Results of Comprehensive Conservative Treatment of Patients With Medium Severity Endocrine Ophthalmopathy

Abstract

Background. Pathogenetic therapy of the moderate severity endocrine ophthalmopathy (EOP) is performed by the administration of glucocorticoids (GC), which possess immunosuppressive, anti-inflammatory and anti-edematous effects. Currently, the application of selenium and pentoxifylline medications, as well as treatment with magnetic field over periorbital region are considered as a part of combined therapy for the disease. Purpose of the study. To evaluate the results of combined conservative treatment of patients with moderate severity EOP. Material and methods. The study included 25 patients (50 orbits) with the clinical signs of moderate severity EOP. Depending on the treatment regimen, patients were divided into group A (comparison) and group B (main). Group A (comparison) – 10 patients who received pulse therapy with methylprednisolone. Group B (main) – 15 patients who were prescribed a combination of pulse therapy with methylprednisalone and a new developed treatment regimen additionally: selenium 100 mgq 2 times a day for 6 months, pentoxifylline at a dose of 600 mg 2 times a day for 6 months, a low-frequency pulsed magnetic field generated by the "UniSPOK" apparatus, lasting for 10-20 minutes, up to 8-12 procedures performed daily. Methylprednisolone application in the form of intravenous pulse therapy was prescribed collegially by an endocrinologist and an ophthalmologist individually for each patient and in total did not exceed 4.5 g recommended for the present process intensity (on average, 4.5±0.5 g in both groups). Results. The sequence in decreasing of EOP clinical signs in patients receiving combination therapy was revealed: a decrease in tremor, eyelid edema and palpebral fissure width in comparison with the initial parameters were noted already by the 3rd month of treatment, after 6 months these indicators disappeared. Lacrimation in the studied groups was not recorded by the 6th month, which can be explained by the corticosteroids application. A significant reduction in exophthalmos under developed therapy was found after 6 months, while no reduction was observed in the standard treatment group. Conclusions. The method of EOP complex treatment, including pulse therapy with methylprednisolone in combination with selenium, pentoxifylline and magnetotherapy, was effective in the moderate severity of the disease and led to the reduction of the ophthalmopathy severity symptoms. The positive effect of the combined therapy indicates the necessity for a six-month treatment course.