Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Curr Opin Ophthalmol. 2012 Sep;23(5):427-32. doi: 10.1097/ICU.0b013e3283560b2b.
Orbital radiotherapy has been used for over 60 years to treat thyroid eye disease (TED) alone or in conjunction with glucocorticoids or orbital decompression surgery. However, numerous observational and randomized controlled trials have yielded conflicting results concerning its efficacy. This review highlights recent systematic reviews concerning the use of radiotherapy for TED.
Three recent systematic analyses have drawn different conclusions about its efficacy. This relates to the varied nature of the disease, the different selection criteria, and different outcome measures (often focussing on global indices or clinical activity scores rather than subjective quality of life scores and individual disease parameters as specified by the VISA Classification).
Radiotherapy should only be offered in the early active phase, is most effective in combination with glucocorticoids, and may have specific indications for dysthyroid optic neuropathy (DON), inflammatory periocular changes, or progressive motility disturbance. Future research may study its potential benefit in preventing or treating DON and compare the ability of combination radiotherapy/intravenous (i.v.) glucocorticoids versus i.v. glucocorticoids monotherapy for limiting complications from progressive TED.
眼眶放射治疗在治疗甲状腺眼病（TED）方面已经应用了 60 多年，单独使用或与糖皮质激素或眼眶减压手术联合使用。然而，大量的观察性和随机对照试验对于其疗效得出了相互矛盾的结果。这篇综述强调了最近关于放射治疗 TED 的系统综述。
三项最近的系统分析对其疗效得出了不同的结论。这与疾病的不同性质、不同的选择标准以及不同的结局指标（通常集中在整体指数或临床活动评分上，而不是主观生活质量评分和 VISA 分类指定的个别疾病参数）有关。
放射治疗仅应在疾病的早期活动期提供，与糖皮质激素联合使用最有效，并且对于甲状腺功能亢进性视神经病变（DON）、炎性眶周改变或进行性运动障碍可能具有特定的适应证。未来的研究可能会研究其在预防或治疗 DON 方面的潜在益处，并比较联合放射治疗/静脉（i.v.）糖皮质激素与 i.v. 糖皮质激素单药治疗对限制进行性 TED 并发症的能力。
