Differentiated approach to the treatment of autoimmune ophthalmopathy

Abstract

The results of comprehensive examinations and therapy of 67 patients with autoimmune ophthalmopathy are presented. In 80 % of the patients the disease coursed along with thyrotoxicosis, in 10 % thyroid function was reduced because of autoimmune thyroiditis, and in the rest autoimmune ophthalmopathy was an individual entity. A staged therapeutic complex for the treatment of this condition is suggested, aimed at correction of thyroid function (stage 1), followed by pathogenetic therapy including antiinflammatory measures, glucocorticoids and nonsteroid antiinflammatory drugs to arrest aseptic inflammation in the orbit, and immunosuppressive therapy to correct the immunity shifts. After clinical and immunologic remission was achieved, courses of maintenance therapy (nonsteroid antiinflammatory drugs) were carried out for 3-5 months monitored by blood analyses and ophthalmologic examinations, immunity status tests, CT clinical data. Choice of the treatment strategy was governed by the morphologic variant of ophthalmopathy, immunologic activity of the process, disease severity and pattern. Such an approach helped achieve positive results and clinico-immunologic remission, as well as timely prevent the progress of the disease.