Orbital radiotherapy for adult thyroid eye disease

Rajendram, Rathie; Bunce, Catey; Lee, Richard WJ; Morley, Susanna

doi:10.1002/14651858.cd007114

Cited by 10 publications

(8 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Orbital radiotherapy has generally been given as a total dose of 20 Gy in 2 Gy fractions over a 2–3‐week period. A Cochrane meta‐analysis has indicated that radiotherapy plus glucocorticoids produces more benefit than glucocorticoid alone 22 . Radiation retinopathy is unusual following orbital radiotherapy, but pre‐existing diabetic retinopathy is considered a contraindication.…”

Section: Therapymentioning

confidence: 99%

Medical and surgical treatment of thyroid eye disease

Hall

Topliss

2022

Internal Medicine Journal

View full text Add to dashboard Cite

Thyroid eye disease is an autoimmune inflammatory disease strongly associated with thyroid disease, principally Graves disease. It can range from mild disease requiring observation or symptomatic treatments only, through to sight‐threatening disease requiring major drug therapy and orbital surgery. Severity is graded by the NOSPECS system and activity by the clinical activity score (CAS) to assist in treatment selection. Non‐surgical management can extend from observation alone to minor therapy such as oral selenium, then glucocorticoid therapy, cyclosporin, mycophenolate, rituximab, immunoglobulin, teprotumumab, and orbital radiotherapy. High‐dose intravenous methylprednisolone therapy is used in active vision‐threatening disease with early use of tarsorrhaphy and orbital decompression. Inactive but moderate to severe disease may be treated by orbital decompression, strabismus and eyelid surgery. Systematic assessment and management by both an endocrinologist and ophthalmologist to achieve and maintain euthyroidism and select and sequence treatments according to activity and severity of thyroid eye disease gives the best results for quality of life and vision.

show abstract

Section: Therapymentioning

confidence: 99%

Medical and surgical treatment of thyroid eye disease

Hall

Topliss

2022

Internal Medicine Journal

View full text Add to dashboard Cite

show abstract

“…Results of another meta-analysis have also reassured the combination therapy (15). After looking at the risk of radiation-induced tumours, cataract, and retinopathy, a study done with 245 patients has demonstrated the safety of orbital radiotherapy for GO, except, possibly for patients who had diabetic retinopathy (16).…”

Section: References Conclusionmentioning

confidence: 99%

Graves' orbitopathy treated with immunosuppressive therapy and orbital radiotherapy in a tertiary care endocrine centre: case series

Kottahachchi

Amarawardena

Ariyawansa

et al. 2016

Sri Lanka J. Diabetes Endocrinol. Metab.

View full text Add to dashboard Cite

Graves' Orbitopathy (GO) is a localized entity of Graves' disease, which is a challenging disease to treat. We describe 6 cases of moderate to severe GO who presented to our endocrine centre, with a mean age of 48.6 years and equal gender distribution. All of them were thyrotoxic before the presentation and were treated with antithyroid drugs. CT scans of orbits in 5 patients were consistent with GO. All of the patients were treated with intravenous methylprednisolone pulse therapy for a duration of 12 weeks and orbital radiotherapy for two weeks according to European Groups on Graves' Orbitopathy (EUGOGO) guideline. All six patients went into remission and remained so after one year of follow-up. Combination therapy seems to be effective in treating moderate to severe GO.

show abstract

“…En un metaanálisis se comparó la combinación de esteroide sistémicos y radioterapia orbital vs. esteroide sistémico solo o radioterapia sola y se encontró mayor efectividad para la terapia combinada (28) . No se dispone de evidencia su�iciente para recomendar un esquema especí�ico de tratamiento, pero las guías recomiendan que la radioterapia se administre con glucocorticoide oral debido a que la evidencia de mayor calidad existe para esta combinación, aunque hay una posibilidad de utilizarla con glucocorticoides IV (1,38,39) . La radioterapia orbitaria puede considerarse como terapia de segunda línea en pacientes con intolerancia a glucocorticoides o dosis acumulada mayor de 8 g de metilprednisolona IV, control inadecuado de síntomas in�lamatorios e imposibilidad del retiro de los glucocorticoides (36) .…”

Section: Radioterapia Combinada Con Esteroides Sistémicosunclassified

Orbitopatía tiroidea: protocolo de manejo basado en revisión de la evidencia

Gómez

Imitola

Taboada

et al. 2019

Rev.ACE

View full text Add to dashboard Cite

La orbitopatía tiroidea es una patología potencialmente grave que amenaza la visión. Es la manifestación extratiroidea más frecuente de la enfermedad de Graves y, aunque la prevalencia no está evaluada en Colombia, puede producir pérdida de la visión, con consecuencias catastróficas. Teniendo en cuenta lo anterior, se realizó este trabajo con el objetivo de describir su enfoque diagnóstico y terapéutico basado en la mejor evidencia disponible. Se elaboró un protocolo de manejo aplicable a nuestro medio y se realizó una evaluación y adaptación de la guía European Group on Graves’ Orbitopathy (EUGOGO) del 2016 (1). Para la evaluación se usó la herramienta AGREE IIy se utilizó la metodología GRADE para la graduación de la calidad de la evidencia y formulación de las recomendaciones (2). Adicionalmente, se hizo una revisión sistemática de la literatura con el objetivo de evaluar la eficacia de la terapia biológica en el manejo de la orbitopatía de Graves. Se presentan las recomendaciones para el diagnóstico, tratamiento y seguimiento. Se recalca la importancia de contar con un equipo multidisciplinario con experiencia en el manejo de la orbitopatía tiroidea (endocrinología, oftalmología, cirugía de órbita, radioterapia y reumatología), idealmente en un centro de tercer nivel de atención. Es esencial la clasificación adecuada para determinar qué pacientes se benefician del tratamiento inmunosupresor. Si se maneja de forma oportuna, se puede lograr una disminución de la aparición de secuelas irreversibles

show abstract

Orbital radiotherapy for adult thyroid eye disease

Cited by 10 publications

References 22 publications

Medical and surgical treatment of thyroid eye disease

Medical and surgical treatment of thyroid eye disease

Graves' orbitopathy treated with immunosuppressive therapy and orbital radiotherapy in a tertiary care endocrine centre: case series

Orbitopatía tiroidea: protocolo de manejo basado en revisión de la evidencia

Contact Info

Product

Resources

About