Restoration of vision by radiotherapy for severe, acute, steroid-refractory, congestive thyroid orbitopathy

We report the case history of a patient treated with radiotherapy for sever e acute thyroid orbitopathy that failed to respond to high-dose corticoster oid therapy. The clinical response to irradiation was rapid, dramatic and s ustained after extended follow-up. Although radiotherapy has been used in d ysthyroid eye disease, there remains debate over the precise indications fo r and the timing of its utilization. A review of the literature on the use of radiotherapy for acute thyroid orbitopathy has been undertaken, emphasiz ing its steroid-sparing potential and its role in avoiding the necessity fo r surgical orbital decompression.