This slide kit covers more complex thyroid eye disease.
|
|
- Homer Reynolds
- 6 years ago
- Views:
Transcription
1 An imbalance in the normal level of thyroid hormone in the body can cause thyroid eye disease. If you wish to explore information on the basics of thyroid eye diseases, please first see: This slide kit covers more complex thyroid eye disease. 1
2 2
3 In 2008, the European Group on Graves orbitopathy (EUGOGO) issued a consensus statement aiming to provide practical information for the management of patients with Graves orbitopathy (GO), which, at the time, was often suboptimal. GO is often mild and self-limiting, with 3-5% of cases posing a threat to eyesight. Bartalena L, et al. Thyroid. 2008;18(3): Bartalena L, et al. Eur J Endocrinol. 2008;158(3):
4 Care of those with thyroid eye disease is often best served in a multidisciplinary environment, with access to experts from a variety of specialties. 4
5 Active and/or severe GO, orbital pain, diplopia and stressful life events were all found to decrease scores in measures of quality of life, suggesting that GO patients are not just physically ill, but they also exhibit emotional distress. Social isolation, psychological burden and professional disadvantages were all key impacts on patients with GO. Ponto KA, Kahaly GJ. Pediatr Endocrinol Rev & Suppl 2:
6 EUGOGO recommends that patients with GO should be managed in a multidisciplinary clinical with input from endocrinologists and ophthalmologists. Survey of patterns of referral within Europe in 2006 revealed that 65% of referring doctors had access to joint thyroid-eye clinics, which was a noticeable improvement from the situation 10 years previously. However, overall, there was insufficient referral of cases with suspected optic neuropathy, and a need for practice guidelines. Perros P, et al. Eur J Endocrinol 2006;155:
7 EUGOGO uses the grades of the US Agency for Health Care Policy and Research (AHCPR) published in 1992, to describe studies. 7
8 The Agency for Healthcare Research and Quality published grading recommendations in
9 Only patients in the active phase of GO are expected to respond to immunosuppressive treatment. A clinical activity score, based on the parameters in the slide above, was developed to identify the one third of patients who present in the active phase of the disease. Terwee CB, et al. Clin Endocrinol (Oxf). 2005;62:
10 Graves orbitopathy is assessed based on clinical examination of the key areas outlined on this slide. Forms to aid initial assessment of patients are available to download from the EUGOGO website. 10
11 The management of patients with GO depends on the degree of severity of the ophthalmology, established by assessing the impact of the disease on that patient s quality of life and the risk of vision loss. All patients who do not have mild or sight-threatening disease are considered moderate-to-severe. Barrio-Barrio J, et al. J Ophthalmol 2015;2015:
12 A comparison of features for mild versus moderate-to-severe disease to distinguish those patient requiring active intervention. Barrio-Barrio J, et al. J Ophthalmol 2015;2015:
13 Patients with the signs and symptoms outlined above should be referred for specialist care immediately. Barrio-Barrio J, et al. J Ophthalmol 2015;2015:
14 A number of signs and symptoms are unpleasant for the patient and should be referred for specialist assessment, but the referral for these patients is not urgent. 14
15 This study followed 443 patients with Graves hyperthyroidism and slight or no ophthalmopathy, randomly assigned to receive radioiodine, radioiodine followed by a 3-month course of prednisolone or methimazole for 18 months. Those receiving radioiodine therapy alone had worsening of their ophthalmopathy more often than those treated with methimazole. Those treated with radioiodine followed by prednisolone fared best of the three groups. Bartalena L, et al. N Eng J Med 1998;338:
16 253 patients with recent onset Graves hyperthyroidism were assessed for at least one year. Results showed that smoking was associated with a 1.3-fold increase in the overall incidence of symptomatic endocrine ophthalmopathy and a 2.6- and 3.1-fold increase in the incidence of proptosis and diplopia, respectively. The relative risk increased relative to the number of cigarettes smoked per day. Former smokers had a significantly lower risk for the occurrence of proptosis and diplopia than active smokers. Pfeilschifter J, et al. Clin Endocrinol (Oxon) 1996;45:
17 Disease activity was measured to see if therapeutic outcome could be predicted via a multivariate prediction model integrating previously tested activity parameters. Duration of GO, soft tissue involovement, elevation, soluble interleukin-2 receptor (sil-2r), soluble CD30, eye muscle reflectivity and octreotide uptake ratio were significant predictors of a response to radiotherapy. Terwee CB, et al. Clin Endocrinol (Oxon) 2005;62:
