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New research · Ophthalmology
International journal of ophthalmology · 4d
StudyInternational journal of ophthalmology · 2026

Medium-dose intravenous methylprednisolone pulse therapy for thyroid-associated orbitopathy.

Ashfaque Rahman Khan, Sadia Sultana, Riffat Rashid … Syeed Mehbub Ul Kadir
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OphthalmologyStudy

Clinical activity score fell after steroid pulse therapy in thyroid eye disease

Medium-dose intravenous methylprednisolone pulse therapy for thyroid-associated orbitopathy.

Ashfaque Rahman Khan … Syeed Mehbub Ul Kadir
International journal of ophthalmology · 2026
Purpose

To evaluate the efficacy and safety of a medium-dose intravenous methylprednisolone (intravenous methylprednisolone) pulse regimen for moderate-to-severe active thyroid-associated orbitopathy (thyroid-associated orbitopathy), with change in clinical activity score (clinical activity score) as the primary outcome.

Methods

With active moderate-to-severe thyroid-associated orbitopathy (clinical activity score≥3) received intravenous methylprednisolone totaling 4.0 g (500 mg daily for 3 consecutive days, followed by 500 mg every 3wk for 5 cycles).

n = 30 patients
Results

clinical activity score dropped, showing much less active eye disease

Baseline
3.66CAS sc
6mo
0.87CAS sc
More results

The mean age of the participants was 38.63±12.11y, and 19 (63.3%) were male.

The mean degree of proptosis decreased from 22.47±1.59 to 20.13±1.97 mm (-2.34±1.25 mm; P <0.0001).

BCVA improved from 0.46±0.31 to 0.15±0.18 logMAR (-0.31±0.28; P =0.02).

The mean IOP decreased from 16.80±3.56 to 14.93±1.73 mm Hg (-1.87±2.45 mm Hg; P <0.001).

“
Conclusion · 1 of 3

Medium-dose intravenous methylprednisolone (4.0 g) significantly improve disease activity, proptosis, visual acuity, and IOP, with an acceptable safety profile.

Conclusion · 2 of 3

This regimen represents an effective and safer alternative to high-dose intravenous methylprednisolone for active moderate-to-severe thyroid-associated orbitopathy, particularly in resource-limited settings.

Conclusion · 3 of 3

Larger, multicenter trials with longer follow-up periods are needed to confirm these findings.

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