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Treatment of Graves’ Ophthalmopathy
Int J Thyroidol
Published online November 15, 2019
© 2019 Korean Thyroid Association.

Jeong Kyu Lee

Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
Correspondence to:
Jeong Kyu Lee, MD, PhD, Department of Ophthalmology, Chung-Ang University College of Medicine,
Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea
Tel: 82-2-6299-1665, Fax: 82-2-825-1666, E-mail:
Received September 24, 2019; Revised October 9, 2019; Accepted October 12, 2019.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Graves’ ophthalmopathy (GO) is an autoimmune disease associated with orbital inflammation and fibrosis
which can result in lid retraction, soft tissue swelling, and proptosis. Treatment should rely on a thorough
assessment of the activity and severity of GO. Control of risk factors for GO progression and topical treatments
for dry eye are recommended for all patients. In mild GO, a careful observation is usually sufficient. In
moderate-to-severe and active GO, high-dose intravenous glucocorticoids can be considered an initial
treatment. The most common schedule for intravenous glucocorticoids is a cumulative dose of 4.5 g of
methylprednisolone, divided into 12 weekly infusions (6 weekly infusions of 0.5 g, followed by 6 weekly infusion
of 0.25 g). Orbital radiation has been shown to be an effective secondary treatment in patients with active
GO unresponsive to intravenous glucocorticoids. Rehabilitative surgery is needed in the patients with GO when
the disease is associated with a significant impact on quality of life or visual function after the disease has
been inactive for at least 6 months.
Keywords : Graves’ ophthalmopathy, Activity, Severity, Steroid, Orbital decompression

November 2019, 12 (2)