Treatment of Orbital Disorders

Graves' orbitopathy (GO) is the most common cause of unilateral and bilateral proptosis in clinical practice. GO is most often associated with hyperthyroidism due to Graves' disease (GD) but some patients can be euthyroid or hypothyroid.1,2 Approximately 70% of patients with GD have subclinical evidence of GO, but fortunately few patients (less than 5%) have severe disease resulting in visual loss from a compressive optic neuropathy. The majority of patients with GO have mild symptomatic disease that requires only supportive therapy. Although great strides have been made in our understanding, detection and management of GO there still remains several unanswered questions. In particular two important questions that still remain are: 1) Which patient with GD will develop GO or have worsening of their GO? 2) What is the optimum treatment regiment for patients with GO? This symposium will review 4 recently published clinical trials on the effect of GD treatment (medical, surgical, and radioactive iodine) on the d elopment and progression of GO. In addition, the results of a pilot study on the use of prolonged low dose orbital radiation in GO will be discussed.