A new study published in Ophthalmology sought to evaluate the efficacy of radiotherapy for Graves' ophthalmopathy (GO).
In this prospective, randomized, internally controlled, double-blind clinical trial, patients with moderate, symptomatic GO (mean clinical activity score, 6.2) were included. Patients with neuropathy, diabetes, recent steroid treatment, previous decompression, or muscle surgery were excluded. A total of 42 of 53 consecutive patients were enrolled.
In each patient, 1 orbit was selected at random and treated with 20 Gy of external beam therapy, whereas the other side was given sham therapy. After 6 months, therapies were reversed.
Volume of extraocular muscle and fat, proptosis, range of extraocular muscle motion, area of diplopia fields, and lid fissure width were measured every 3 months for 1 year. Treatment for GO is considered effective if ≥1 of these parameters are modified.
At 6 months, no clinically or statistically significant difference was found between the orbits in any of the main outcome measures. At 12 months, in the orbit that was treated first, muscle volume and proptosis improved slightly.
The authors concluded that they were unable to demonstrate any beneficial therapeutic effect of radiotherapy in this group of patients.
Gorman CA, Garrity JA, Fatourechi V, et al. A prospective, randomized, double-blind, placebo-controlled study of orbital radiotherapy for graves' ophthalmopathy. Ophthalmology. 2020;127(4S):S160-S171.