Phenotypes of Thyroid Eye Disease

Uddin, Jimmy; Rubinstein, Tal J.; Hamed-Azzam, Shirin

doi:10.1097/iop.0000000000001147

Cited by 38 publications

(25 citation statements)

References 27 publications

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“…These subgroups typically do not express the classic signs of inflammation that dominate the clinical activity score. 22,23,176,177 It is unclear how these "active" patients with a low CAS will respond to teprotumumab as they were not included in the clinical trials. Future studies regarding outcomes of teprotumumab when stratified by disease subtypes may be clinically relevant.…”

Section: Chronic Tedmentioning

confidence: 99%

Teprotumumab

Winn

Kersten

2021

Ophthalmology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Chronic Tedmentioning

confidence: 99%

Teprotumumab

Winn

Kersten

2021

Ophthalmology

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“…Daraufhin entsteht wahrscheinlich ein Circulus vitiosus, bei dem hypoxieinduzierte Reaktionen die Inflammation verstärken und zu noch mehr Kompression und Hypoxie führen [32]. Stark verdickte Muskeln können auch direkt den N. opticus komprimieren, ohne dass die Patienten eine ausgeprägte Inflammation aufweisen ("white eye apex phenotype" [33]). Bei Patienten mit visusbedrohender EO kann eine maximale i. v. Steroidtherapie versucht werden (3 × 1 g innerhalb 1 Woche für 2 Wochen).…”

Section: Sonderfall Visusbedrohende Endokrine Orbitopathieunclassified

“…The likely result is then a vicious circle in which hypoxia-induced reactions exacerbate the inflammation, in turn resulting in more compression and more hypoxia [32]. Highly swollen muscles can also compress the optic nerve directly absent a pronounced inflammation in the patient (white eye apex phenotype [33]).…”

Section: Special Case: Eyesight-threatening Gomentioning

confidence: 99%

Gravesʼ Orbitopathy: Current Concepts for Medical Treatment

Oeverhaus

Stöhr

Möller

et al. 2021

Klin Monbl Augenheilkd

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Background The therapy of severe manifestations of Gravesʼ orbitopathy (GO) is still a challenge and requires good interdisciplinary cooperation. It is especially important to use stage-adapted anti-inflammatory therapy to avoid irreversible damage. Material and Methods Discussion of the latest results of multicentre randomised therapy studies on anti-inflammatory treatments for Gravesʼ orbitopathy, as well as new therapeutic concepts. Results Mild cases of GO can be treated with only selenium supplementation and a watchful waiting strategy. In the moderate-to-severe active form of GO, primary therapy consists of i. v. steroids (cumulative 4 – 5 g) in combination with orbital irradiation in patients with impaired motility. In patients with insufficient therapeutic response after 6 weeks, treatment should be switched to other immunosuppressive agents. In severe sight-threatening disease, bony orbital decompression is usually necessary. As basic research has improved our understanding of the underlying pathophysiology of GO, it has been possible to develop targeted therapies for GO. Teprotumumab, an IGF-1 receptor antibody, was effective in treating GO patients in a phase III trial and should soon be awarded approval for Europe. Conclusion The current therapy concept for Gravesʼ orbitopathy is as follows: first anti-inflammatory therapy then surgical correction of the permanent defects. This may soon be modified, due to the use of targeted therapies.

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“…Die klinischen Symptome der endokrinen Orbitopathie sind sowohl hinsichtlich der Entzündungssymptomatik als auch hinsichtlich der Manifestationen sehr variabel [16]. Viele Patienten haben eine erheblich eingeschränkte Lebensqualität [17].…”

Section: Klinische Symptomeunclassified

Update endokrine Orbitopathie

Eckstein¹,

Oeverhaus²,

Stöhr³

et al. 2020

Radiopraxis

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Die endokrine Orbitopathie (EO) ist die häufigste extrathyreoidale Manifestation des Morbus Basedow. Für Therapieentscheidungen wird die Erkrankung in eine aktive und eine inaktive Phase eingeteilt sowie eine Unterscheidung zwischen einer milden, moderaten und schweren visusbedrohenden Manifestation vorgenommen, wobei die Lebensqualität der Patienten bei den beiden letzteren erheblich eingeschränkt ist.

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Phenotypes of Thyroid Eye Disease

Cited by 38 publications

References 27 publications

Teprotumumab

Teprotumumab

Gravesʼ Orbitopathy: Current Concepts for Medical Treatment

Update endokrine Orbitopathie

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