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Predictive Factor for Therapeutic Results after Intravenous Glucocorticoid Therapy in Thyroid-Associated Ophthalmopathy / 대한갑상선학회지
Journal of Korean Thyroid Association ; : 114-122, 2011.
Artigo em Inglês | WPRIM | ID: wpr-151704
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Little has been known for factors predicting improvement of proptosis in patients with thyroid-associated ophthalmopathy (TAO) after intravenous (IV) glucocorticoid therapy. This study aimed to evaluate the efficacy of IV glucocorticoid therapy and to find factor predicting treatment outcomes in patients with TAO. MATERIALS AND

METHODS:

Forty-two consecutive patients with TAO treated by IV glucocorticoid from 2000 to 2009 were retrospectively analyzed. They received IV methylprednisolone of 7.0 g over 18 weeks. Before and after treatment, patients underwent orbital CT for assessment of proptosis and extraocular muscle hypertrophy, and physical examination for clinical activity score (CAS).

RESULTS:

Thirteen patients (31%) showed improvement in proptosis after therapy. High extraocular muscle diameter index was an independent predictor for improvement in proptosis (odds ratio=1.25, p=0.03). Smoking, age, gender and initial CAS did not predict improvement. Seven of 16 patients with initial CAS or =3 (77%) showed improvement in diplopia after treatment (p=0.002). Of patients with CAS> or =3, patients with intermittent, inconstant and constant diplopia showed improvement in diplopia in 100%, 80% and 63%, respectively. Of patients with CAS<3, patients showed improvement in 80%, 33% and 20%, respectively.

CONCLUSION:

Presence of extraocular muscle hypertrophy was the only factor predicting improvement in proptosis after IV glucocorticoid therapy. In patients with TAO, IV glucocorticoid therapy could be considered to improve proptosis when they present with increased extraocular muscle diameter, or to improve diplopia especially when they also have high initial CAS.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Órbita / Exame Físico / Fumaça / Metilprednisolona / Fumar / Exoftalmia / Doença de Graves / Troleandomicina / Estudos Retrospectivos / Diplopia Tipo de estudo: Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Humanos Idioma: Inglês Revista: Journal of Korean Thyroid Association Ano de publicação: 2011 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Órbita / Exame Físico / Fumaça / Metilprednisolona / Fumar / Exoftalmia / Doença de Graves / Troleandomicina / Estudos Retrospectivos / Diplopia Tipo de estudo: Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Humanos Idioma: Inglês Revista: Journal of Korean Thyroid Association Ano de publicação: 2011 Tipo de documento: Artigo