Somatostatin Receptors in the Orbits

Clinical implications of somatostatin-receptor scintigraphy in ophthalmic Graves' disease

“…Similarly, Gerding et al (26) reported that visual semi-quantitative analysis of 4 h/24 h planar images during SRS was correlated with the ophthalmologic progression. Conversely, no significant correlation between the 111 In-DTPA-d-Phe 1 -octreotide activity and the degree of ophthalmopathy (determined using Werner's classification) was reported by Durak et al (24). Taken together, these studies suggested that orbital uptake of labelled octreotide can be used to determine the pathological phase of TAO.…”

“…By contrast, neither octreotide nor corticosteroids significantly improved proptosis, whereas glycosaminoglycan excretion was reduced after both treatments (35). No beneficial effects of octreotide treatment were reported by Durak et al (24) in 3 patients with active TAO, despite the use of a high dose of the drug (1 mg/day). Uysal et al (36) recently reported the effects of a 3-month treatment with octreotide at a dose of 300 mg/day in 9 patients with TAO and positive clinical activity scores and who were either unresponsive to, or unsuitable for, glucocorticoid treatment.…”

“…The future availability of somatostatin analogues labelled with 99m technetium could overcome such problems. Moreover, orbital scintigraphy with 111 In-DTPA-d-Phe 1 -octreotide is not specific, since positive scans may be obtained in patients with orbital meningioma, malignant lymphoma, pseudo-tumour orbitae, orbital myositis, sarcoidosis, Wegener's granulomatosis, necrotizing scleritis, sinusitis or infections of the nasal mucosa (24,45). Finally, orbital scintigraphy does not allow precise imaging and thus the evaluation of eye-muscle swelling and apical crowding still requires imaging with CT or MRI scans (Fig.…”

Effect of Octreotide Treatment on Graves' Ophthalmopathy.

“…Recently it was suggested that only octreotide orbital scanning (OctreoScan) positive patients benefit from this therapy [3,9,10]. On the other hand Durak et al, who used OCT in three OctreoScan positive patients, found no beneficial effect of the drug [6]. We did not perform OctreoScan in our patients, as it is expensive and time consuming.…”

“…These existing treatments are not fully satisfactory and have several major and/or minor side effects. Octreotide (OCT), a potent somatostatin analogue which has been used for the treatment of several diseases, has recently been proposed as an effective drug in the treatment of GO in some studies [1][2][3][4][5], but there is doubt about its value since it was found to be not beneficial in one study [6].…”