Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan.
Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Jpn J Radiol. 2019 Aug;37(8):612-618. doi: 10.1007/s11604-019-00846-y. Epub 2019 Jun 14.
To evaluate the effectiveness of radiation therapy and steroids for Asian patients with Graves' ophthalmopathy using the clinical activity score (CAS), and changes in external ocular muscles and eye proptosis determined by magnetic resonance imaging (MRI).
We retrospectively reviewed 48 patients who received combined orbital radiation and systemic glucocorticoids in our hospital. MRI was performed both before and 1 month after treatment in all patients. We calculated the areas of five extraocular muscles and the degree of proptosis on transverse sections, and we evaluated the activity of the disease using CAS before and 1 month after treatment and toxicity.
The areas of external ocular muscles, the length of eye prominence and CAS were significantly improved by the combination of orbital radiation and steroids. The change in the area of the medial rectus muscle had a significant correlation with the change in CAS (P < 0.05). Graves' ophthalmopathy progressed again in 4 of the 48 patients; however, there were no patients with serious side effects in a median observation period of 41.5 months.
Treatment with the combination of orbital radiation and systemic glucocorticoids is subjectively and objectively effective for Asian Graves' ophthalmopathy without severe toxicity.
使用临床活动评分（CAS）评估亚洲格雷夫斯眼病患者的放射治疗和类固醇的疗效，并通过磁共振成像（MRI）评估眼外肌和眼球突出度的变化。
我们回顾性分析了在我院接受联合眼眶放射治疗和全身糖皮质激素治疗的 48 例患者。所有患者在治疗前和治疗后 1 个月均行 MRI 检查。我们计算了五个眼外肌的面积和横断面上眼球突出度的程度，并在治疗前和治疗后 1 个月评估了疾病的活动度和毒性。
眼眶放射治疗联合类固醇治疗可显著改善眼外肌面积、眼球突出度和 CAS。内直肌面积的变化与 CAS 的变化有显著相关性（P<0.05）。在中位观察期 41.5 个月内，48 例患者中有 4 例格雷夫斯眼病再次进展，但无严重毒性反应的患者。
眼眶放射治疗联合全身糖皮质激素治疗对亚洲格雷夫斯眼病患者具有良好的疗效，且无严重毒性。
