The aftermath of orbital radiotherapy for graves' XXXX .

@entity1 @entity2743 @entity6875 @entity134 @entity989 @entity892
OBJECTIVE: To determine whether long-term improvement could be observed after orbital radiotherapy for @entity2743 ; in addition, to evaluate ancillary treatments needed for those who have received radiotherapy, to search for late-emerging adverse consequences of radiotherapy, and to relate orbital changes to serum levels of thyroid-stimulating immunoglobulin (TSI). DESIGN: Three-year follow-up of noncomparative interventional case series. @entity1 : Forty-two @entity1 . INTERVENTION: All @entity1 had received orbital radiotherapy within 6 months of study entry. Twelve months after study entry, @entity1 were free to select any additional treatment for their @entity6875 . MAIN OUTCOME MEASURES: Need for surgery, @entity134 therapy, volume of extraocular muscles and fat, proptosis, area of @entity892 fields and range of extraocular muscle motion, volume changes after decompression and correlations of eye findings with serum TSI levels, retinal status. RESULTS: Half of the @entity1 elected to have a surgical procedure on their eyes or orbits. Among @entity1 who were not decompressed, we found only slight improvement in some of the main outcome measures. TSI did not positively correlate with baseline status or with any observed change in major outcome measures. After orbital decompression, the volumes of both muscle and fat increase, but bony orbital volume increases more and proptosis diminishes. @entity989 consistent with @entity989 developed de novo in five eyes of three @entity1 within 3 years of radiation therapy. CONCLUSIONS: In this 3-year uncontrolled follow-up phase, limited evidence for a clinically significant improvement was observed, which may be the result of treatment or of natural remission. In either case, the changes are of little clinical significance. Because it is neither effective nor innocuous, radiotherapy does not seem to be indicated for treatment of mild to moderate @entity6875 .
