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목적 : To compare the efficacy and safety of combination therapy with orbital irradiation and systemic steroids versus steroid monotherapy in the management of active Graves’ orbitopathy(GO) in Korean patients.
방법 : The clinical charts of 321 patients with active inflammation due to GO who received steroid pulse therapy with or without orbital radiotherapy between 2010 and 2014 were reviewed. Patients were divided into two treatment groups: 1) combined orbital radiotherapy and steroid pulse therapy(SRT group) and 2) steroid pulse therapy only(ST group).The clinical activity score(CAS); NOSPECS classification; ocular motility impairment; exophthalmos at 1,3,6, and 12 months after treatment and the change in extraocular muscle volume after treatment, measured by orbit computed tomography, were evaluated.
결과 : Sixty-eight patients were included in the SRT group, and 59 patients were in the ST group. Although both groups experienced a significant reduction in CAS and NOSPECS, the SRT group demonstrated significantly greater improvements in ocular motility impairment and exophthalmos. EOM volume was reduced after treatment in both groups; however, the change was significant in the SRT group. Compressive optic neuropathy after treatment developed in 0% of the SRT group and 3.4%(2/59) of the ST group. Reactivation of inflammation occurred in 11.8%(8/68) of the SRT group and 28.8%(17/59) of the ST group.
결론 : Orbital radiotherapy in combination with steroid treatment significantly improved ocular motility by reducing EOM volume in patients with active GO.
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