DR. SUBHAV PERSHAD

DR..MOHAMMED MOINUL HOQUE, DR. SANTOSH G. HONAVAR

Abstract

Purpose: To study outcomes of IVMP pulse therapy and immunomodulation in active TED.

Methods: A retrospective study of 80 patients (147 eyes) with active TED treated with pulse IVMP with or without oral azathioprine(AZT)/mycophenolate mofetil.Results: Mean age at presentation was 45.8±11.3 (range 17-69) years. Immunomodulation was required in 48 patients (103 eyes). Mean follow-up was 17±11.4 (range 6-47)months

Exophthalmos improved in 50 (55.5%) of 90 eyes. Mean improvement in exophthalmos was 1.51(range 1-9)mm. 23 patients had orbital decompression for residual exophthalmos. Of 59 patients with diplopia, 31(52.5%) resolved and 13 needed prisms/EOM surgery. Overall, 72(90%) patients had complete remission in activity. Mean EUGOGO activity score was 6±0.5 baseline and 1.76±1.2 post treatment . AZT was discontinued in 1(3%) patient with pneumonitis.Conclusion: Monitored IVMP pulse therapy with short-term immunomodulation is safe and effective in controlling disease activity in TED.