Identification of a subgroup of Graves’ disease patients at higher risk for severe ophthalmopathy after radioiodine

Barth, Andreas; Probst, Philipp; Bürgi, H

doi:10.1007/bf03346790

Cited by 33 publications

(13 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This observation has been confirmed subsequently by other authors (48,49), including ourselves in a prospective study (50,51). However, this view is not shared by all authors (30,33,52,53) (Table 1).…”

Section: Radioiodine Treatmentsupporting

confidence: 67%

Relationship Between Graves' Ophthalmopathy and Type of Treatment of Graves' Hyperthyroidism

Marcocci

Bartalena²,

Bogazzi³

et al. 1992

Thyroid

View full text Add to dashboard Cite

The relationship between the treatment of Graves' hyperthyroidism and the course of ophthalmopathy is rather unclear. Antithyroid drugs may improve eye manifestations, possibly by restoring normal thyroid function and reducing orbit-directed autoimmune reactions, whereas ophthalmopathy may worsen after radioiodine administration or thyroidectomy. This might occur because of a treatment-related release of thyroid antigens and activation of the autoimmune response that might involve the orbit. On the other hand, some authors suggest that complete thyroid ablation, either by radioiodine or surgery, might be beneficial for ophthalmopathy. However, reported effects of radioiodine and thyroidectomy on Graves' ophthalmopathy are conflicting. This may be due, at least in part, to the retrospective feature of most studies and the lack of precise evaluation of ocular involvement. Two prospective studies were performed in which patients with Graves' disease with mild or no ophthalmopathy were randomly assigned to treatment by radioiodine or subtotal thyroidectomy alone or in association with systemic glucocorticoids. Both treatments were followed by a progression of pre-existing mild ophthalmopathy in a substantial proportion of cases: glucocorticoids prevented such an exacerbation. Ophthalmopathy did not develop in patients without clinical evidence of eye disease prior to therapy. Therefore, it is recommended that a course of glucocorticoids be instituted concomitantly with radioiodine therapy or thyroidectomy in Graves' patients with some degree of ocular involvement.

show abstract

Section: Radioiodine Treatmentsupporting

confidence: 67%

Relationship Between Graves' Ophthalmopathy and Type of Treatment of Graves' Hyperthyroidism

Marcocci

Bartalena²,

Bogazzi³

et al. 1992

Thyroid

View full text Add to dashboard Cite

show abstract

“…In addition, these changes were transient as at the conclusion of the study the increase in CAS readings had subsided in the majority of patients and only 27.3% CBZ patients and 21.4% RAI patients had persistently active disease. This observation is in contrast to previous studies showing [3,17]. The reason for these findings is unclear but one possible explanation is delayed onset of ophthalmopathy as it is well documented that up to 40% of patients are diagnosed with TAO after the onset of hyperthyroidism [1].…”

Section: Discussioncontrasting

confidence: 84%

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

et al. 2010

View full text Add to dashboard Cite

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 diagnosis of 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 MRI-measured 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.

show abstract

“…Some retrospective studies did report an association but others did not [1][2][3][4][5][6][7][8]. A systematic review was conducted and showed that RAI for Graves' disease was associated with increased risk of occurrence or progression of ophthalmopathy when compared with ATD or surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The development of Graves' ophthalmopathy post radioiodine treatment for multi-nodular goiter (toxic or nontoxic) has been rarely described [11][12][13]. Presence of TRAb has been described in 15% -52% of patients with toxic and non-toxic nodular goiter [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. It is possible that such patients may be harboring sub-clinical Grave's disease which may be uncovered after radio-iodine therapy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Grave’s Eye Ophthalmopathy Developing Following Radioiodine Therapy for Toxic Adenoma

Ahmadieh¹,

Salti²

2013

OJEMD

View full text Add to dashboard Cite

The development of Grave's ophthalmopathy following radioiodine treatment for Grave's disease is well recognized. However, development of Grave's ophthalmopathy following radioiodine therapy given for toxic adenoma or toxic nodular goiter has been reported but very rarely. Hereby, we reported a case of a 69-year-old male patient who developed ophthalmopathy after receiving 30 mCi (1110 mBq) 131 I radioiodine treatment for a toxic nodule. In addition, a review of the current literature with regards to this topic is presented.

show abstract

Identification of a subgroup of Graves’ disease patients at higher risk for severe ophthalmopathy after radioiodine

Cited by 33 publications

References 13 publications

Relationship Between Graves' Ophthalmopathy and Type of Treatment of Graves' Hyperthyroidism

Relationship Between Graves' Ophthalmopathy and Type of Treatment of Graves' Hyperthyroidism

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

Grave’s Eye Ophthalmopathy Developing Following Radioiodine Therapy for Toxic Adenoma

Contact Info

Product

Resources

About