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One-year recurrence rate of Graves ophthalmopathy presenting as diplopia in the primary position after varied doses of intravenous methylprednisolone followed by oral prednisolone with dosing based on the magnetic resonance imaging findings

  • Clinical Investigation
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Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To reveal the recurrence rate of Graves ophthalmopathy (GO) presenting as diplopia in the primary position for 1 year after varied doses of intravenous methylprednisolone (IVMP) followed by oral prednisolone, with dosing based on the magnetic resonance imaging (MRI) findings.

Study design

Retrospective study.

Methods

We analyzed the medical charts of 25 patients who were diagnosed with new-onset GO and who received treatment for diplopia in the primary position at our hospital. Treatment consisted of MRI-determined varied doses of IVMP followed by oral prednisolone. If the MRI findings showed deterioration or were unchanged after 6 g of IVMP, 3 g of IVMP was added for further treatment. Simple and multiple linear regression analyses were performed to reveal the associations between the independent variables and the dependent variable, defined as recurrence.

Results

The mean patient age (± standard deviation) was 61.3 ± 11.3 years. The female to male ratio was 15:10. Twenty-one of the 25 patients received a total of 6 g of IVMP, whilst the remaining 4 patients received a total of 9 g of IVMP. In 5 patients (20%), the GO recurred within 1 year of IVMP administration. Simple and multiple linear regression analyses showed that the MRI findings after 6 g of IVMP affected recurrence (P < .05).

Conclusion

This study showed that in 20% of patients, GO recurred within 1 year of administration of varied doses of IVMP, with the dosing based on the MRI findings. Furthermore, assessment of inflammation by use of MRI after 6 g of IVMP has a potential role in predicting recurrence.

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Authors and Affiliations

  1. Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Asahimachi-dori 1-757, Chuo-ku, Niigata, 951-8510, Japan

    Satoshi Ueki, Yukari Hasegawa, Tetsuhisa Hatase, Megumi Kiyokawa & Takeo Fukuchi

Authors
  1. Satoshi Ueki
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  2. Yukari Hasegawa
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  3. Tetsuhisa Hatase
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  4. Megumi Kiyokawa
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  5. Takeo Fukuchi
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Corresponding author

Correspondence to Satoshi Ueki.

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Conflicts of interest

S. Ueki, None; Y. Hasegawa, None; T. Hatase, None; M. Kiyokawa, None; T. Fukuchi, None.

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Corresponding Author: Satoshi Ueki

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Ueki, S., Hasegawa, Y., Hatase, T. et al. One-year recurrence rate of Graves ophthalmopathy presenting as diplopia in the primary position after varied doses of intravenous methylprednisolone followed by oral prednisolone with dosing based on the magnetic resonance imaging findings. Jpn J Ophthalmol 67, 91–96 (2023). https://doi.org/10.1007/s10384-022-00954-9

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  • DOI: https://doi.org/10.1007/s10384-022-00954-9

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