Journal ArticleDOI
Natural history of thyroid associated ophthalmopathy
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TLDR
The natural history of thyroid associated ophthalmopathy is poorly documented and it is widely thought that many cases improve spontaneously with time, but is also a critical factor when assessing the effects of different treatments.Abstract:
Summary
BACKGROUND The natural history of thyroid associated ophthalmopathy is poorly documented, although It is widely thought that many cases Improve spontaneously with time. This has Important Implications in the management of patients and is also a critical factor when assessing the effects of different treatments.
OBJECTIVE To document the natural history of thyroid associated ophthalmopathy, 59 patients were studied longitudinally and the severity of eye disease documented at regular Intervals.
METHODS Fifty-nine patients with thyroid associated ophthalmopathy who had not received Immunosuppressive or surgical treatment for their eye disease, were recruited from a combined thyroid-eye clinic. They were assessed at presentation and at 3–6-monthly Intervals for a median of 12 months. The eyes were assessed by separate and objective measurements relating to the status of the eyelids, cornea, extraocular muscles, proptosis and optic nerve function. In addition, a scoring system based on the above measurements was used to grade the overall severity of eye disease.
RESULTS Thirteen patients (22%) Improved substantially, 25 patients (42·4%) showed minor Improvement, 13 patients (22%) did not change, and 8 patients (13·5%) deteriorated progressively, to the extent that Immunosuppressive treatment was considered to be necessary.
CONCLUSIONS A significant proportion of patients with thyroid associated ophthalmopathy (64·4% in the present series) Improve spontaneously so serial assessment plays an Important part in deciding which patients require Immunosuppressive treatment. These findings also support the view that clinical trials designed to test the efficacy of new treatments in thyroid associated ophthalmopathy should be scrupulously controlled to allow for the natural tendency towards remission.read more
Citations
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Journal ArticleDOI
2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis
Douglas S. Ross,Henry B. Burch,David S. Cooper,M. Carol Greenlee,Peter Laurberg,Ana Luiza Maia,Scott A. Rivkees,Mary H. Samuels,Julie Ann Sosa,Marius N. Stan,Martin A. Walter +10 more
TL;DR: One hundred twenty-four evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.
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Management of Graves' ophthalmopathy: reality and perspectives.
TL;DR: Thyroid ablation may prove beneficial for the ophthalmopathy in view of the pathogenetic model relating eye disease to autoimmune reactions directed against antigens shared by the thyroid and the orbit.
Journal ArticleDOI
Selenium and the Course of Mild Graves' Orbitopathy
Claudio Marcocci,George J. Kahaly,Gerasimos E Krassas,Luigi Bartalena,Mark F. Prummel,M Stahl,Maria Antonietta Altea,Marco Nardi,Susanne Pitz,Kostas G. Boboridis,Paolo Sivelli,George von Arx,Maarten P. Mourits,Lelio Baldeschi,Walter Bencivelli,Wilmar M. Wiersinga +15 more
TL;DR: Selenium administration significantly improved quality of life, reduced ocular involvement, and slowed progression of the disease in patients with mild Graves' orbitopathy.
Journal ArticleDOI
Thyrotropin Receptor Autoantibodies Are Independent Risk Factors for Graves’ Ophthalmopathy and Help to Predict Severity and Outcome of the Disease
Anja Eckstein,Marco Plicht,Hildegard Lax,Markus Neuhäuser,Klaus Mann,Sebastian Lederbogen,Christian Heckmann,Joachim Esser,Nils G. Morgenthaler +8 more
TL;DR: Follow-up measurements of TBII allow, in half of the patients, assessment of the prognosis of GO and, therefore, could be of additional help for the disease management.
Journal ArticleDOI
Epidemiology and Prevention of Graves' Ophthalmopathy
TL;DR: The natural history of Graves' ophthalmopathy is incompletely defined, but in many instances, especially in mild forms, the disease may remit or improve spontaneously, and the risk of radioiodine-associated progression of the opthalmopathy can be eliminated by concomitant treatment with middle-dose glucocorticoids.
References
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Journal ArticleDOI
Modification of the classification of the eye changes of Graves' disease: recommendations of the Ad Hoc Committee of the American Thyroid Association.
Journal ArticleDOI
Age and gender influence the severity of thyroid‐associated ophthalmopathy: a study of 101 patients attending a combined thyroid‐eye clinic
TL;DR: There is a need to identify possible predisposing factors of thyroid‐associated ophthalmopathy, which is thought to be autoimmune, although environmental and genetic factors are also considered to be important.
Journal ArticleDOI
Effect of abnormal thyroid function on the severity of Graves' ophthalmopathy.
Mark F. Prummel,Wilmar M. Wiersinga,Maarten Ph. Mourits,Leo Koornneef,A Berghout,R van der Gaag +5 more
TL;DR: The findings suggest that meticulous control of thyroid function also during antithyroid treatment is important in the management of Graves' ophthalmopathy.
Journal ArticleDOI
Endocrine ophthalmopathy: current ideas concerning etiology, pathogenesis, and treatment
TL;DR: This work will review the clinical, anatomic, histologic, and immunologic features of endocrine ophthalmopathy particularly as they apply to exophthalmos with goiter and the most rational and efficacious methods of treatment.
Journal ArticleDOI
Does early administration of thyroxine reduce the development of Graves' ophthalmopathy after radioiodine treatment?
TL;DR: A retrospective study of records from all patients with this disease treated with 131I for 4 years suggests that early administration of T4 after 131I therapy reduces the occurrence of Graves' ophthalmopathy.