Intravenous
glucocorticoids are used for
Graves' orbitopathy, alone or associated with/followed by additional treatments (orbital
radiotherapy, orbital
decompression, palpebral or eye surgery). However, the relation between associated/additional treatments and other variables with
Graves' orbitopathy outcome following intravenous
glucocorticoids is not clear. Thus, the present study was conducted to investigate retrospectively the impact of associated/additional treatments and other variables on
Graves' orbitopathy outcome after intravenous
glucocorticoids. We evaluated 226 untreated
Graves' orbitopathy patients. Following first observation, patients were given intravenous
glucocorticoids and re-examined after a median of 46.5 months. The end-points were the relation between
Graves' orbitopathy outcome, outcome of NOSPECS score and of the single
Graves' orbitopathy features with several variables, including associated/additional treatments. All
Graves' orbitopathy features improved significantly
after treatment. Overall,
Graves' orbitopathy improved in ~60 % of patients (responders), whereas it was stable or worsened in ~40 % of patients (non-responders). Time between first and last observation and clinical activity score at first observation correlated significantly with
Graves' orbitopathy outcome. The outcomes of NOSPECS, eyelid aperture, clinical activity score and
diplopia correlated with time between the first and last observation. The NOSPECS outcome correlated with gender. The outcomes of
proptosis, eyelid aperture and visual acuity correlated with orbital
decompression. The outcome of
diplopia correlated with orbital
radiotherapy. Taking into account the limitations of retrospective investigations, our findings confirm that time (i.e. the natural history of
Graves' orbitopathy) is a key factor in determining the long-term outcome of
Graves' orbitopathy,
radiotherapy is effective for
diplopia, and orbital
decompression is followed by an amelioration of several
Graves' orbitopathy features.