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Graves' disease and ophthalmopathy are much more common in women than in men. It is unclear whether treatments for Graves' disease promote the development of ophthalmopathy. This study assessed eye problems in 443 patients, including 358 women, with Graves' hyperthyroidism. After 3 to 4 months of treatment with methimazole, patients were randomized to radioiodine, radioiodine followed by 3 months of prednisone, or 18 months of methimazole. Thyroid function was evaluated and treated promptly as necessary; eye examinations assessed proptosis, lid width, diplopia, and ophthalmopathy activity every 1 to 2 months.
At baseline, all groups had mild or no eye problems. Within 6 months of treatment, ophthalmopathy developed or worsened in 15% of the …