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Changes in therapeutic response, ocular manifestations of Graves’ orbitopathy and quality of life during the first year after orbital radiotherapy

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Abstract

Purpose

The aim of our study was to assess the changes in the therapeutic response, ocular manifestations of GO and quality of life during the first year after OR.

Methods

The study involved 26 consecutive patients with active moderate-to-severe GO indicated for OR, 18 females, mean age 57 ± 12.5. At baseline, all patients underwent comprehensive ocular examination and thyroid hormone and antibody testing. Then, OR was performed with a total dose of 20 Gy, divided into 10 sessions of 2 Gy each with concomitant oral intake of low-dose glucocorticoids. Therapeutic response and individual ocular manifestations were evaluated 1, 3, 6 and 12 months after OR, and QoL—at 3, 6 and 12 months by a disease-specific questionnaire.

Results

One month after OR, 61.6% of patients had a therapeutic response (full or partial). During the follow-up, the proportion of full-responders gradually increased up to 57.5% at 12 months, while that of non-responders gradually decreased, reaching 11.5% at 12 months. All individual ocular manifestations improved significantly 1–3 months after OR. QoL related to visual functioning increased significantly at 6 months, whereas QoL related to appearance improved significantly at 12 months.

Conclusions

The vast majority of our patients with active moderate-to-severe GO exhibited full or partial therapeutic response after OR. The initial effect on the therapeutic response and individual ocular parameters was evident as soon as 1–3 months after the procedure. OR also has a beneficial effect on patients’ QoL.

Trial registration number

NCT05775185/07.03.2023, retrospectively registered.

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Data availability

The data that support the findings of this study are available from the corresponding author, M.S., upon reasonable request.

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Funding

The authors declare that no funds, grants or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Endocrinology, Medical University of Sofia, University Hospital of Endocrinology, 2 Zdrave Str., 1431, Sofia, Bulgaria

    Mariya Asenova Stoynova, Alexander Dimitrov Shinkov, Inna Dimitrova Dimitrova, Inna Angelova Yankova & Roussanka Dimitrova Kovatcheva

  2. Department of Radiooncology, Medical University of Sofia, University Hospital “Tsaritsa Yoanna”, Sofia, Bulgaria

    Miroslav Todorov Novoselski

  3. Department of Ophthalmology, Medical University of Sofia, University Hospital of Endocrinology, Sofia, Bulgaria

    Victoria Vladimirova Petrova

Authors
  1. Mariya Asenova Stoynova
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Contributions

All authors contributed to the study conception and design. Patients’ selection was performed by MAS, IDD, IAY, VPP, ADS and RDK. VPP examined patients’ ocular status at baseline and during the follow-up. MAS, IDD, IAY, ADS and RDK also examined patients’ ocular status, as well as clinical, hormonal and immunological status at baseline and during the follow-up. MTN performed orbital radiotherapy on the selected patients. Data analysis was performed by MAS and commented by all co-authors. The first draft of the manuscript was written by MAS, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mariya Asenova Stoynova.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The study protocol was approved by the Institutional Ethical Committee (Approval number 21B/25.07.2017) and was in accordance with the 1964 Declaration of Helsinki and its later amendments.

Consent to participate

All patients included in the study signed an informed consent.

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Stoynova, M.A., Shinkov, A.D., Novoselski, M.T. et al. Changes in therapeutic response, ocular manifestations of Graves’ orbitopathy and quality of life during the first year after orbital radiotherapy. Int Ophthalmol 43, 4305–4314 (2023). https://doi.org/10.1007/s10792-023-02842-8

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