Prophylaxis against Exophthalmos or its Progression in Newly-Treated Thyrotoxicosis

Abstract

Exophthalmos usually did not appear nor did pre-existent exophthalmos progress in thyrotoxic patients treated with desiccated thyroid in full replacement dosages, 2½ to 3 grains per day, simultaneously with thyroid blocking agent therapy, ¹³¹I administration, or thyroidectomy. Indeed, in most patients so treated, exophthalmos present prior to therapy of the hyperthyroidism decreased or disappeared. Our observations are consonant with the hypothesis that full replacement dosages of thyroid hormones started at essentially the same time that treatment of the thyrotoxic state is initiated may provide prophylaxis against the appearance or the progression of the exophthalmos which follows treatment of thyrotoxicosis. We do not intend to suggest, however, that exophthalmos which appears, progresses, or enters a malignant phase after successful treatment of hyperthyroidism at some time in the past is benefited by such treatment.

Treatment of graves' ophthalmopathy by steroid therapy, orbital radiation therapy, plasmapheresis and thyroxine replacement.

“…Dandona et al (1981) tried plasmapheresis for the treatment of exophthalmos and reported it to be effective. Danowski et al (1971) suggested that prescription of adequate doses of thyroid hormone at the time of treatment of thyrotoxicosis is beneficial. The present study reports our results with steroid therapy, supervoltage orbital radiotherapy, plasmapheresis and thyroxine replacement therapy in 13 patients with moderately severe ophthlamopathy.…”