2007
DOI: 10.1038/ncpendmet0497
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Management of Graves' ophthalmopathy

Abstract: Management of Graves' ophthalmopathy is preferably done in a multidisciplinary setting. Smoking is associated with worse disease outcome. (131)I therapy for hyperthyroidism can also worsen ophthalmopathy, especially if administered during active disease or to patients who smoke or have severe hyperthyroidism, or those with high levels of TSH-receptor-binding inhibitory immunoglobulins. Coadministration of steroids and (131)I therapy is recommended for such high-risk patients. (131)I therapy is safe for patient… Show more

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Cited by 75 publications
(58 citation statements)
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References 64 publications
(42 reference statements)
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“…Furthermore, a study from a tertiary referral centre for TED found that 75% of patients with TED seen at the centre had the disease for over a year (15). Assessment and management of TED, particularly if it is moderately severe or severe, can be complex and is best carried out by an endocrinologist and ophthalmologist working together (16,17). In addition, early referral to specialist centres is imperative for optimal outcomes in patients with TED.…”
Section: Discussionmentioning
confidence: 99%
“…Furthermore, a study from a tertiary referral centre for TED found that 75% of patients with TED seen at the centre had the disease for over a year (15). Assessment and management of TED, particularly if it is moderately severe or severe, can be complex and is best carried out by an endocrinologist and ophthalmologist working together (16,17). In addition, early referral to specialist centres is imperative for optimal outcomes in patients with TED.…”
Section: Discussionmentioning
confidence: 99%
“…Although cataracts can occur earlier after OR than naturally, they are easily treated by surgery. Retinal microvascular abnormalities have been detected in a minority of patients (79), mostly in those with concomitant severe hypertension or diabetic retinopathy, and these two comorbidities are considered absolute contraindications to OR (80,81). It is possible that diabetes, even in the absence of retinopathy, represents a risk factor for the development of retinal changes after OR (78), but the evidence is less clear (77).…”
Section: Box 4 Simple Measures That May Alleviate Symptoms In Gomentioning
confidence: 99%
“…† In the rare event of reactivation of GO after rehabilitative surgery, systemic GCs, and/or OR can be used with the usual expected efficacy (99). (77,78,80,81), at least using a 20 Gy cumulative dose. † Diabetes and/or hypertension are not contraindications to surgical orbital decompression or other surgical treatments for GO.…”
Section: Box 8 Sight-threatening Corneal Breakdown In Gomentioning
confidence: 99%
“…It is increasingly recognised that assessment and management of TED can be complex and best carried out by a specialist multidisciplinary team (39,40). In addition to endocrinologists and ophthalmologists, the specialist multidisciplinary team could include specialist nurses, orthoptists and occupational therapists.…”
Section: Improving Quality Of Care For Patients With Tedmentioning
confidence: 99%