Systemic management of dysthyroid ophthalmopathy.

The best systemic treatment of dysthyroid ophthalmopathy remains high dosage Prednisolone. Other methods of immunosuppression such as Azathioprine and Cyclosporin A have proved disappointing, as has plasmapheresis. Other localised means may be used and these are radiotherapy to the retrobulbar tissues or orbital decompression. These methods may be used in addition to or instead of high dose Prednisolone but some surgeons prefer to try Prednisolone as a first measure.