Update on the clinical assessment and management of thyroid eye disease

Roos, Jonathan C. P.; Murthy, Rachna

doi:10.1097/icu.0000000000000596

Cited by 24 publications

(27 citation statements)

References 68 publications

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“…It was reported that TAO not only restricted patients' daily activities but also led to dysfunctions in social roles and impaired self-confidence associated with altered appearance (Zeng et al, 2019). The reality for these patients is that their eyes are stared at by strangers (Roos and Murthy, 2019), their identities are changed (Estcourt et al, 2008), and their social functions are disabled (Coulter et al, 2007). Both social isolation and constant ocular disturbances impact the mental state of TAO patients (Kahaly et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Disrupted Spontaneous Neural Activity in Patients With Thyroid-Associated Ophthalmopathy: A Resting-State fMRI Study Using Amplitude of Low-Frequency Fluctuation

Chen

et al. 2021

Front. Hum. Neurosci.

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PurposeThe purpose of the study was to investigate the brain functional alteration in patients with thyroid-associated ophthalmopathy (TAO) by evaluating the spontaneous neural activity changes using resting-state functional magnetic resonance imaging (rs-fMRI) with the amplitude of low-frequency fluctuation (ALFF) method.Materials and MethodsThe rs-fMRI data of 30 TAO patients (15 active and 15 inactive) and 15 healthy controls (HCs) were included for analyses. The ALFF values were calculated and compared among groups. Correlations between ALFF values and clinical metrics were assessed.ResultsCompared with HCs, active TAOs showed significantly decreased ALFF values in the left middle occipital gyrus, superior occipital gyrus, and cuneus. Compared with inactive TAOs, active TAOs showed significantly increased ALFF values in the bilateral precuneus. Additionally, inactive TAOs showed significantly decreased ALFF values in the left middle occipital gyrus, superior occipital gyrus, cuneus, and bilateral precuneus than HCs. The ALFF value in the right precuneus of TAOs was positively correlated with clinical activity score (r = 0.583, P < 0.001) and Mini-Mental State Examination (MMSE) score (r = 0.377, P = 0.040), and negatively correlated with disease duration (r = −0.382, P = 0.037). Moreover, the ALFF value in the left middle occipital gyrus of TAOs was positively correlated with visual acuity (r = 0.441, P = 0.015).ConclusionTAO patients had altered spontaneous brain activities in the left occipital lobe and bilateral precuneus. The neuropsychological aspect of the disease should be noticed during clinical diagnosis and treatment.

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Section: Introductionmentioning

confidence: 99%

Disrupted Spontaneous Neural Activity in Patients With Thyroid-Associated Ophthalmopathy: A Resting-State fMRI Study Using Amplitude of Low-Frequency Fluctuation

Chen

et al. 2021

Front. Hum. Neurosci.

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“…e underlying mechanism is yet to be completely elucidated; it might be that the patient's orbital remodeling and Journal of Ophthalmology eventual fibrosis occur very early in the course of the disease, so there is no hope that whatsoever medical treatment be effective if these changes have taken place [28]. Although effective, GC treatment is not devoid of adverse events [12,29]. eir toxicity is related to preexisting disease, dose, and treatment schedule [11] and remained one of the most common causes of iatrogenic illness [30].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Different Intravenous Glucocorticoid Regimens in the Treatment of Graves’ Ophthalmopathy: A Meta-Analysis

