Abstract

Purpose: Aim was to report outcome in 18 patients of moderate to severe thyroid associated orbitopathy (TAO) treated with intravenous steroids.

Methods: Eleven males and 7 females with mean age of 52.92 years received methylprednisolone. Examination revealed decreased vision(15), lid inflammation(15), & movement restriction(16). They were hyperthyroid(8), hypothyroid(3), euthyroid(7), & 8 had pre-existing thyroid disease. Field defects(8), apical crowding(3) and corneal involvement(4) were present. Treatment regime was, regular for 3 days(10), pulse therapy(5) & combined(3). Response to treatment was evaluated by VISA classification.

Results: Improvement was seen in vision(14), inflammation(17), movement(16) and appearance(15). Determinants of poor outcome were, diabetic status, corneal involvement, raised intraocular pressure, preexisting thyroid disease and pulse therapy.

Conclusion: Intravenous methylprednisolone is safe & efficacious in improving TAO in majority of acute cases along with control of co-morbid conditions.

Keywords: Thyroid associated orbitopathy; Proptosis; Intravenous steroids; Methylprednisolone