Thyroid Associated Orbitopathy (TAO): Effects of Medical And Surgical Treatments

Purpose: To assess the effects of treating hyperthyroidism with antithyroid drugs, iodine-131 and surgery on development or aggravation of Graves’ ophthalmopathy (TAO) . Methods: A prospective analysis of 52 patients diagnosed with hyperthyroidism caused by Graves’ disease in Department of Surgery and Ophthalmology, Maharani Laxmi Bai Medical College, Jhansi from November 2014 to May 2017 was performed. The patients were stratified in two study groups: group1(age 20 to 55 years) received treatment with methimazole or iodine-131 and group 2(20 to 55 years) cases underwent subtotal thyroidectomy. The main outcome measures included clinical findings of ophthalmopathy, radiological features (NCCT head with orbits) and treatment options. Results: 12 patients(23%) presented with infiltrative ophthalmopathy at randomization while 22 cases (42.3%) had palpable thyroid mass. The mean age (years) was 44.8 ± 4.68 (range 20-55) and 46.6 ± 5.53 (range 2055) in group 1 and 2 respectively . During follow-up period of 12 months, ophthalmopathy developed in 14 cases(27%) amd worsened in 10 cases(19.2%). Conclusion: In our study both groups showed development or exacerbation of orbitopathy after medical and surgical treatments, however iodine-131 treatment showed more number of cases for the same as compared to methimazole and surgery.