Single-stage Orbital Decompression, Strabismus and Eyelid Surgery in Moderate to Severe Thyroid Associated Orbitopathy

Quaranta‐Leoni, Francesco M.; Marino, Matteo Di; Leonardi, Antonella; Verrilli, Sara; Romeo, Raffaello

doi:10.1080/01676830.2020.1860092

Cited by 8 publications

(1 citation statement)

References 32 publications

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“…None required additional eyelid surgery, and 17% needed strabismus surgery for new-onset diplopia ( 21 ). Quaranta-Leoni et al described a series of 45 patients undergoing orbital decompression plus simultaneous strabismus and/or eyelid surgery and compared them with control groups having similar procedures in a traditional multistep fashion, with similar outcomes in the simultaneous vs staged groups ( 22 ). Although these novel approaches of combined surgery are not yet widely adopted by TED surgeons, they provide they offer the opportunity of a faster achievement of surgical goals and improve patient satisfaction.…”

Section: Surgerymentioning

confidence: 99%

Future Projections in Thyroid Eye Disease

Barbesino

Salvi

Freitag

2022

The Journal of Clinical Endocrinology &Amp; Metabolism

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Background and Aims This review aims to summarize current and emerging therapies for treatment of thyroid eye disease (TED), in the light of novel understanding of pathogenetic mechanisms, leading to new treatment options and clinical trials. Methods We reviewed and analyzed peer-reviewed literature reporting recent translational studies and clinical trials in the treatment of TED. Searches were made at www.pubmed.gov with keywords “thyroid eye disease,” “Graves’ ophthalmopathy,” “thyroid orbitopathy,” and “Graves’ orbitopathy.” Results Surgery is reserved for rehabilitation in chronic TED or for emergent compressive optic neuropathy. Oral and intravenous glucocorticoid therapy has been used for decades with variable efficacy in acute TED, but results may be temporary and side effects significant. Nonsteroidal oral immunosuppressive agents offer modest benefit in TED. Several immunomodulatory monoclonal antibodies, including rituximab and tocilizumab, have shown efficacy for inactivating TED. Recently, teprotumumab, an insulin-like growth factor 1 receptor (IGF-1R) inhibitor, has demonstrated significant improvement in proptosis, clinical activity score, diplopia, and quality of life in patients with active TED, with good tolerability. Newly proposed TED therapies, currently in preclinical and clinical trial phases, include thyroid-stimulating hormone (TSH) receptor inhibitory drugs, RVT-1401, local anti-vascular endothelial growth factor therapy, IGF-1R drugs delivered subcutaneously and orally, and desensitization to the TSH receptor with modified TSH receptor peptides. Conclusion New, albeit incomplete, understanding of the molecular mechanisms of TED has led to new promising therapies and offered improved outcomes in TED patients. Their full role and their relationship to classical immune suppression should be clarified over the next few years.

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Section: Surgerymentioning

confidence: 99%