Paper

The Use of Orbital Radiotherapy for Graves' Ophthalmopathy: Quantitative Review of the Evidence
Rui-Li Wei, Jin-Wei Cheng, Ji-Ping Cai

Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China

Address of Corresponding Author

Ophthalmologica 2008;222:27-31 (DOI: 10.1159/000109275)

  Key Words

• Graves' ophthalmopathy
• Orbital radiotherapy
• Glucocorticoids
• Meta-analysis

  Abstract

Objective: To systematically evaluate the efficacy of orbital radiotherapy in the treatment of Graves' ophthalmology. Methods: Pertinent studies were selected through an electronic search of Cochrane Library, Medline, Embase and Chinese Biomedical Database. Studies meeting selected criteria were reviewed systematically by meta-analysis. The treatment effect was measured as risk difference (RD) of treatment failure, and pooled estimates were computed according to a random effect model. Results: A total of 18 studies were included in this meta-analysis, 8 cohort and 10 randomized. Orbital radiotherapy alone was significantly more effective than a vehicle control [pooled RD = -0.26, 95% confidence interval (CI) = -0.41 to -0.10] and as effective as oral corticosteroids (pooled RD = -0.10, 95% CI = -0.20 to -0.00). The combination of orbital radiotherapy and oral corticosteroids was markedly more effective than other treatment modalities (pooled RD = -0.27, 95% CI = -0.36 to -0.17). Orbital radiotherapy combined with intravenous methylprednisolone was more efficacious than other treatment modalities (pooled RD = -0.18, 95% CI = -0.30 to -0.07). Conclusions: Orbital radiotherapy appears to be an effective treatment for Graves' ophthalmology and seems to have an increased effect when given with systemic corticosteroids. Orbital radiotherapy combined with intravenous methylprednisolone seems to have the best documented efficacy.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Rui-Li Wei
Department of Ophthalmology, Shanghai Changzheng Hospital
415 Fengyang Road
Shanghai 200003 (China)
Tel. +86 21 6361 0109 73451, Fax +86 21 6351 9814, E-Mail ruiliwei@gmail.com

  Article Information

Published online: December 19, 2007
Number of Print Pages : 5
Number of Figures : 3, Number of Tables : 1, Number of References : 27