Risk Factors For The Development Or Progression Of Grave’S Ophthalmopathy Following Radioiodine Therapy

Abstract

 

Purpose:

 

To investigate the incidence of known risk factors for the development or progression of Grave’s Ophthalmopathy (GO) in patients undergoing radioiodine therapy (RAI) for hyperthyroidism.

 

Methods:

 

Retrospective case note review. A random sample of patients with hyperthyroidism who had undergone RAI in 2009 was identified from the database in the Department of Nuclear Medicine. The following risk factors were identified post RAI: smoking history, repeated radioiodine, hypothyroidism, corticosteroids and pre-existing GO.

 

Results:

 

49 patients were included of whom 22.4% has pre-existing GO. Smoking history was noted in 44.9% of cases. The average total dose of RAI was 944.64MBq and 677.71MBq in those with and without GO. Up to 50% of those with GO had uncontrolled hypothyroidism post-RAI. Assessment of GO was seldom recorded during post-RAI follow-up (in 15.9% of patients at 6 months, for example). Corticosteroids were prescribed in 72.2% of cases where they were indicated.

 

Conclusions:

 

Identification and modification of known risk factors for GO following RAI in patients with Graves Disease is needed. These risk factors, such as hypothyroidism, are prevalent and regimens to modify them to reduce debilitating ophthalmic disease are required.  

 

Keywords: orbit