M.P., Lepri A., Rossi G., Martino E., Pinchera A., Relation between therapy for hyperthyroidism and the course of Graves' ophthalmopathy, New England Journal of Medicine, 338, 2, pp. 73-78, (1998)

[4]

Gorman C.A., Offord K.P., Therapy for hyperthyroidism and Graves' ophthalmopathy, N Engl J Med, 338, pp. 1546-1547, (1998)

[5]

Werner S.C., Coelho B., Quimby E.H., Ten year results of I-131 therapy of hyperthyroidism, Bull N Y Acad Med, 33, pp. 783-806, (1957)

[6]

Calissendorff B.M., Soderstrom M., Alveryd A., Ophthalmopathy and hyperthyroidism. A comparison between patients receiving different antithyroid treatments. Acta Ophthalmol, Copenh, 64, pp. 698-703, (1986)

[7]

Manso P.G., Furlanetto R.P., Wolosker A.M., Paiva E.R., De Abreu M.T., Maciel R.M., Prospective and controlled study of ophthalmopathy after radioiodine therapy for Graves' hyperthyroidism, Thyroid, 8, pp. 49-52, (1998)

[8]

Perros P., Kendall-Taylor P., Neoh C., Frewin S., Dickinson J., A prospective study of the effects of radioiodine therapy for hyperthyroidism in patients with minimally active Graves' ophthalmopathy, J Clin Endocrinol Metab, 90, pp. 5321-5323, (2005)

[9]

Sridama V., DeGroot L.J., Treatment of Graves' disease and the course of ophthalmopathy, Am J Med, 87, pp. 70-73, (1989)

[10]

Feldt-Rasmussen U., Bech K., Date J., Petersen P.H., Johansen K., A prospective study of the differential changes in serum thyroglobulin and its autoantibodies during propylthiouracil or radioiodine therapy of patients with Graves' disease, Acta Endocrinol (Copenh), 99, pp. 379-385, (1982)

← 1 2 3 →