Ocular treatment of thyroid eye disease

Eichhorn, K.; Harrison, Andrew R.; Bothun, Erick D.; McLoon, Linda K.; Lee, Michael S.

doi:10.1586/eop.10.31

Cited by 5 publications

(4 citation statements)

References 73 publications

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“…In a relevant literature, Graves' ophthalmopathy (GO) is defined as an autoimmune disease affecting ocular and orbital tissues [1], typically appearing in hyperthyroidism. Orbital fibroblasts have the central position in the pathogenesis of GO.…”

Section: Dear Editormentioning

confidence: 99%

Etanercept in the treatment of Graves’ ophthalmopathy with primary hypothyroidism and rheumatoid arthritis

Boskovic

Medenica

Radojević

et al. 2019

cejoi

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Graves' ophthalmopathy (GO) is an autoimmune disease affecting ocular and orbital tissues. Overproduction of tumor necrosis factor α (TNF-α) in rheumatoid arthritis (RA) and GO has destructive consequences. The subject of this paper is a case of a female patient initially diagnosed with primary hypothyroidism substitution with levothyroxine, and subsequent diagnosis of RA with insufficient therapeutic efficacy of a standard medication. Three years later, the patient presented symptoms and signs of GO. Etanercept was administrated for RA, and after four months, an improvement of the eye symptoms and reduced exophthalmos were observed and confirmed using visual methods. Graves' ophthalmopathy association with primary hypothyroidism is uncommon. The treatment of RA using etanercept led to clinical improvement of GO symptoms, which indicates that RA and GO may share similar pathogenic features. The paper suggests that etanercept may suppress the symptoms and clinical signs of GO. However, controlled trials are needed to further evaluate the effect of TNF-α inhibitors, particularly etanercept, and to compare its side effects with the current options for medical treatment.

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Section: Dear Editormentioning

confidence: 99%

Etanercept in the treatment of Graves’ ophthalmopathy with primary hypothyroidism and rheumatoid arthritis

Boskovic

Medenica

Radojević

et al. 2019

cejoi

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“…The two most common signs of GO are upper eyelid retraction (90% of patients) and proptosis [ 1 , 14 ]. Upper eyelid retraction is produced by levator/Müller muscle inflammation and fibrosis or by levator complex overaction secondary to inferior rectus restriction (pseudo-lid retraction).…”

Section: Clinical Features Of Graves' Ophthalmopathymentioning

confidence: 99%

“…Only patients with active disease will respond to immunosuppressive treatments such as systemic corticosteroids or orbital radiation. These treatments have no benefit for patients in the quiescent phase in whom disease manifestations are the consequence of fibrotic changes in the orbital tissues [ 14 ].…”

Section: Management Protocols Of Graves' Ophthalmopathymentioning

confidence: 99%

“…Available procedures include orbital decompression for disfiguring proptosis [ 53 ]; strabismus surgery for symptomatic ocular motility restriction; eyelid recession for eyelid retraction causing lagophthalmos, exposure keratitis, and disfigurement; and blepharoplasty for excessive soft tissue prominence of the eyelids [ 14 , 39 , 54 ]. If necessary, orbital decompression must be first addressed because of its influence on ocular motility and lid width followed by strabismus surgery and, finally, eyelid surgery.…”

Section: Management Protocols Of Graves' Ophthalmopathymentioning

confidence: 99%

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Graves’ Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management

Barrio-Barrio

Sabater

Bonet-Farriol

et al. 2015

Journal of Ophthalmology

175

118

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Graves' ophthalmopathy (GO) is an autoimmune inflammatory disorder associated with thyroid disease which affects ocular and orbital tissues. GO follows a biphasic course in which an initial active phase of progression is followed by a subsequent partial regression and a static inactive phase. Although the majority of GO patients have a mild, self-limiting, and nonprogressive ocular involvement, about 3–7% of GO patients exhibit a severe sight-threatening form of the disease due to corneal exposure or compressive optic neuropathy. An appropriate assessment of both severity and activity of the disease warrants an adequate treatment. The VISA (vision, inflammation, strabismus, and appearance), and the European Group of Graves' Orbitopathy (EUGOGO) classifications are the two widely used grading systems conceived to assess the activity and severity of GO and guide the therapeutic decision making. A critical analysis of classification, assessment, and management systems is reported. A simplified “GO activity assessment checklist” for routine clinical practice is proposed. Current treatments are reviewed and management guidelines according to the severity and activity of the disease are provided. New treatment modalities such as specific monoclonal antibodies, TSH-R antagonists, and other immunomodulatory agents show a promising outcome for GO patients.

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Management of thyroid eye disease in the United Kingdom: A multi-centre thyroid eye disease audit

Mellington

Dayan

Dickinson

et al. 2017

Orbit

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Ocular treatment of thyroid eye disease

Cited by 5 publications

References 73 publications

Etanercept in the treatment of Graves’ ophthalmopathy with primary hypothyroidism and rheumatoid arthritis

Etanercept in the treatment of Graves’ ophthalmopathy with primary hypothyroidism and rheumatoid arthritis

Graves’ Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management

Management of thyroid eye disease in the United Kingdom: A multi-centre thyroid eye disease audit

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