Radiotherapy for Thyroid Eye Disease (TED)

Summary of American Academy of Ophthalmology Report
Ophthalmology 2008;115:298-409

Activated T-cells and fibroblasts are radiosensitive
Therapy is local and avoids systemic complications of systemic immunosuppression with corticosteroids

Results of treatment
i) Diplopia – improved vertical range of movement in radiation-treated subjects compared with controls
ii) Proptosis, lid swelling/retraction – no improvement
iii) No studies have looked at the role of irradation for TED induced optic neuropathy

Definite radiation retinopathy 1% to 2% within 10 years of treatment. Up to 21% possible radiation retinopathy within 10 years of treatment. Minimal risk of secondary malignancy.