Abstract ID: 26-534
PREDICTORS OF THYROID-ASSOCIATED ORBITOPATHY PROGRESSION FOLLOWING RADIOACTİVE IODINE THERAPY
Author: Bercin Tarlan Base Hospital / Institution: Gazi University Hospital
Presentation Type: ePoster Presentation
Purpose
To identify predictors of de novo or progressive thyroid-associated orbitopathy after radioactive iodine (RAI) therapy.
Methods
This retrospective cohort included adults referred for follow-up regarding progressing of Graves Orbitopathy after RAI treatment for their hyperthyroidism between January 2013 and December 2023. Demographic features, smoking history, thyroid function tests, antibody levels, and ophthalmologic findings were reviewed. Severity of orbitopathy was classified according to EUGOGO criteria. Patients were categorized as stable or progressive, and factors associated with progression were analyzed. In patients with available pre-RAI ophthalmologic data, baseline MRD, Hertel exophthalmometry values, CAS, and diplopia scores were evaluated.
Results
Sixty-five patients were included (mean age: 48.0 ± 12.6 years; 71.9% female). During follow-up, 44 (67.7%) showed worsening of ophtalmopathy, including 15 (23.1%) with de novo disease and 29 (44.6%) with progression of pre-existing ophthalmopathy, while 21 (32.3%) remained stable. Smoking status and cumulative smoking exposure were significantly associated with progression (p < 0.001). Higher pre-RAI TRAb levels were also associated with progression (p = 0.033). In the progressive group, 23 patients (35.9%) received IV corticosteroids, and 17 (26.6%) underwent surgery, including orbital decompression, strabismus, and eyelid surgery. In the subgroup of 21 patients with pre-RAI ophthalmologic data, the progressive group had significantly higher MRD, Hertel exopthalmometry values, CAS, and diplopia scores (p < 0.05), suggesting baseline orbital involvement may predict post-RAI progression.
Conclusion
A substantial proportion of patients may develop new-onset or worsening TAO after RAI therapy. Smoking and elevated pre-treatment TRAb levels appear to be major risk factors for progression. Baseline ophthalmologic involvement may help identify patients at risk for post-RAI worsening. Careful patient selection and close ophthalmologic follow-up are essential in high-risk patients.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Onur | Konuk | Gazi University Hospital |
| Damla | Balaban | Gazi University Hospital |
| L.Raşid | Alkan | Polatlı State Hospital |