A Prospective Study of the Effects of Radioiodine Therapy for Hyperthyroidism in Patients with Minimally Active Graves’ Ophthalmopathy
Open accessAbstract
CONTEXT: Radioiodine is an effective and safe treatment for hyperthyroidism but has been implicated as a risk factor for deterioration or new presentation of Graves' ophthalmopathy (GO). Prophylactic glucocorticoids appear to prevent this effect. OBJECTIVE: The objective of this study was to document the course of GO after radioiodine therapy. DESIGN: This was a prospective observational study. Patients were assessed at baseline and 2, 4, 6, and 12 months after radioiodine therapy. SETTING: The study was conducted at a tertiary referral center. PATIENTS: Seventy-two GO patients with minimally active eye disease participated in the study. INTERVENTION: A fixed dose of radioiodine was administered. T(4) was commenced 2 wk later to prevent hypothyroidism. MAIN OUTCOME MEASURES: Change in activity and severity of GO were analyzed. RESULTS: Exophthalmometer readings, the width of the palpebral aperture, diplopia scores, and the clinical activity score improved significantly. By clinically significant criteria, the eye disease improved in four patients (transiently in three of the four cases), most likely attributable to the natural course of the disease. No patient's eyes deteriorated. CONCLUSIONS: Radioiodine is not associated with deterioration of GO in patients with minimally active eye disease when postradioiodine hypothyroidism is prevented.
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Smoking history did not impact GO outcome in this cohort.
“Smoking history did not impact GO outcome in this cohort.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [536]
Two cohort studies in which patients received levothyroxine therapy early after RAI with the specific intent of preventing hypothyroidism noted that deterioration of GO rarely occurred (0%-2%).
“Subsequently, two cohort studies in which patients received levothyroxine therapy early after RAI with the specific intent of preventing hypothyroidism noted that deterioration of GO rarely occurred (0%-2%) (534,536).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [536]
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- Authors
- Perros, P., Kendall-Taylor, P., Neoh, C., Frewin, S., & Dickinson, J.
- Affiliations
- Freeman Hospital (GB)
- Royal Victoria Infirmary (GB)
- Corresponding author
- Perros, Petros
- ORCID
- Perros, Petros
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2005-09
- Volume
- 90
- Issue
- 9
- Pages
- 5321-5323
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2017184687
- Cited by
- 156
- References
- 6
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 5 · 2023: 9 · 2022: 12 · 2021: 3 · 2020: 9 · 2019: 7 · 2018: 3 · 2017: 1 · 2016: 10 · 2015: 7 · 2014: 8 · 2013: 2 · 2012: 7
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Neurology › Myasthenia Gravis and Thymoma
- Keywords
- radioiodine therapy, Graves' ophthalmopathy, hyperthyroidism, proptosis, diplopia, post-radioiodine hypothyroidism, levothyroxine, Graves' disease
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Graves Disease, Humans, Hyperthyroidism, Iodine Radioisotopes, Male, Middle Aged, Prospective Studies, Severity of Illness Index, Thyroid Gland, Thyroxine, Treatment Outcome, Hormone Replacement Therapy
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