Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2005) 9 P169

BES2005 Poster Presentations Thyroid (33 abstracts)

Early response to high dose intravenous steroids in thyroid associated ophthalmopathy

CF Rosales 1 , P Perros 2 , AJ Dickinson 2 & C Neoh 2


1The Medical School, University of Newcastle upon Tyne, UK; 2Combined Thyroid Eye Clinic, Newcastle upon Tyne Hospitals NHS Trust, UK.


High dose steroids are effective in treating active thyroid-associated ophthalmopathy (TAO), however the side effects are considerable. This study aimed to establish whether long term response to intravenous methylprednisolone can be predicted by a detailed ophthalmological assessment 1 to 2 weeks after the first dose of steroid.

45 patients with moderate to severe, active TAO (including 31 with optic neuropathy), treated with intravenous methylprednisolone were studied. Ophthalmological parameters were noted immediately before treatment, 1 to 2 weeks after treatment and at a year follow up. Early response was compared to severity of disease at a year using paired t-tests and Wilcoxon sum tests. In addition to high dose steroids other treatments given within one year of commencing high dose steroids included: orbital irradiation (n=27), orbital decompression (n=20) and eye muscle surgery(n=2).

Visual acuity, clinical activity score, exophthalmos and soft tissue swelling scores showed statistically significant improvement at early follow up (p<0.05). These responses were sustained at 1 year. Diplopia and total movement scores did not show any early or late response.

This study demonstrates that ophthalmological assessment of response to treatment 1 to 2 weeks after high dose steroids is valuable in deciding whether continuation of steroid therapy is likely to lead to long-term benefits. It also suggests that unlike visual acuity and soft tissue features, dysmotility tends to be resistant to steroid therapy even in patients with active disease.

Volume 9

24th Joint Meeting of the British Endocrine Societies

British Endocrine Societies 

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