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99mTc-DTPA SPECT/CT provided guide on triamcinolone therapy in Graves’ ophthalmopathy patients

  • Dan Liu
  • Xueliang Xu
  • Sha Wang
  • Chengzhi Jiang
  • Xinhui Li
  • Jia TanEmail author
  • Zhihong DengEmail author
Original Paper
  • 1 Downloads

Abstract

Introduction

Distinguishing between the active and inactive stages of Graves’ ophthalmopathy (GO) is essential for making treatment decisions. 99mTc-DTPA SPECT/CT is sensitive in identifying inflammation in extraocular muscles of GO patients, which we designate 99mTc-DTPA-active. This study aimed to evaluate the response of 99mTc-DTPA-active GO patients to local immunosuppressive therapy.

Materials and methods

Sixty-four 99mTc-DTPA-active GO patients (89 eyes) were retrospectively analyzed. Forty-five patients (64 eyes) received repeated peribulbar triamcinolone injection, and 19 patients (25 eyes) received no immunosuppressive treatment. Ophthalmological assessment, including clinical activity score, eyelid retraction, eyelid aperture, proptosis, diplopia, and ocular mobility, was recorded before and after treatment.

Results

Compared with untreated patients, the clinical activity score decreased significantly (P  < 0.001) while eye symptoms (soft-tissue swelling and eyelid retraction and aperture) improved significantly (P  = 0.02, P  < 0.001, P  < 0.001, respectively) in treated patients after six months. The inferior and medial recti were significantly smaller (P  < 0.001, P  < 0.001, respectively), and 99mTc-DTPA uptake in the two recti was significantly less (P  = 0.001, P  = 0.01, respectively) in treated patients than in untreated patients after 3 months.

Conclusion

Clinical activity score of < 3 does not indicate inactive GO, as revealed with 99mTc-DTPA SPECT/CT. Patients with 99mTc-DTPA-active GO can improve the symptoms with peribulbar triamcinolone injection.

Keywords

Triamcinolone Graves’ ophthalmopathy SPECT/CT 

Notes

Compliance with ethical standards

Conflict of interest

No conflict of interest

Funding

This study was supported by Hunan Provincial Natural Science Foundation (No. 2019JJ80012).

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of OphthalmologyXiangya Hospital Central South UniversityChangshaChina
  2. 2.Department of Nuclear Medicine, Xiangya HospitalCentral South UniversityChangshaChina
  3. 3.Department of Ophthalmology, The Third Xiangya HospitalCentral South UniversityChangshaChina

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