Orbital Radiation May Prevent, Treat Compressive Optic Neuropathy

Orbital radiation, used with or without corticosteroids, may prevent or treat compressive optic neuropathy (CON), promoting mobility, and reducing clinical activity in thyroid eye disease (TED), according to a literature review published in Ophthalmology. The research also found that orbital radiation may facilitate tapering of corticosteroids.

Researchers reviewed the current literature on the safety and efficacy of orbital radiation for the treatment of TED. They conducted a literature search last in February 2021 of the PubMed database to identify all articles published in the English language on original research that evaluated the influence of orbital radiation on TED. The review included 18 articles. 

According to the researchers, 2 large, well-designed, retrospective studies show that radiation therapy may be a reliable method, with or without corticosteroids use, in preventing or treating CON. Several studies emphasize the role of orbital radiation therapy in facilitating the tapering of corticosteroids. Several other studies suggest that radiation therapy may improve diplopia and soft tissue signs.

The study authors report several limitations. For example, the data included is retrospective. Also, the most effective dose of radiation therapy for TED remains underdetermined, the researchers note.    

“This assessment updates the 2008 Ophthalmic Technology Assessment on the efficacy and safety of orbital radiation for TED,” according to the report. “Short-term risks of orbital radiation are minor, but long-term outcome data are lacking.”

Reference

Sobel RK, Aakalu VK, Vagefi MR, et al. Orbital Radiation for Thyroid Eye Disease. Ophthalmol. Published online December 8, 2021. doi:10.1016/j.ophtha.2021.10.025