Academic Journal
No retinopathy after orbital irradiation in patients with thyroid eye disease - a follow up study.
| Τίτλος: | No retinopathy after orbital irradiation in patients with thyroid eye disease - a follow up study. |
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| Συγγραφείς: | Makhoul S; Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.; Doctoral School of Clinical Medicine, University of Debrecen, Debrecen, Hungary., Aranyosi JK; Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Csiki E; Department of Oncoradiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Urbancsek H; Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Nagy EB; Divison of Radiology and Imaging Science, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Erdei A; Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Fodor M; Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Kovacs A; Department of Oncoradiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Nagy EV; Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Ujhelyi B; Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.; Doctoral School of Clinical Medicine, University of Debrecen, Debrecen, Hungary. |
| Πηγή: | Frontiers in endocrinology [Front Endocrinol (Lausanne)] 2025 Dec 10; Vol. 16, pp. 1720650. Date of Electronic Publication: 2025 Dec 10 (Print Publication: 2025). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Frontiers Research Foundation] Country of Publication: Switzerland NLM ID: 101555782 Publication Model: eCollection Cited Medium: Print ISSN: 1664-2392 (Print) Linking ISSN: 16642392 NLM ISO Abbreviation: Front Endocrinol (Lausanne) Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Lausanne : Frontiers Research Foundation] |
| Ιατρικοί όροι (MeSH): | Graves Ophthalmopathy*/radiotherapy , Retinal Diseases*/etiology , Retinal Diseases*/epidemiology , Radiation Injuries*/etiology , Radiation Injuries*/epidemiology , Orbit*/radiation effects, Humans ; Follow-Up Studies ; Male ; Female ; Middle Aged ; Adult ; Aged |
| Περίληψη: | Introduction: Thyroid eye disease (TED) is an autoimmune disease of the orbit. In moderate to severe active disease, orbital radiotherapy (ORT) is a treatment option. Diabetes is considered a relative contraindication because of potential induction of retinopathy. The purpose of this study was to decide if ORT remains a risk towards retinopathy in the era of linear accelerators with 3D computer aided design. Follow up examinations were performed to detect radiogenic retinopathy. Methods: Of the 151 patients who received ORT for TED between 2004-2020 at the University of Debrecen, 97 patients were available for follow up. In each case, 3D-based LINAC radiotherapy with a total dose of 20 Gy in 2 Gy daily fractions was administered. Eighteen patients had type 2 and one patient had type 1 diabetes. Median duration of diabetes was 16 (IQR:11.75-17.0) years; most recent HbA1c before irradiation was 6.55 (IQR:6.22-6.95) %. Ophthalmological follow up included slit-lamp and fundus examination, visual acuity, exophthalmometry and clinical activity score (CAS) calculation. Results: Median time between TED start and ORT was 2 (IQR:1-8) years. At the time of ORT, median TSH was 0.84 (IQR:0-1.41) mU/L, fT4 18 (IQR:12.15-25.40) pmol/L and fT3 6.5 (IQR:4.4-11.0) pmol/L, CAS was 5 (IQR:4-6). No diabetic retinopathy was present before ORT. The median follow-up period after completion of ORT was 60 (IQR:38-100) months. No patient developed retinopathy. Discussion: The risk of radiation-induced retinopathy after orbital irradiation, including well controlled diabetic patients, appears to be negligible. In the absence of pre-existing diabetic retinopathy and with good glycemic control ORT might be safe if linear accelerator with 3D planning is used. However, ophthalmic surveillance is still recommended. (Copyright © 2025 Makhoul, Aranyosi, Csiki, Urbancsek, Nagy, Erdei, Fodor, Kovacs, Nagy and Ujhelyi.) |
| Competing Interests: | The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. |
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| Contributed Indexing: | Keywords: diabetes; exophthalmos; radiotherapy; retinopathy; thyroid eye disease |
| Entry Date(s): | Date Created: 20251226 Date Completed: 20251226 Latest Revision: 20251228 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12728236 |
| DOI: | 10.3389/fendo.2025.1720650 |
| PMID: | 41450582 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1664-2392 |
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| DOI: | 10.3389/fendo.2025.1720650 |