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Chieh-Chih Tsai, MD; Shu-Ching Kao, MD; Ching-Yu Cheng, MD, MPH; Hui-Chuan Kau, MD, MS; Wen-Ming Hsu, MD; Cheng-Feng Lee, PhD; Yau-Huei Wei, PhD

Arch Ophthalmol. 2007;125(12):1652-1656.

Objectives  To measure the 8-hydroxy-2'-deoxyguanosine (8-OHdG) level in patients having active Graves ophthalmopathy (GO) and to compare this oxidative stress biomarker and the clinical evolution of patients after systemic corticosteroid treatment.

Methods  In 8 euthyroid patients having active GO, we determined the 8-OHdG levels in urine before, during, and after intensive corticosteroid therapy. Clinical activity and ophthalmopathy index scores were assessed. Nine age- and sex-matched healthy volunteers served as control subjects.

Results  The mean 8-OHdG level was statistically significantly increased in patients having active GO compared with that of controls (17.47 vs 5.97 ng/mg of creatinine, P < .001). During and after maximal systemic corticosteroid treatment, patients had statistically significantly lower mean 8-OHdG levels (7.19 and 10.18 ng/mg of creatinine, respectively) compared with the mean level before treatment. These changes were accompanied by decreases in clinical activity and ophthalmopathy index scores. The urinary 8-OHdG levels were subsequently elevated in 2 patients having recurrent active GO when corticosteroid therapy was tapered or withdrawn.

Conclusions  Oxidative stress may have a role in the pathogenesis of GO. Urinary 8-OHdG level can be used not only as a noninvasive biomarker of oxidative stress in patients having GO but also as an objective and quantitative parameter in the follow-up of patients during immunosuppressive treatment.

Author Affiliations: Department of Ophthalmology, Taipei Veterans General Hospital (Drs Tsai, Kao, Cheng, and Hsu), and Institute of Clinical Medicine (Dr Tsai) and Departments of Ophthalmology (Drs Tsai, Kao, Cheng, Kau, and Hsu) and Biochemistry and Molecular Biology (Drs Lee and Wei), National Yang-Ming University; and Department of Ophthalmology, Koo Foundation Sun Yat-Sen Cancer Center (Dr Kau), Taipei, Taiwan; and Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, and Inherited Disease Research Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland (Dr Cheng).

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