To assess the effectiveness of orbital radiotherapy for Thyroid eye disease at Waikato Hospital. Thyroid eye disease (TED) is a well-known side effect of Graves’ disease. Signs and symptoms may includeproptosis, gritty eyes, tearing, orbital pain, blurred vision, diplopia, periorbital edema, change in colour vision and in more severe cases loss of vision conjunctival inflammation and ulceration. [1, 8] TEDis primarily a disease of the eye orbit caused by the response of retroocular tissues to autoantibodies to the thyroid stimulating hormone receptor (TSHR) [1, 3,...

Retrospective review of radiation therapy and clinical records to identify and assess patients suitable for the audit. Assessment of patient symptoms both before (baseline) and then at least 6 months after radiotherapy (post) was assessed by using the NOSPECS symptom severity scoring system. Response to radiotherapy was assessed by [(baseline score - post score)/baseline score] Fig. 1 Patients were treated to a dose of 20Gy/10fx, using 3D-CRT using parallel opposing fields, with target volume encompassing entire orbital contents. Anteriorly, non-divergent field edges were placed just...

During the fifteen year period from 2004-2019 we identified 14 patients treated with orbital radiotherapy for TED at Waikato DHB.Three patients were lost to or had inadequate time for follow up. Of the remaining 11 patients, 36% (4total) had a mild improvement in symptoms 54% (7 total) had moderate or significant improvement in their symptoms 45% (5 total) eventually needed decompression surgery due to poor response, 3 of these patients had a mild improvement while 2 had a moderate improvement based on the NOSPECS scoring...

Orbital radiotherapy with concurrent steroid therapy is an appropriate intervention in severe TED where steroids have failed or can’t be used and there is a wish to avoid going straight to decompressive surgery. The short term radiotherapy side-effects were negligible and long term effects in our small cohort appear to be minimal based on current follow up data. All patient in our audit had at least a mild improvement in symptoms, greater than half had moderate orsignificantimprovment at >6months. Disappointly 4 eventually required decompressive surgery...

1.Bahn, R., Graves' ophthalmopathy. N Engl J Med, 2010.Issue 326, p. 726. 2.Bartalena, L. et.al., Orbital cobalt irradiation combined with systemic corticosteroids for Graves' ophthalmopathy: comparison with systemic corticosteroids alone.. J Clin Endocrinol Metab, 1983. Volume 56, p. 1139. 3.Burch, H. B. & Wartofsky, L., Graves' ophthalmopathy: current concepts regarding pathogenesis and management.. Endocr Rev, 1993.Volume 14, p. 747. 4.Eckstein, A. K. et.al., Thyrotropin receptor autoantibodies are independent risk factors for Graves' ophthalmopathy and help to predict severity and outcome of the disease. J Clin...