HYPOTHYROIDISM IN PROGRESSIVE OPHTHALMOPATHY OF GRAVES‘ DISEASE

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Abstract
Thirty patients with Graves' disease and progressive ophthalmopathy which required pterional orbital decompression were followed from 1964 to 1971 regarding their general health, and thyroid and eye functions. Twenty patients developed progressive ophthalmopathy after radio‐iodine treatment, 9 after subtotal thyroid resection and 1 during neomercazole treatment.Twenty‐five of 30 patients had documented hypothyroidism after the treatment of their basic disorder. In every case, the ophthalmopathy started or became progressive during the period of hypothyroidism. A remarkably acute onset of ophthalmopathy was reported in nine cases within four weeks of antithyroid therapy. Another nine patients developed slight hypothyroidism but displayed an ophthalmopathy one year or more after the basic treatment. Five patients without documented hypothyroidism developed progressive ophthalmopathy two months to 2.5 years after therapy.Seven patients had recurrent Graves' disease, and in five of these a deterioration of ophthalmopathy occurred during the recurrent episodes. The hypothyroidism developing after treatment of the hyperthyroidism of Graves' disease seems to be a major pathogenic factor in progressive ophthalmopathy.