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Eye-Related Adverse Events After I-131 Radioiodine Therapy: A Systematic Review of the Current Literature Publisher Pubmed



Rahmanipour E1 ; Askari E2 ; Ghorbani M3 ; Mirzaei M4 ; Rahimi B5 ; Daskareh M6 ; Mirshahvalad SA7, 8
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Authors Affiliations
  1. 1. Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  2. 2. Nuclear Medicine Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
  3. 3. Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  4. 4. Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  5. 5. Department of Ophthalmology, University of Washington, Seattle, WA, United States
  6. 6. Department of Radiology, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Joint Department of Medical Imaging, Mount Sinai Hospital & Women's College Hospital, University Medical Imaging Toronto (UMIT), University Health Network, University of Toronto, Toronto, ON, Canada
  8. 8. Department of Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Endocrine Practice Published:2024


Abstract

Objective: Although I-131 is relatively safe, there is limited focus on probable eye-related side effects after radioactive iodine (RAI) therapy. Thus, we aimed to provide evidence for the adverse outcomes of I-131, exclusively in patients with thyroid cancer. Methods: A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was designed to examine the ocular complications of RAI therapy. Databases including PubMed, Scopus, and Web of Science were searched until October 2023 with specific thyroid neoplasms, ophthalmology and iodine terms. After thorough screening and review, relevant data were extracted. Results: The database search yielded 3434 articles, which resulted in the final 28 eligible studies. These studies investigated ophthalmic symptoms following RAI therapy, classifying them as obstructive diseases (for example, nasolacrimal duct obstruction; median incidence rate: 6.8%), inflammatory symptoms (median incidence rate: 13%), and cataracts (median incidence rate: 2.5 and 5%). The most common time interval between RAI therapy and the onset of symptoms was within the first 12 months and then declined in the preceding years. A strong positive correlation was observed between higher I-131 doses of more than 100 to 150 mCi (3.7-5.55 GBq) and the risk of symptom development. Ages older than 45 also showed a significant association with nasolacrimal duct obstruction. Conclusion: The risk of ophthalmic complications is associated with various factors, including the administration of high I-131 doses, age of more than 45 years, and time to event within the first 12 months. Considering these conditions may help enhance patient care and prevent adverse outcomes that may limit patients’ quality of life. © 2024 AACE
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