Thyroid-Associated Ophthalmopathy after Treatment for Graves´Hyperthyroidism with Antithyroid Drugs or lodine-131

• Context: Previous randomized trials have suggested an association   between radioiodine treatment for Graves' hyperthyroidism and   thyroid-associated ophthalmopathy (TAO).   Objectives: The aim of the study was to compare the occurrence of   worsening or development of TAO in patients who were treated with   radioiodine or antithyroid drugs.   Design: We conducted a randomized trial (TT 96) with a follow-up of 4   yr.   Patients, Setting, and Intervention: Patients with a recent diagnosis   of Graves' hyperthyroidism were randomized to treatment with iodine-131   (163 patients) or 18 months of medical treatment (150 patients). Early   substitution with T-4 was given in both groups.   Main Outcome Measure: Worsening or development of TAO was significantly   more common in the iodine-131 treatment group (63 patients; 38.7%)   compared with the medical treatment group (32 patients; 21.3%) (P <   0.001).   Results: The risk for de novo development of TAO was greater in   patients treated with iodine-131 (53 patients) than with medical   treatment(23patients). However, worsening of TAO in the 41 patients who   had ophthalmopathy already before the start of treatment was not more   common in the radioiodine group (10 patients) than in the medical group   (nine patients). Smoking was shown to influence the risk of worsening   or development of TAO, and smokers treated with radioiodine had the   overall highest risk for TAO. However, in the group of smokers,   worsening or development of TAO was not significantly associated with   the choice of treatment for hyperthyroidism.   Conclusions: Radioiodine treatment is a significant risk factor for   development of TAO in Graves' hyperthyroidism. Smokers run the highest   risk for worsening or development of TAO irrespective of treatment modality.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Nyckelord

MEDICINE

MEDICIN

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)