Weigand A, Hinzpeter B, Schicha H
Klinik und Poliklinik für Nuklearmedizin der Universität zu Köln.
Nuklearmedizin. 1998;37(7):234-8.
Our goal was to show the development of EO in RITH and compare it with the outcome of surgery or thyreostatic therapy.
In this study 103 cases of an RITH at 82 patients were performed. The EO findings were measured before RITH and several times afterwards by the same experienced researcher according to the following criteria: 1. subjective complaints, 2. NOSPECS-classification, 3. exophthalmometry, 4. by photo. The observation period was at least 12 months. The measured dosage to the thyroid gland was on average 210 +/- 80 Gy. In 57 cases no EO and in 46 cases an EO of grades I to IV before therapy occurred.
In 11 cases there was an improvement and in 8 cases a worsening of the EO. In 84 cases the EO findings remained unchanged. Our data pointed towards the fact that with an achieved dosage to the thyroid of less than 200 Gy, a pretherapeutic thyroid gland volume greater than 55 ml, or implementation of RITH with preexisting EO without accompaning cortison therapy can worsen the EO findings.
In comparison to surgical or thyreostatic therapy there was no increased risk of EO during or subsequent to RITH under cortison.
我们的目标是展示放射性碘治疗性甲状腺切除术中眼部病变（EO）的发展情况，并将其与手术或甲状腺抑制治疗的结果进行比较。
本研究对82例患者进行了103例放射性碘治疗性甲状腺切除术。在放射性碘治疗性甲状腺切除术之前及之后由同一位经验丰富的研究人员根据以下标准多次测量眼部病变的表现：1. 主观症状，2. NOSPECS分级，3. 突眼测量，4. 拍照。观察期至少为12个月。甲状腺平均接受的辐射剂量为210±80 Gy。57例患者术前无眼部病变，46例患者术前出现I至IV级眼部病变。
11例患者的眼部病变有所改善，8例患者的眼部病变恶化。84例患者的眼部病变表现保持不变。我们的数据表明，当甲状腺接受的辐射剂量小于200 Gy、治疗前甲状腺体积大于55 ml或在已有眼部病变的情况下进行放射性碘治疗性甲状腺切除术且未同时进行皮质激素治疗时，眼部病变的表现可能会恶化。
与手术或甲状腺抑制治疗相比，在皮质激素治疗下，放射性碘治疗性甲状腺切除术中或术后眼部病变的风险并未增加。
