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 severe acute thyroid orbitopathy that failed to respond to high-dose corticosteroid therapy. The clinical response to irradiation was rapid, dramatic and sustained after extended follow-up. Although radiotherapy has been used in dysthyroid eye disease, there remains debate over the precise indications for and the timing of its utilization. A review of the literature on the use of radiotherapy for acute thyroid orbitopathy has been undertaken, emphasizing its steroid-sparing potential and its role in avoiding the necessity for surgical orbital decompression.