Treatment of Graves’ Ophthalmopathy by Retrobulbar Corticosteroids Associated With Orbital Cobalt Radiotherapy
Combined therapy with systemic corticosteroids and orbital cobalt radiotherapy (RT) has proven an effective method for treatment of severe Graves’ ophthalmopathy (1). The use of large doses of systemic corticosteroids is potentially risky. In more than 100 patients treated so far at our Institution with systemic corticosteroids either alone or in combination with radiotherapy, relevant side effects have been observed in 4 cases: one patient had an increase of intraocular tension, one showed depressive psychosis, one developed diabetic syndrome requiring insulin, and one had infective encephalitis within the first month of treatment (2). This prompted us to assess the therapeutic effectiveness of retrobulbar long-acting corticosteroids (RBC) in substitution for systemic corticosteroids in the combined therapy in a group of 44 consecutive patients with active Graves’ ophthalmopathy.
KeywordsCobalt Corticosteroid Neuropathy Encephalitis Methylprednisolone
Unable to display preview. Download preview PDF.
- 1.L. Bartalena, C. Marcocci, L. Chiovato, M. Laddaga, G. Lepri, D. Andreani, G. Cavallacci, L. Baschieri, and A. Pinchera, Orbital cobalt irradiation combined with systemic corticosteroids for Graves’ ophthalmopathy: comparison with systemic corticosteroids alone, J. Clin. Endocrinol. Metab. 56:1139 (1983).PubMedCrossRefGoogle Scholar
- 2.A. Pinchera, L. Bartalena, L. Chiovato, and C. Marcocci, Radiotherapy of Graves’ ophthalmopathy, in.: “The Eye and Orbit in Thyroid Disease”, C.A. Gorman, R.R. Waller, and J.A. Dyer, eds., Raves Press, New York, p. 301, (1984).Google Scholar
- 4.I.D. Thomas and J.K. Hart, Retrobulbar repository corticosteroid therapy in thyropid ophthalmopathy, Med. J. Austl. 2:484 (1974).Google Scholar
- 7.C. Marcocci, L. Bartalena, M. Panicucci, C. Marconcini, F. Cartei, G. Cavallacci, M. Laddaga, G. Campobasso, L. Baschieri, and A. Pinchera, Orbital cobalt irradiation combined with retrobulbar or systemic corticosteroids for Graves’ ophthalmopathy: a comparative study, Clin. Endocrinol.(Oxf) in pressGoogle Scholar