{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:03:39Z","timestamp":1784174619043,"version":"3.55.0"},"reference-count":0,"publisher":"Press of International Journal of Ophthalmology (IJO Press)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Ophthalmol"],"published-print":{"date-parts":[[2026,8,18]]},"abstract":"<jats:p>AIM: To evaluate the efficacy and safety of a medium-dose intravenous methylprednisolone (IVMP) pulse regimen for moderate-to-severe active thyroid-associated orbitopathy (TAO), with change in clinical activity score (CAS) as the primary outcome.\nMETHODS: This prospective interventional study was conducted at a tertiary eye care center in Bangladesh between February and November 2022. Patients with active moderate-to-severe TAO (CAS\u22653) received IVMP totaling 4.0 g (500 mg daily for 3 consecutive days, followed by 500 mg every 3wk for 5 cycles). Clinical outcomes, including CAS, proptosis measured by Hertel exophthalmometry, best-corrected visual acuity (BCVA; logMAR), and intraocular pressure (IOP), were assessed at baseline and at 6mo.\nRESULTS: A total of 30 patients with active TAO were enrolled and completed the 6-month follow-up. The mean age of the participants was 38.63\u00b112.11y, and 19 (63.3%) were male. The mean CAS decreased significantly from 3.66\u00b11.03 to 0.87\u00b10.63 (mean change \u22122.79\u00b10.95; P&lt;0.0001). The mean degree of proptosis decreased from 22.47\u00b11.59 to 20.13\u00b11.97 mm (\u22122.34\u00b11.25 mm; P&lt;0.0001). BCVA improved from 0.46\u00b10.31 to 0.15\u00b10.18 logMAR (\u22120.31\u00b10.28; P=0.02). The mean IOP decreased from 16.80\u00b13.56 to 14.93\u00b11.73 mm Hg (\u22121.87\u00b12.45 mm Hg; P&lt;0.001). Eyelid swelling, conjunctival redness, chemosis, and retro-orbital pain resolved in more than 90% of patients. Adverse events, including transient increased IOP (26.66%), hyperglycemia (20.00%), and elevated SGPT (6.67%), were mild and reversible; no severe hepatic, cardiovascular, or psychiatric complications occurred.\nCONCLUSION: Medium-dose IVMP (4.0 g) significantly improve disease activity, proptosis, visual acuity, and IOP, with an acceptable safety profile. This regimen represents an effective and safer alternative to high-dose IVMP for active moderate-to-severe TAO, particularly in resource-limited settings. Larger, multicenter trials with longer follow-up periods are needed to confirm these findings.<\/jats:p>","DOI":"10.18240\/ijo.2026.08.14","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:06:34Z","timestamp":1784171194000},"page":"1556-1562","source":"Crossref","is-referenced-by-count":0,"title":["Medium-dose intravenous methylprednisolone pulse therapy for thyroid-associated orbitopathy"],"prefix":"10.18240","volume":"19","author":[{"name":"Bangladesh Eye Hospital, Zigatola Ltd., Dhaka 1209, Bangladesh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashfaque Rahman","family":"Khan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riffat","family":"Rashid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Oculoplasty, Ispahani Islamia Eye Institute and Hospital, Dhaka 1215, Bangladesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzana","family":"Afzal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Oculoplasty, Ispahani Islamia Eye Institute and Hospital, Dhaka 1215, Bangladesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syeed Mehbub Ul","family":"Kadir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Oculoplasty, National Institute of Ophthalmology &amp; Hospital, Dhaka 1207, Bangladesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7543","container-title":["International Journal of Ophthalmology"],"original-title":[],"link":[{"URL":"https:\/\/www.ijo.cn\/gjyken\/article\/pdf\/20260814","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:07:00Z","timestamp":1784171220000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ijo.cn\/gjyken\/article\/abstract\/20260814"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":0,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,18]]}},"URL":"https:\/\/doi.org\/10.18240\/ijo.2026.08.14","relation":{},"ISSN":["2222-3959","2227-4898"],"issn-type":[{"value":"2222-3959","type":"print"},{"value":"2227-4898","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]}}}