• P Grassi, D Strianese, R Piscopo, R Pacelli, and G Bonavolontà.
• Department of Neuroscience, Odontostomatological and Reproductive Sciences, University "Federico II" of Naples, via Pansini no 5, 80131, Naples, Italy. pjgrassi@libero.it.
• Ir J Med Sci. 2017 Aug 1; 186 (3): 647-652.

Background And AimsTo evaluate the efficacy of orbital radiotherapy (OR) for the treatment of thyroid eye disease (TED).MethodsThirty-five consecutive patients with active TED with contraindications to steroid therapy received a course of OR. Bilateral retrobulbar irradiation was performed with a total dose of 20 Gy. 7-points clinical activity score (7-CAS), ocular motility, visual acuity (VA), exophthalmos and eyelid retraction were prospectively evaluated at 3, 6 and 12 months and compared with baseline data.ResultsThere was a statistically significant improvement in 7-CAS at 3, 6 and 12 months post-treatment (p < 0.05). Ocular motility disturbances improved at 6 and 12 months (p < 0.05). Visual acuity remained stable; there was no significant change in exophthalmos (mean 24 mm, SD 3 mm) or eyelid retraction (marginal reflex distance mean 6 mm, SD 1.5 mm) during the follow-up period. No side effects were registered.ConclusionsThis study suggests that OR might be effective in reducing 7-CAS and ocular motility disturbances. No significant improvement in proptosis or eyelid retraction should be expected from this treatment. OR might be considered a suitable alternative treatment in TED for patients who cannot tolerate steroids.

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