Reactivation of Graves’ Orbitopathy after Rehabilitative Orbital Decompression

Consensus statement of the European Group on Graves' orbitopathy (EUGOGO) on management of GO

“…However, orbital decompression can be considered also in patients with active GO who are intolerant or nonresponsive to GCs, if waiting for spontaneous inactivation of GO can potentially be hazardous for visual function. † Almost all studies show the efficacy and relative safety of orbital decompression (46,(94)(95)(96)(97)(98)(99)(100)(101); however, the available studies do not allow any meaningful comparison of the available techniques (93,94,100,101). † Eye muscle and lid surgeries are effective treatments for correcting diplopia and improving lid function and appearance.…”

“…Does orbital decompression compromise subsequent non-surgical therapy? † In the rare event of reactivation of GO after rehabilitative surgery, systemic GCs, and/or OR can be used with the usual expected efficacy (99). (77,78,80,81), at least using a 20 Gy cumulative dose.…”

Consensus Statement of the European Group on Graves' Orbitopathy (EUGOGO) on Management of Graves' Orbitopathy

“…In the rare event of reactivation of GO after rehabilitative surgery, systemic GCs and=or OR can be used with the usual expected efficacy (99).…”

Is Recombinant Human TSH a Trigger for Graves’ Orbitopathy?

“…In our cases, reactivation of GO after rhTSH occurred 18 months (cases 1 and 2) and 5 years (case 3) after the first manifestation of GO. Late reactivation of orbitopathy (after more than 5 years of quiescent disease), is an uncommon phenomenon, but occasionally occurs under euthyroid conditions with no obvious risk factors [23,24,25]. Franzco et al [26] reported an incidence of 5% (8/193 patients), with a mean time interval of 12 years.…”