Combining orbital intensity modulated radiation therapy with periorbital triamcinolone acetonide injection for Graves' orbitopathy.

IF 1.9 4区医学 Q2 OPHTHALMOLOGY

International journal of ophthalmology Pub Date : 2025-05-18 eCollection Date: 2025-01-01 DOI:10.18240/ijo.2025.05.17

Huan Jian, Rui-Xin Ma, Wei-Min He

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引用次数: 0

Abstract

Aim: To evaluate the efficacy of combined orbital radiation and periorbital triamcinolone acetonide injection for patients with Graves' orbitopathy (GO) who experienced treatment failure with glucocorticoid pulse therapy (GPT).

Methods: A total of 57 eligible patients (35.09% males, mean age of 51.19±11.90y) were included in this case-series study. The medical information collected during each visit was evaluated and analyzed.

Results: Significant improvement was observed in patients six months after radiation therapy. Both the clinical activity score and the efficacy score showed substantial improvement (P<0.001). Furthermore, there was significant resolution of extraocular muscle inflammation on magnetic resonance imaging at three and six months after radiation therapy. The initial high signal intensity ratio (SIR) max was found to be associated with greater improvement in SIR sum (P<0.001, B=2.002, 95%CI: 1.377 to 2.628), while the presence of sight-threatening stage or moderate to severe diplopia negatively influenced the improvement of SIR sum (P=0.045, 0.008, 0.006; B=-1.966, -1.478, -0.997; 95%CI: -3.886 to -0.045, -2.552 to -0.403, -1.694 to -0.300; respectively).

Conclusion: The combination therapy demonstrates significant effectiveness in treating patients with GO who experienced severe ocular inflammation and have previous GPT failure. Noticeable improvement is observed as early as one month after initiating radiation therapy, and patients with more severe inflammatory states showes greater benefit from the treatment.

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眼眶调强放疗联合眼眶周注射曲安奈德治疗Graves眼病。

目的：评价眼眶放射联合眶周注射曲安奈德治疗糖皮质激素脉冲治疗（GPT）失败的Graves眼病（GO）的疗效。方法：本病例系列研究共纳入57例患者，其中男性占35.09%，平均年龄51.19±11.90岁。对每次访问期间收集的医疗信息进行评估和分析。结果：患者在放疗后6个月有明显改善。临床活动评分和疗效评分均有显著改善（PPB=2.002, 95%CI: 1.377 ~ 2.628），而存在视危期或中重度复视对SIR总分的改善有负向影响(P=0.045, 0.008, 0.006；B=-1.966, -1.478, -0.997；95%CI: -3.886 ~ -0.045, -2.552 ~ -0.403, -1.694 ~ -0.300；分别)。结论：该联合疗法对既往GPT治疗失败并伴有严重眼部炎症的GO患者有显著疗效。早在放射治疗开始一个月后就可以观察到明显的改善，炎症状态更严重的患者从治疗中获益更大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of ophthalmology Medicine-Ophthalmology

CiteScore

2.50

自引率

7.10%

发文量

3141

审稿时长

4-8 weeks

期刊介绍： · International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online). This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed, PubMed-Central, Chemical Abstracts, Scopus, EMBASE , and DOAJ. IJO JCR IF in 2017 is 1.166. IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication. General Scientific Advisors include Prof. Hugh Taylor (President of ICO); Prof.Bruce Spivey (Immediate Past President of ICO); Prof.Mark Tso (Ex-Vice President of ICO) and Prof.Daiming Fan (Academician and Vice President, Chinese Academy of Engineering. International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of AAO/PAAO) et al. Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society). Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press). Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics). Associate Editors-in-Chief include: Prof. Ning-Li Wang (President Elect of APAO); Prof. Ke Yao (President of Chinese Ophthalmological Society) ; Prof.William Smiddy (Bascom Palmer Eye instituteUSA) ; Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA); Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society); Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA); Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA). IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles, both basic and clinical papers. Instruction is Welcome Contribution is Welcome Citation is Welcome Cooperation organization International Council of Ophthalmology(ICO), PubMed, PMC, American Academy of Ophthalmology, Asia-Pacific, Thomson Reuters, The Charlesworth Group, Crossref,Scopus,Publons, DOAJ etc.