Chen

Sun

et al. 2021

Journal of Ophthalmology

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Purpose. The intravenous glucocorticoid (iv GC) represents the mainstay of therapy for Graves’ ophthalmopathy (GO), but uncertainty remains concerning the optimal regimen. Although the European Group on Graves’ Orbitopathy (EUGOGO) regimen has been commonly employed, evidence for its superiority to other regimens is still lacking. The aim of this meta-analysis was to compare the efficacy and safety of the EUGOGO regimen with higher-dose regimens in the management of GO. Methods. A systematic review and meta-analysis of randomized controlled trials (RCTs) and cohort studies comparing the EUGOGO regimen with higher-dose regimens was conducted. PubMed, Embase, and Web of Science databases were searched for relevant studies. The efficacy outcomes were response rate, change in clinical activity score (CAS), rate of proptosis improvement, and retreatment rate. The safety outcome was the incidence of adverse events. Results. In the five included eligible trials, 136 participants in the EUGOGO regimen and 177 participants in higher-dose regimens were evaluated. Compared with the EUGOGO regimen, higher-dose regimens had no beneficial effect on the response rate, change of CAS, rate of proptosis improvement, and retreatment rate (OR: 1.3; 95% CI: 0.36–4.65; SMD: –0.04; 95% CI: –0.54, 0.45; OR: 0.79; 95% CI: 0.44–1.44; OR: 0.87; 95% CI: 0.27–2.77). For the incidence of adverse events, the results also showed no significant difference between the 2 groups (OR: 1.14; 95% CI: 0.62–2.09). Conclusion. The current evidence showed that the efficacy of the EUGOGO regimen was comparable with higher-dose regimens. Since there was no significant difference in the incidence of adverse events between the two regimens, appropriate selection of patients and careful monitoring were required in both regimens. More well-designed, large-scale, and longer follow-up period studies were needed to further verify the finding of this analysis.

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“…Signs, such as RAPD and papilledema are often not synchronised with the development of disease, resulting in delayed diagnosis. Furthermore, the strength of radiographic signals varies with time and between machines [ 13 ] and does not always provide strong evidence of a correlation with DON. Leave VF tests and VEPs to help tailor the prediction of functional abnormalities in the visual system of DON prior to structural changes, and the objectivity and sensitivity of these tests were the other reasons we chose them for comparison.…”

Section: Discussionmentioning

confidence: 99%

Comparing isolated-check visual evoked potential, pattern visual evoked potential, and standard automated perimetry in dysthyroid optic neuropathy eyes

Tong

et al. 2020

Eye

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Objective To determine the diagnostic ability of isolated-check visual evoked potential (icVEP), pattern visual evoked potential (pVEP), and standard automated perimetry (SAP) between dysthyroid optic neuropathy (DON) and thyroid-associated ophthalmopathy (TAO) without DON (non-DON). Methods This is a case-control study, 49 bilateral patients (26 DON and 23 non-DON) were included. icVEP, pVEP, and SAP were conducted in all the subjects, icVEP parameters compared were signal-to-noise ratios (SNRs) under 8, 16, and 32% depth of modulation (DOM). pVEP parameters compared were amplitude and latency. SAP parameters were mean deviation (MD) and pattern standard deviation (PSD). The area under the receiver operating characteristic (ROC) curve (AUC), net reclassification index (NRI), integrated discrimination index (IDI), and decision curve analysis (DCA) were applied for analysis. Results In icVEP, values of SNR in DON were significantly smaller than non-DON (p < 0.05). In pVEP, P100 latent time in DON was significantly larger than non-DON (p = 0.0026). In SAP, value of PSD in DON was larger than non-DON (p = 0.0006), and value of MD in DON was smaller (p = 0.0007). AUC, NRI, and IDI among the three tests were not significantly different. DCA showed that SNR of icVEP under 8% DOM was the farthest from the two extreme curves. Conclusions icVEP, pVEP, and SAP have equal diagnostic capabilities to discern between DON and non-DON. In addition, icVEP may represent a significant ancillary diagnostic approach to DON detection, with more clinical benefit.

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Update on the clinical assessment and management of thyroid eye disease

Cited by 24 publications

References 68 publications

Disrupted Spontaneous Neural Activity in Patients With Thyroid-Associated Ophthalmopathy: A Resting-State fMRI Study Using Amplitude of Low-Frequency Fluctuation

Disrupted Spontaneous Neural Activity in Patients With Thyroid-Associated Ophthalmopathy: A Resting-State fMRI Study Using Amplitude of Low-Frequency Fluctuation

Efficacy and Safety of Different Intravenous Glucocorticoid Regimens in the Treatment of Graves’ Ophthalmopathy: A Meta-Analysis

Comparing isolated-check visual evoked potential, pattern visual evoked potential, and standard automated perimetry in dysthyroid optic neuropathy eyes

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