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Eighty-two consecutive patients with moderate-to-severe and active Graves’ ophthalmopathy were randomly treated with orbital radiotherapy combined with either oral (prednisone; starting dose, 100 mg/d; withdrawal after 5 months) or iv (methylprednisolone; 15 mg/kg for four cycles and then 7.5 mg/kg for four cycles; each cycle consisted of two infusions on alternate days at 2-wk intervals) glucocorticoids. The two groups did not differ for age, gender, duration of hyperthyroidism and ophthalmopathy, prevalence of smokers, thyroid volume, and pretreatment ocular conditions. Both groups of patients received radioiodine therapy shortly before treatment for Graves’ ophthalmopathy. Follow-up lasted for 12 months.

A significant reduction in proptosis (from 23.2 ± 3.0 to 21.6 ± 1.2 mm in the iv glucocorticoid group, P < 0.0001; and from 23 ± 1.8 to 21.7± 1.8 mm in oral glucocorticoid group, P < 0.0001) and in lid width …