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Title: Effectiveness of immunosuppressive treatment of Graves’ orbitopathy against earlier treatment modalities in Graves’ disease : determination of unfavorable disease course risk factors : electrophysiological and OCT tests in Graves’ Orbitopathy evaluation
Abstract:
Aims of the study: 1. To evaluate the efficacy of immunosuppressive treatment of Graves’ Orbitopathy (GO) in patients after radioiodine therapy (131-I) or treated with anti-thyroid drugs (ATD) 2. To determine the factors affecting the activity and severity of GO and to identify the predictive factors of poor response to treatment 3. To perform a functional and structural evaluation of the anterior visual pathway in patients with GO using electrophysiological tests and Optical Coherence Tomography (OCT) and to identify potential parameters useful in detecting early optic nerve damage. Material and methods: In the first part a total of 214 patients with exacerbation of GO were studied. They were divided into two groups: the ATD group and the 131-I group. All patients were treated with methylprednisolone i.v. pulses followed by orbital irradiation. CAS (Clinical Activity Score) and IO (Index of Orbitopathy) indices, TSH, fT4, and TRAb levels were evaluated prior to, and 1, 6, and 12 months after treatment. In the second part 47 GO patients were enrolled in the study and divided into three groups: Group 1 with mild GO, Group 2 with moderate-to- severe GO, and Group 3 with sight-threatening GO (DON-Dysthyroid Optic Neuropathy). Pattern and flash visual evoked potential (pVEP, fVEP), pattern electroretinogram (pERG), and OCT findings were compared between the groups. Results and conc ; lusions: 1. The efficacy of treatment of GO was the same in both groups and did not depend on earlier Graves’ disease treatment (ATD or 131-I). 2. Higher TRAb levels and more advanced age increase the risk of active GO. Higher TRAb levels and more active disease increase the risk of more severe GO. In turn patients with more severe disease have a higher risk of poor response to immunosuppressive treatment. 3. Electrophysiological responses and OCT parameters differ significantly in patients with different GO severity and may be of use in diagnosis of DON and in monitoring patients with less severe GO to detect subclinical changes in optic nerve function and morphology.
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Rada Dyscypliny Nauki medyczne
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Last modified:
Dec 18, 2024
In our library since:
Feb 6, 2024
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http://dl.cm-uj.krakow.pl:8080/publication/5025
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| Edition name | Date |
|---|---|
| ZB-137394 | Dec 18, 2024 |
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