There was a study published in the New England Journal of Medicine, in January, but of what year I cannot remember. (Why can I remember January, but not the year???) The researchers studied the various treatment options (ATDs, surgery and RAI) watching to see if there were any effects of the treatment on the eye disease. Their results — which apparently are still taken seriously (i.e. no other studies have repudiated this one, yet) –showed that in 16% of patients RAI resulted in a “temporary” worsening of the symptoms of TED. The article I read did not quantify “temporary”, nor did it indicate degree of “worsening”. The same study, however, showed that use of prednisone at the time of RAI resulted in no patients having this temporary worsening. The researchers seemed to think that RAI might stimulate the immune system temporarily. Surgery for study subjects did not show a worsening effect on the eyes. So the implications for patients with existing eye disease symptoms, or for those patients whose history suggests that they are at greater risk of the eye disease developing, are that they either do surgery to remove their thyroids OR they take prednisone concurrently with their RAI. In short, RAI does not cause the eye disease to develop, but in a minority of patients it can result in a temporary worsening of the eye symptoms. There can be medical reasons which indicate whether a patient with eye disease can do surgery or can do the RAI plus steroids, so the decision needs to be carefully weighed with your doctor.
Bobbi – NGDF Online Facilitator
