Treatment of thyrotoxic ophthalmopathy

: Ophthalmopathy of Graves-Basedow disease appears in 20-50% of patients suffering from thyreotoxicosis. It is usually bilateralophthalmopathy with different degrees of severity. Many noninvasive diagnostical methods are used today. In diagnostic procedure, and especially in therapy, multidisciplinary approaches are compulsory. Although therapeutical effects vary from person to person, only a long follow-up can offer some clinical data about therapeutical success. The authors describe a 39-year-old woman with thyrotoxic bilateral ophthalmopathy. Thyrostatics, such as MMi and PTU, gave no satisfactory therapeutical results. Therefore a therapeutic dose of 131J was administered after which egsophthalmometry (Hertel) revealed regression of thyrotoxic ophthalmopathy, while the ocular signs were more pronounced after the partial thyroidectomy which had had to be carried out because of the existing thyroid functional nodule. The patient responded to corticosteroid therapy by showing a reduction in periorbital oedema, chemosis and hyperemia as well as by lowering the antibody titre against thyroglobulin and disappearing the serum immune complexes.