I-131 and thyroid-associated ophthalmopathy

Objective: Radioiodine (I-131) used to obtain euthyroidism in thyrotoxic pa tients is suspected of having a worsening or provoking effect on thyroid-as sociated ophthalmopathy (TAO), an autoimmune disease closely related to Gra ves' disease. Design: This review summarises the existing literature and describes risk f actors influencing the course of TAO including thyroid function, cigarette smoking and treatment of Graves' hyperthyroidism (especially I-131 therapy) . Conclusion: It is recommended that patients who may be at a greater risk of worsening ophthalmopathy are considered when choosing the modality of ther apy of hyperthyroidism and also in deciding whether prophylactic systemic g lucocorticoid treatment is indicated.