Ophthalmological evaluation in thyroid‐associated ophthalmopathy

Åsman, Peter

doi:10.1034/j.1600-0420.2003.00147.x

Cited by 39 publications

(34 citation statements)

References 109 publications

(121 reference statements)

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“…In the present study, no relationship was observed between GD status (hyperthyroidism, euthyroidism, or hypothyroidism) and CAS of patients with TAO, confirming data from other studies (3,6,7). Additionally, some authors found that ultrasound results are more sensitive than clinical exam (16,17).…”

Section: Discussionsupporting

confidence: 79%

“…T hyroid-associated ophthalmopathy (TAO) is an autoimmune disorder of the orbit associated with Graves' disease (GD) which presents signs and symptoms in 50% of the cases (1)(2)(3), even though activity is clinically detected in few cases (2)(3)(4). The natural course of the disease shows an initial active phase followed by an inactive phase (4,5).…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonography compared to magnetic resonance imaging in thyroid-associated Graves' ophthalmopathy

Vlainich

Romaldini

Pedro

et al. 2011

Arq Bras Endocrinol Metab

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Objective: To compare ultrasonography (US) to magnetic resonance imaging (MRI) and the clinical activity score (CAS) in Graves' ophthalmopathy. Subjects and methods: Nineteen patients underwent extraocular muscle thickness measurements by US and MRI, reflectivity by US and signal-intensity ratio by MRI. There were also twelve US control subjects. Results: US median thicknesses were greater than in controls. Correlation was found between US and MRI in the median thickness of the left eye rectus medial muscle as well as between signal-intensity ratio (SIR) and thickness by US. An inverse correlation was found between reflectivity and SIR in the inferior and lateral rectus. On associating the tests for detecting activity the best results were obtained with CAS plus MRI (sensitivity 75%), and US and MRI (positive predictive value 77% and specificity 80%). Conclusion: CAS and US results showed poor correlation with MRI results suggesting that they cannot replace each other but when combined these methods can improve the evaluation of thyroid-associated ophthalmopathy. Arq Bras Endocrinol Metab. 2011;55(3):184-8 Keywords Graves' disease; thyroid-associated ophthalmopathy; orbital ultrasonography; magnetic resonance imaging RESUMO Objetivo: Comparar a ultrassonografia (US) à ressonância magnética nuclear (RMN) e o índice de atividade clínica (IAC) na oftalmopatia de Graves. Sujeitos e métodos: Dezenove pacientes submetidos à medida da espessura dos músculos extraoculares por US e RMN, refletividade ao US e razão da intensidade de sinal (RIS) à RMN. Grupo controle para US de 12 indivíduos. Resultados: Espessura mediana ao US foi maior que dos controles. Houve correlação entre US e RMN na espessura mediana dos músculos retos mediais dos olhos esquerdos e entre a RIS e a espessura ao US e correlação inversa entre refletividade e SIR nos retos inferior e lateral. Detectando atividade, os melhores resultados foram associando IAC e RMN (sensitividade de 75%) e US e RMN (valor preditivo positivo de 77% e especificidade de 80%). Conclusão: Resultados do IAC e US mostraram pouca correlação com a RMN, sugerindo que não podem ser substituídos, mas, quando combinados, esses métodos podem melhorar a avaliação da oftalmopatia associada à tiroide. Arq Bras Endocrinol Metab. 2011;55(3):184-8 Descritores Doença de Graves; oftalmopatia associada à tiroide; ultrassonografia orbitária; ressonância magnética nuclear

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Ultrasonography compared to magnetic resonance imaging in thyroid-associated Graves' ophthalmopathy

Vlainich

Romaldini

Pedro

et al. 2011

Arq Bras Endocrinol Metab

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“…It is bilateral in 80% -90% of cases [26]. In our study, Exophthalmos was present in only 33.3% (n -28) of cases, restrictive extra ocular myopathy was seen in only in 11.95% (n -10) of cases.…”

Section: Discussionmentioning

confidence: 55%

Ocular Manifestations in Thyroid Eye Disorder: A Cross-Sectional Study from Nepal

Sabita¹,

Ajit²,

Narayan³

et al. 2016

IJCM

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Background: Thyroid eye disease represents an organ-specific autoimmune process that is usually associated with thyroid disease. Graves' disease is the most common thyroid abnormality associated with thyroid eye disease. Aim: This study was conducted for the profile of ocular manifestation in Thyroid Eye Disease (TED). Methodology: A cross-sectional study of 117 cases of thyroid dysfunction was carried out at BP Koirala Institute of Health System, out of which 84 (71.79%) cases had ocular manifestation. They were evaluated and analyzed in detail and the characteristics documented included patient's demography, ocular and systemic history and as well as ocular examination and some of the systemic and laboratory findings. Results: In this study, mean age of presentation of TED was 39.7 years. 59 patients were female and 25 were male. The maximum patients of both sexes were in the fourth decade of their lives. The common lid signs were lid retraction and lid lag. Proptosis was seen in 33.3% of cases out of which 68% had bilateral proptosis. Corneal ulcer was seen in 7.1% and optic neuropathy in 1.2% of cases. In 27.3% of cases there was elevation of IOP. Dry eye was seen in 61.9% of cases and POAG seen in 8.3% of cases. In the study population 75% were hyperthyroiditic, 16.7% were hypothyroiditic and 8.3% were in euthyroid state. Conclusion: Female was more commonly affected. The maximum number of patients of both sexes was in the fourth decade of their lives. Hyperthyroidism patient had greater chance of ocular manifestation.

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“…Radioiodine and thyroid surgery are the definitive treatment options (2), but many patients decline these treatments, in part because of the risk of permanent hypothyroidism. Thyroid-associated ophthalmopathy (TAO) is a serious feature, present in some degree in half the patients, which often requires immunosuppressive treatment and sometimes retrobulbar irradiation or surgical orbital decompression (1,3). The hyperthyroidism of GD is a classical autoantibody-dependent autoimmune disorder, while the pathogenesis of the extrathyroidal manifestations is more complicated.…”

Section: Introductionmentioning

confidence: 99%

The rationale for B lymphocyte depletion in Graves’ disease. Monoclonal anti-CD20 antibody therapy as a novel treatment option

Fassi¹,

Nielsen²,

Hasselbalch³

et al. 2006

eur j endocrinol

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We have reviewed the immunology of thyroid autoimmunity with special reference to the importance of B lymphocytes (B cells) in thyroidal and extrathyroidal Graves' disease (GD), thus providing a framework for the hypothesis that B cell depletion may be beneficial in GD. Additionally, after reviewing the efficacy and safety in other autoimmune diseases, we propose that treatment with the B celldepleting agent Rituximab may become a clinically relevant treatment option in selected cases of GD, particularly when complicated with thyroid-associated ophthalmopathy.European Journal of Endocrinology 154 623-632

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Ophthalmological evaluation in thyroid‐associated ophthalmopathy

Cited by 39 publications

References 109 publications

Ultrasonography compared to magnetic resonance imaging in thyroid-associated Graves' ophthalmopathy

Ultrasonography compared to magnetic resonance imaging in thyroid-associated Graves' ophthalmopathy

Ocular Manifestations in Thyroid Eye Disorder: A Cross-Sectional Study from Nepal

The rationale for B lymphocyte depletion in Graves’ disease. Monoclonal anti-CD20 antibody therapy as a novel treatment option

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