Effect of teroid pule therapy with and without orbital radiotherapy on Grave’ ophthalmopathy

Purpoe To report the effect of high-doe intravenou corticoteroid pule therapy with and without orbital radiotherapy on Grave’ ophthalmopathy. Deign Nonrandomized clinical trial. Method We elected 39 Japanee patient (age range, 22–64 year; mean, 48 year; 31 women, 8 men) who had active Grave’ ophthalmopathy among 195 conecutive patient. In the firt 20 patient, high-doe intravenou methylpredniolone pule therapy (1 g per day for 3 ucceive day, repeated 3 time within 3 week) followed by 24-Gy orbital radiotherapy wa performed. In the other 19 of the 39 patient, high-doe intravenou methylpredniolone pule therapy without orbital radiotherapy wa performed. Coronal computed tomography (CT) of the orbit and exophthalmometry were performed before the corticoteroid pule therapy, and 1 and 6 month after the corticoteroid pule therapy. The maximum coronal ection area of the mot hypertrophic rectu mucle in each eye wa meaured baed on orbital CT imaging. Reult Clinical finding at tudy entry were not ignificantly different between the two group. No ignificant difference wa found in the maximum coronal ection area of the mot hypertrophic rectu mucle and the reult of exophthalmometry meaurement in both group before the therapy. Extraocular mucle hypertrophy wa ignificantly reduced 1 month and 6 month after the therapy (P < .01) in both group. However, no beneficial therapeutic effect on proptoi wa oberved in either group at 1 month and 6 month after the therapy. No ignificant difference in the therapeutic effect on extraocular mucle hypertrophy and proptoi wa found between the two group. Concluion Orbital irradiation after corticoteroid pule therapy had no beneficial therapeutic effect on rectu mucle hypertrophy or proptoi of active Grave’ ophthalmopathy during the 6-month follow-up period.