Current trends in the management of thyroid eye disease

Rao, Rohini; MacIntosh, Peter W.; Yoon, Michael K.; Lefebvre, Daniel R.

doi:10.1097/icu.0000000000000203

Cited by 32 publications

(29 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Restoration and maintenance of the euthyroid state is essential for all patients with TAO since wide swings in thyroid function can negatively impact its course [4, 60, 62]. Anti-thyroid drugs and surgical thyroidectomy are extremely effective for managing hyperthyroidism.…”

Section: Management Of Taomentioning

confidence: 99%

“…Radioiodine treatment confers a small additional risk of exacerbating TAO or provoking its development de novo, particularly in those who smoke tobacco and in patients with severe hyperthyroidism. Immunosuppressive therapies such as B cell depletion with rituximab may prove effective and should be overseen by a collaborating rheumatologist/clinical immunologist [60, 62]. …”

Section: Management Of Taomentioning

confidence: 99%

“…Although the mechanisms responsible for its negative impact are not completely clarified, studies suggest that oxidative stress might represent the culprit, by inducing the expression of fibrosis-related genes and the increase of intracellular pro-inflammatory cytokines [63]. Smoking can lead to progression of TAO, smokers generally have more severe disease, and immunosuppressive treatment is typically less effective in smokers [60, 62, 64, 65]. Advanced age of onset, duration and severity of thyrotoxicosis, and smoking are risk factors [66].…”

Section: Management Of Taomentioning

confidence: 99%

“…Should this prove ineffective, emergency orbital decompression surgery may become necessary [61]. GC can be administered orally, intravenously, or locally injected into the orbit [62]. …”

Section: Therapy Of Active Moderate To Severe Taomentioning

confidence: 99%

“…Efficacy of intravenous and oral GCs were compared in moderately severe TAO patients; parenteral steroids were more effective in reducing CAS by at least 3 points, improvement in visual acuity, and decreasing disease activity at 3 months [62, 65]. In another study, GCs induced complete visual recovery in DON, improved visual acuity, color sensitivity, and normalized visual field defects after 2 weeks of treatment [72].…”

Section: Therapy Of Active Moderate To Severe Taomentioning

confidence: 99%

See 4 more Smart Citations

Update on thyroid-associated Ophthalmopathy with a special emphasis on the ocular surface

Novaes

Grisolia

Smith

2016

Clin Diabetes Endocrinol

View full text Add to dashboard Cite

Thyroid-associated ophthalmopathy (TAO) is a condition associated with a wide spectrum of ocular changes, usually in the context of the autoimmune syndrome, Graves’ disease. In this topical review, we attempted to provide a roadmap of the recent advances in current understanding the pathogenesis of TAO, important aspects of its clinical presentation, its impact on the ocular surface, describe the tissue abnormalities frequently encountered, and describe how TAO is managed today. We also briefly review how increased understanding of the disease should culminate in improved therapies for patients with this vexing condition.

show abstract

Section: Management Of Taomentioning

confidence: 99%

Section: Management Of Taomentioning

confidence: 99%

Section: Management Of Taomentioning

confidence: 99%

“…Should this prove ineffective, emergency orbital decompression surgery may become necessary [61]. GC can be administered orally, intravenously, or locally injected into the orbit [62]. …”

Section: Therapy Of Active Moderate To Severe Taomentioning

confidence: 99%

Section: Therapy Of Active Moderate To Severe Taomentioning

confidence: 99%

See 3 more Smart Citations

Update on thyroid-associated Ophthalmopathy with a special emphasis on the ocular surface

Novaes

Grisolia

Smith

2016

Clin Diabetes Endocrinol

View full text Add to dashboard Cite

show abstract

Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A North American survey

Higgins,

Lane,

Goyal

2024

Laryngoscope Investig Oto

View full text Add to dashboard Cite

BackgroundOrbital decompression is recommended for TED especially in the treatment of severe, refractory cases yet there are no clear guidelines regarding the optimal surgical approach. Previously conducted surveys assessed variations in the management of TED but only amongst ophthalmologists. Our study attempts to better characterize surgical and perioperative preferences amongst otolaryngologists in the management of TED.MethodsA survey was administered to the American Rhinologic Society and Canadian Society of Otolaryngology – Head and Neck Surgery via REDCap with 52 total respondents. Respondent demographic information and pre‐operative management, procedural specifics, and post‐operative management preferences were collected.ResultsThe majority of respondents practiced in a metropolitan (82.7%), academic setting (73.1%) and received subspecialty training in Rhinology & Skull Base Surgery (88.9%). Most elected for corticosteroids (63.5%) and medical management (69.2%) prior to orbital decompression but did not use any classification system (86.5%). Orbital decompression was most often done with ophthalmology collaboration (71.2%). Removal of two bony walls (55.8%) via medial wall (97.9%) and orbital floor (72.3%) removal was most preferred. Removal of one orbital fat aspect (60.6%) via the medial fat pad was most preferred. Combined bone and fat removal (59.6%) completed via an endoscopic approach (71.2% and 97.0%, respectively) was most common. Post‐operatively, most patients were not admitted (88.4%) with saline nasal rinses (92.3%) utilized by most respondents.ConclusionsThis survey completed by otolaryngologists highlights several key distinctions in the preferred surgical approach during orbital decompression and the perioperative management of TED when compared to ophthalmologists and current recommendations.Level of evidenceLevel 4.

show abstract

Case 14

Lee¹,

Digre²

2017

A Case-Based Guide to Eye Pain

View full text Add to dashboard Cite

Current trends in the management of thyroid eye disease

Abstract: TED continues to be a difficult condition for the patient to cope with and for the clinician to treat, and recent research builds on the present foundation of knowledge and treatments, but unfortunately does not offer paradigm-shifting information at the present time.

Cited by 32 publications

References 48 publications

Update on thyroid-associated Ophthalmopathy with a special emphasis on the ocular surface

Update on thyroid-associated Ophthalmopathy with a special emphasis on the ocular surface

Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A North American survey

Case 14

Contact Info

Product

Resources

About