Endocrine Abstracts (2006) 11 P146

Using of pulse methylprednisolon therapy in Graves’ ophthalmopathy

O Nechaeva, Y Bardeeva, O Perepelova, T Shestakova & I Chikh

Moscow Regional Research Clinical Institute, Moscow, Russia.

The aim of the study is to estimate the efficacy of intravenous corticosteroid therapy in patients with active, sever Graves’ ophthalmopathy.

Material and methods: 16 patients with bilateral active, sever Graves’ ophthalmopathy were included to the study. Euthyroididsm has been provided, mean dose of methimasol therapy was 9.4±6.6 mg a day, median of TSH- 0.3 mlU/l, median of fT4 –15.3 pmol/l. The median of duration of GO was 6.5 months. All patients were administered methylprednisolone intravenously at a daily dose of 1 g for 3 consecutive days and repeated 3 times for 3 weeks. Disease activity was carried out with Clinical Activity Score (CAS), disease severity – with exophthalometry, visual acuity and presents of diplopia.

Results: Initially the median of CAS was 4 points, the mean proptosis −20.8±4.3 mm, median of visual acuity –0.8. 35.2% of patients had lagophthalm and besides more than half of them had bilateral lagophthalm; 52.9% of subjects had diplopia (more than half of them – in primary gaze).

In 1 month after treatment the median of CAS became 1 point and it has been continuing the same after 6 months of therapy. In 6 months visual acuity was not changed after treatment; the degree of proptosis became no significantly less (mean level 18.8±5.1 mm); the frequency of lagophthalm was decreased to 5.9% (what’s more there were no patients with bilateral lagophthalm already in 1 month after treatment); the frequency of diplopia was significantly decreased to 5.9% to (there were no cases of diplopia in primary gaze already in 1 month after pulse therapy). Thus in 6 months only 1 patient (5.9%) had active process, unilateral lagophthalm, diplopia in extreme gaze and so the course was repeated with positive effect.

Conclusion: Pulse therapy with methylprednisolone can decrease symptoms of activity, frequency of lagophthalm and diplopia.

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