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Orbital radiotherapy for thyroid eye disease

Dolman, Peter J.; Rath, Suryasnata

Current Opinion in Ophthalmology: September 2012 - Volume 23 - Issue 5 - p 427–432
doi: 10.1097/ICU.0b013e3283560b2b

Purpose of review Orbital radiotherapy has been used for over 60 years to treat thyroid eye disease (TED) alone or in conjunction with glucocorticoids or orbital decompression surgery. However, numerous observational and randomized controlled trials have yielded conflicting results concerning its efficacy. This review highlights recent systematic reviews concerning the use of radiotherapy for TED.

Recent findings Three recent systematic analyses have drawn different conclusions about its efficacy. This relates to the varied nature of the disease, the different selection criteria, and different outcome measures (often focussing on global indices or clinical activity scores rather than subjective quality of life scores and individual disease parameters as specified by the VISA Classification).

Summary Radiotherapy should only be offered in the early active phase, is most effective in combination with glucocorticoids, and may have specific indications for dysthyroid optic neuropathy (DON), inflammatory periocular changes, or progressive motility disturbance. Future research may study its potential benefit in preventing or treating DON and compare the ability of combination radiotherapy/intravenous (i.v.) glucocorticoids versus i.v. glucocorticoids monotherapy for limiting complications from progressive TED.

Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada

Correspondence to Peter J Dolman, MD, FRCSC, Eye Care Centre, 2550 Willow Street, University of British Columbia, Vancouver, BC V5Z 3N9, Canada. Tel: +1 604 875 4346; fax: +1 604 875 4701; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.