Ophthalmic manifestation as adverse factor for cure in radioiodine treatment of Graves' disease

Yetunde A Onimode, Kayode S Adedapo, Magbagbeola D Dairo

Thyroid Research and Practice 2017 14(1):18-21

Context: Figures from several states indicate the prevalence of primary hyperthyroidism as 1.5%–5.4%. Goiters (including Graves' disease [GD]) and diabetes mellitus are the most common presentations at Nigerian endocrine clinics. Aim: This study aims to assess the efficacy of radioactive iodine-131 therapy (RAIT) of GD, evaluate factors affecting its outcome, and to find the impact of ophthalmic symptoms on response of GD to RAIT. Participants and Methods: A retrospective review of RAI-naϊve GD patients treated from 2006 to 2016 was performed. Results: Eighty-one treatments were made in this period to 75 patients; of these, 51 patients had had no prior RAI treatment. Overall, 41 patients (78.8%) were cured by mean time to cure 4.5 ± 2.36 months. Fourteen patients (26.9%) were cured by 3 months, an additional 19 (36.5%) by 6 months, an additional 5 (9.6%) by 9 months, and 1 more by 14 months, and 2 were cured later. Cure comprised euthyroidism in 14 patients (26.9%) and outright hypothyroidism in 27 (51.9%). Graves' ophthalmopathy (GO) is associated with less likelihood of cure (P = 0.025). Those with GO were ten times less likely to be cured than those without GO (odds ratio = 0.105, confidence interval = 0.11–0.979, P = 0.048). Conclusions: Findings suggest that GO is an adverse factor in RAIT for GD (as was found in an earlier study from this center) and also suggest that patients with GO will benefit from larger doses of RAI.

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