Author(s)

Muhammad Shah Alam¹, A. B. M. Kamrul-Hasan^2*, Syeda Tanzina Kalam³, Ajit Kumar Paul⁴, Shahjada Selim⁵

¹Department of Medicine, Army Medical College, Cumilla, Bangladesh.
²Department of Endocrinology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh.
³Department of Medicine, Cumilla Medical College Hospital, Cumilla, Bangladesh.
⁴Department of Endocrinology, Mainamati Medical College, Cumilla, Bangladesh.
⁵Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Background: Graves’ ophthalmopathy (GO) is the most frequent extrathyroidal manifestation of Graves’ disease (GD). The effect of intravenous methylprednisolone on the signs and symptoms of GO has not been evaluated in the Bangladeshi population. Objective: To observe the effect of intravenous methylprednisolone in active Graves’ ophthalmopathy. Materials/Methods: This prospective study conducted in a tertiary hospital of Bangladesh from May 2009 to November 2010 included 30 patients having moderate to severe ophthalmopathy. In addition to the clinical activity score (CAS), eye involvement was assessed by using the “NOSPECS” scoring system. Results: The mean (±SD) age of the patients was 38.1 ± 10.6 years and male-female ratio was 1.2:1. NOSPECS eye findings before treatment and during the final (3rd) visit of the patients were observed. It was found that lid retraction or lid lag was improved in 21 (70%) of the patients during the final visit. All of the patients had soft tissue swelling initially and all of them improved at the final visit. Bilateral proptosis was present in 19 patients before treatment and improved in 12 (62%) patients during the final visit. Right eye proptosis was present in 9 patients before treatment and improved in 5 (60%) patients during final visit. Extraocular muscle involvement (Diplopia) was present in 15 patients before treatment but improved in 13 (86.0%) patients during the final visit. A significant number of subjects showed significant improvement in all of the NOSPECS eye findings (except unilateral right eye proptosis) during the final visit; all had inactive GO (CAS < 2) at the end of the 3rd visit. Conclusion: Intravenous methylprednisolone appears to be an effective treatment option for active Graves’ ophthalmopathy.

Graves’ Ophthalmopathy, NOSPECS, Methylprednisolone

Alam, M. , Kamrul-Hasan, A. , Kalam, S. , Paul, A. and Selim, S. (2019) Effect of Intravenous Methylprednisolone on the Signs & Symptoms of Graves’ Ophthalmopathy. Open Journal of Endocrine and Metabolic Diseases, 9, 95-101. doi: 10.4236/ojemd.2019.99010.