Radiation therapy for Graves’ ophthalmopathy: a systematic review and meta-analysis of randomized controlled trials Radioterapia para oftalmopatia de Graves: uma revisão sistemática e meta-análise de ensaios clínicos randomizados e controlados

Graves’ ophthalmopathy is a debilitating disease impairing the quality of life of the affected individuals. Despite recent progress in the understanding of its pathogenesis, treatment is often not sa ­ tisfactory. In mild cases, local therapeutic measures (artificial tears and ointments, sunglasses, nocturnal eyes taping, prisms) can con­ trol symptoms and signs. In severe forms of the disease, aggressive measures are required. The management strategy for moderate to­ severe Graves’ ophthalmopathy is controversial. Systemic steroids are often effective, but relapse is common when they are tapered or withdrawn. A number of retrospective studies have reported the efficacy of orbital irradiation but prospective studies have shown conflicting results. Some investigators have suggested that ste ­ roids provide excellent improvement in orbital inflammation in the short term, whereas the effects of orbital irradiation take longer to appear. Studies that have compared combination therapy of or ­ bi tal irradiation and systemic steroids with steroids alone therapy have produced conflicting results. The accomplishment of a sys tematic review is the best manner for describing the state of our knowledge, and hence becomes the best way of obtaining high qua lity scientific evidence. Consequently, this systematic review was proposed to analyze the results from clinical trials that compared ra ­ diotherapy to any other treatment. Radiation therapy for Graves’ ophthalmopathy: a systematic review and meta-analysis of randomized controlled trials