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2017 ; 47
(2
): 94-105
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Thyroid-associated Ophthalmopathy
#MMPMID28405484
?ahl? E
; Gündüz K
Turk J Ophthalmol
2017[Apr]; 47
(2
): 94-105
PMID28405484
show ga
Thyroid-associated ophthalmopathy is the most frequent extrathyroidal involvement
of Graves' disease but it sometimes occurs in euthyroid or hypothyroid patients.
Thyroid-associated ophthalmopathy is an autoimmune disorder, but its pathogenesis
is not completely understood. Autoimmunity against putative antigens shared by
the thyroid and the orbit plays a role in the pathogenesis of disease. There is
an increased volume of extraocular muscles, orbital connective and adipose
tissues. Clinical findings of thyroid-associated ophthalmopathy are soft tissue
involvement, eyelid retraction, proptosis, compressive optic neuropathy, and
restrictive myopathy. To assess the activity of the ophthalmopathy and response
to treatment, clinical activity score, which includes manifestations reflecting
inflammatory changes, can be used. Supportive approaches can control symptoms and
signs in mild cases. In severe active disease, systemic steroid and/or orbital
radiotherapy are the main treatments. In inactive disease with proptosis, orbital
decompression can be preferred. Miscellaneous treatments such as
immunosuppressive drugs, somatostatin analogs, plasmapheresis, intravenous
immunoglobulins and anticytokine therapies have been used in patients who are
resistant to conventional treatments. Rehabilitative surgeries are often needed
after treatment.
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