REGRESSION OF OPHTHALMOPATHY IN GRAVES‘ DISEASE FOLLOWING THYROIDECTOMY A systematic study of changes of ocular signs

Marushak, Danuta; Faurschou, Svend; Blichert-Toft, M

doi:10.1111/j.1755-3768.1984.tb05805.x

Cited by 9 publications

(4 citation statements)

References 18 publications

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“…Ablation of the thyroid gland, either surgically or by radioiodine, seems to be the most disputed method. Catz [12], Gwinup and associates [13], and Marushak and colleagues [14] evaluated improvement of endocrine ophthalmopathy after thyroid ablation. According to Levitt and coworkers [15], who examined 19 patients, subtotal thyroidectomy has no significant effect on ophthalmopathy.…”

Section: Discussionmentioning

confidence: 99%

The influence of surgery on endocrine ophthalmopathy

Frilling

Grußendorf

et al. 1990

World j. surg.

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Since the pathogenesis of endocrine ophthalmopathy is unclear, there has been little agreement on the treatment of the disease. The influence of thyroid surgery on endocrine ophthalmopathy is controversial. To evaluate the effect of thyroid surgery on the course of the disease, we developed a special ophthalmopathy index. As a standard procedure, subtotal thyroidectomy with thyroid remnants of 3-5 g was performed. A total of 176 patients with Graves' disease underwent the above treatment between 1986 and 1988. In 78 patients suffering from concomitant endocrine ophthalmopathy, ocular status was examined prior to operation and postoperatively. The history of endocrine ophthalmopathy had been present less than 2 years preoperatively in 74% of the patients. Follow-up ranged from 6 to 36 months. Postoperatively, 54 (69%) patients showed a marked improvement of their eye symptoms. In 18 (23%), there was no change and, in 6 (8%) patients, the severity of the eye symptoms increased after the operation. As a result of these data, a cautious and preliminary conclusion may be justified--that subtotal thyroidectomy may have a positive effect on endocrine ophthalmopathy.

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Section: Discussionmentioning

confidence: 99%

The influence of surgery on endocrine ophthalmopathy

Frilling

Grußendorf

et al. 1990

World j. surg.

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“…Three of them had nodular goitre and 12 had diffuse hyperplastic goitre on clinical examination. The mean follow-up duration was 17.4 months (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). According to WHO grading, 4 patients had grade 1 goitre and 11 had grade 2 and 3 goitres.…”

Section: Resultsmentioning

confidence: 99%

“…The three principal options for ensuring euthyroidism are antithyroid drugs, radioiodine therapy and surgical thyroidectomy, of which the latter two are ablative therapies. Ablative therapies often constitute the definitive therapy for Graves' disease [22], as the antithyroid drug treatment is associated with side effects, drug non-compliance and higher relapse rates [23]. Moreover, the ablative therapy destroys or removes the thyroid gland, thereby reducing autoimmunity, which could contribute to reversal of autoimmune manifestations.…”

Section: Discussionmentioning

confidence: 99%

Regression of Ophthalmopathic Exophthalmos in Graves’ Disease After Total Thyroidectomy: a Prospective Study of a Surgical Series

Bhargav¹,

Mayilvaganan

Kumar

et al. 2016

Indian J Surg

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Autoimmune ophthalmopathy is one of the salient clinical features associated with Graves' disease. Exophthalmos is one of the commonest manifestations of Graves' associated ophthalmopathy. It is reported to regress after thyroidectomy favourably compared to radioiodine or antithyroid drug therapy. In this context, we present our experience based on a surgical series of Graves' disease. This is a prospective study of 15 patients of Graves' disease associated with ophthalmopathic exophthalmos. Preoperative and monthly postoperative evaluation of exophthalmos was done with Hertel's exophthalmometer, apart from documenting lid, extra-ocular muscle and orbital involvement. The minimum follow-up of the cohort was 12 months. The female to male ratio was 12:3 and the mean age of the subjects was 33.4 years (18-55). Exophthalmos was bilateral in 13 and unilateral in 2 patients. All the 15 patients underwent total thyroidectomy without any major morbidity. Exophthalmos regressed in 12 patients at a mean follow-up of 15.6 ± 6.4 months (14-38) and was static in 3. None of the cases had worsened ophthalmopathy at the final follow-up. Mean regression of exophthalmos was 2.1 mm (1-5). The regression was statistically significant at value = 0.035. Surgery has a positive impact on the regression of ophthalmopathic exophthalmos associated with Graves' disease.

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“…This has also been a problem in other studies and may explain some of the disparate results. Some studies indicate that progressive endocrine ophthalmopathy is less frequent with drug antithyroid treatment (Beierwalter 1948;Werner 1960;Aranow & Day 1965;Barbosa 1972;Ingbar & Woeber 1974), while others indicate that ablation of the thyroid, surgically or by radioactive iodine, improve the course of ophthalmopathy (Catz & Perzik 1965;Bauer & Catz 1966;Rothmund et al 1981;Gwinup et al 1982; Marushak et al 1984).…”

Section: Discussionmentioning

confidence: 99%

Ophthalmopathy and hyperthyroidism

Calissendorff

Söderström

Alveryd

1986

Acta Ophthalmologica

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The ocular manifestations in 125 thyrotoxic patients observed for 6-20 years are presented. The incidence and development of ophthalmopathy in three different treatment group medical- (eta = 72), radionuclear (eta = 36) and surgical (eta = 17) are showed. The degree of ophthalmopathy is similar in all groups, and no statistically significant difference is found in the development of ophthalmopathy.

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REGRESSION OF OPHTHALMOPATHY IN GRAVES‘ DISEASE FOLLOWING THYROIDECTOMY A systematic study of changes of ocular signs

Cited by 9 publications

References 18 publications

The influence of surgery on endocrine ophthalmopathy

The influence of surgery on endocrine ophthalmopathy

Regression of Ophthalmopathic Exophthalmos in Graves’ Disease After Total Thyroidectomy: a Prospective Study of a Surgical Series

Ophthalmopathy and hyperthyroidism

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