Therapy with somatostatin analogs in patients with Graves' ophthalmopathy and positive octreoscan

We prospectively evaluated 28 persons with active endocrine ophthalmopathy and positive sonographic criteria (A-mode) on extraocular eye muscles. To e valuate somatostatin-receptor status SPELT of the orbits was performed with a double-headed rotating gamma camera after application of 110 MBq 111-In- Pentreotide. 9 patients (12/56 eyes respectively) showed a marked uptake ra tio (> 2 in circular ROIs by semiquantitative calculation) and were selecte d for lanreotide (30 mg i.m. every 14 d) treatment. 5 individuals had contr ol scan after clinical progression which became positive in two of them. Al l but one tolerated modest side-effects of lanreotide treatment (diarrhea). Therapy was discontinued after 3-10 months when thyroid eye disease had le ad to fibrotic stage. This subgroup, with the exception of two women, who r eceived corticosteroids additionally, presented stable disease. One of thos e had to be sent to surgery because of endangered optical nerve. Clinical o phthalmological control showed promising results in patients receiving soma tostatin analogues at early stage when positive on octreo-scan.