Endocrine Abstracts

Objective: To evaluate the efficacy, safety and to determine the criteria for the glucocorticoid therapy scheme: intravenous pulse therapy followed by tablet form in prolonged regime in the treatment of active phase of endocrine ophthalmopathy (EOP).

Materials and methods: 28 patients of both sexes (52 eyes) with endocrine ophthalmopathy in the active phase were included in the study. The average age – 43.4±10.6 years. The duration of the disease ranged from 3 to 12 months. The activity of disease was evaluated according to a scale of clinical activity of EOP – Clinical Activity Score (CAS), and thickening of the extraocular muscles based on MSCT of the orbits.

Results: One month after the start of pulse therapy there was a significant reduction of EOP activity and severity in all patients, which was confirmed by an increase in vision, a decrease in the level of intraocular pressure, reduction in the amount exophthalmus at 0.8±0.02 mm (P <0.05) and the frequency of diplopia. 3 months after the start of glucocorticoid therapy in 100% of cases a transition to the inactive phase of the disease was determined. Reoccurrence of the disease after 12 months was diagnosed in 3 patients (10.7%).

Conclusions:: i) Intravenous pulse therapy with high doses of methylprednisolon followed by oral administration in prolonged regime is effective and safe; it contributes to the rapid achievement of clinical effect and stable remission of the disease. ii) A thickening of the extraocular muscles is the criteria for the start of glucocorticoid therapy.