New Therapy for
Graves' Hyperthyroid Patients
with Active Thyroid Eye disease.
The presence of thyroid tissue is felt to be a stimulus to promote
thyroid eye disease. Therefore removing all thyroid tissue has been
shown to decrease eye disease. Total thyroidiectomy still leaves
a small amount of thyroid tissue behind. 55 patients with Grave's
hyperthyroidism and mild or moderate eye changes (swelling, double
vision, protrusion of the eyes). All had thyroidectomy, and 16 of
the 55 had Radioiodine ablation of the residual thyroid tissue after
the surgery. All received T4 therapy. Clinical eye scoring was done
at the time of surgery and at 6, 12, and 24 months.
Results - 31 had active eye disease
at the time of the surgery. There was a 61% drop in active eye disease
by 6 months, and 71% were inactive at 24 months. 38% of inactive
eye disease patients became active during 24 month follow-up.
Of the 39 patients treated by thyroidectomy alone the eye disease
was still active in 46%. However, all 16 patients treated by TX,
and Radioiodine had inactive eye disease by 24 months.
Conclusion - In patients with
Graves' Ophthalmopathy, complete thyroid tissue destruction by thyroidectomy
followed by radioiodine ablation, is more effective than thyroidiectomy
alone in decreasing the activity of the thyroid eye disease.
2.Thyroid Notes by Dr. Robert Utiger
Clinical Thyroidology, November 2003