Radiation Retinopathy 15 Years after Orbital Irradiation for Thyroid Orbitopathy

Introduction

Orbital irradiation (OR) is the second choice therapy in cases with early and acute thyroid orbitopathy [1], [2], [3]. OR may improve ocular motility, but is not effective against exophthalmos and long-standing eye muscle dysfunction. Intravenous glucocorticosteroid pulse therapy seems to offer the greatest therapeutical impact on thyroid orbitopathy and is therefore regarded as the first choice therapeutical option [4]. A combination of both, oral glucocorticosteroids and orbital radiation therapy may have a synergistic effect [5], [6] and was previously discussed as a first choice alternative to oral corticosteroids alone. Evidence that the combination of OR with intravenous glucocorticosteroid pulse therapy may be more efficient than glucocorticosteroid therapy alone is still missing. Generally, orbital radiation according to the commonly used protocol (20 Gy 10 × 2 Gy fractions over 2 weeks [7] is regarded as relatively safe. In the case reported here radiation retinopathy (RRP) was diagnosed 15 years after unilateral orbital irradiation according to the commonly used protocol in thyroid orbitopathy.

^* Both Authors equally contributed to this publication.

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