18 18
19 EUGOGO questionnaire revealed the treatment used most regularly for severe orbitopathy was IV steroids. Wiersinga WM et al. Eur J Endocrinol 2006;155:
20 70 euthyroid outpatients with untreated, active and severe GO received either once weekly iv methylprednisolone (0.5g then 0.25 g for 6 weeks each) or oral prednisolone starting with 0.1 g/d, then tapering the dose by 0.01 g/week. Kahaly GJ et al. J Clin Endocrinol Metab 2005;90:
21 Assessment at 3 months revealed that in patients with active and severe GO, iv glucocorticoids were more effective and better tolerated that oral steroids. Kahaly GJ et al. J Clin Endocrinol Metab 2005;90:
22 In addition, thyroid stimulating hormone receptor antibody titers decreased during iv steroid administration (P<0.001), and smoking had a strong inpact on the therapy response (P<0.001) Kahaly GJ et al. J Clin Endocrinol Metab 2005;90:
23 This meta-analysis of 15 studies, evaluated the efficacy of corticosteroids in the treatment of Graves Ophthalmopathy in comparison with other treatments. Results showed that the combination of oral corticosteroid treatment and radiotherapy was markedly more effective than either modality alone (pooled RRR 70%). The number of patients who should be treated with the combination to prevent one treatment failure was between 3 and 8. Intravenous corticosteroids, with and without radiotherapy had the best documented efficacy. Pulse therapy with intravenous corticosteroids helped overcome side effects. Abalkhail S, et al. Med Sci Monit 2003;9:CR
24 A study comparing treatment of Graves ophthalmopathy found that both orbital cobalt irradiation combined with systemic methylprednisolone and systemic methylprednisolone therapy alone are valuable methods of treatment, but the combined therapy was more effective. Bartalena L et al. J Clin Endocrinol Metab 1983;56:
25 The T2 relaxation times of intraocular muscles and orbital fat, areas of extraocular muscles and degree of ophthalmos were measured by magnetic resonance imaging (MRI) in 23 patients with Graves ophthalmology who underwent radiation therapy. This study revealed that patients with primarily elevated extraocular muscle T2 times (probably suggestive of acute inflammatory changes), showed a better therapy response regarding muscle thickening than patients with primarily normal T2 times. Just M, Kahaly GJ, et al. Radiology 1991;179:
26 This study tested whether steroids, irradiation or both were optimal treatments for moderately severe Graves orbitopathy. For the irradion, external beam radiation was compared with sham irradiation. Treatment was successful in 18/30 irradiated patients and 9/29 shamirradiated patients. The difference was caused by improvements in diplopia grade, but not by reduction of proptosis nor of eyelid swelling. Quantitatively, elevation improved significantly in the radiotherapy group. Mourits MP, et al. Lancet 2000;355;
27 The safety of long-term orbital radiotherapy has been investigated in several studies: Marcocci followed 204 patients for between 5 and 25 years and found there was no increase in the incidence of cataract nor in the incidence of tumours. Hypertension, especially if associated with diabetes, was suggested as a contraindication, as it may cause retinopathy. Wakelkamp considered the long-term safety of orbital radiation in 245 GO patients, compared with patients not receiving radiation but treated with glucocorticosteroids. Mortality rate was similar between the groups. Ophthalmic follow-up after approximately 11 years, found possible retinopathy in 15% of patients, 22 of those irradiated and 1 of the nonirradiated patients. In 5 patients (all of whom had been irradiated) definite retinopathy was present. Of these, 3 had diabetes, and 1 had hypertension. Gorman et al concluded in their 12 month follow up of 42 patients with mild-to-moderate ophthalmopathy receiving orbital radiotherapy that there was limited evidence for clinically significant improvement due to the therapy. Marcocci C, et al. J Clin Endocrin Metab 2003;88: Wakelkamp IM, et al. Ophthalmology 2004;111: Gorman CA, et al. Ophthalmology 2005;109:
28 Patients with moderately severe GO were randomly assigned to receive orbital radiotherapy as 20 divided fractions of 1 Gray weekly over 20 weeks, or 10 fractions of 1 Gray or 2 Gray daily over 2 weeks. Result showed that the 1 Gray/week protocol was more effective and better tolerated than the other regimens. Kahaly GJ, et al. J Clin Endocrinol Metab 2000;85: Kahaly GJ, et al. J Clin Endocrinol Metab 2001;145:
29 A meta-analysis of the treatments for active and severe GO found that the optimum first-line treatment was a 12-week course of high dose iv glucocorticoid pulses. This regimen has a response rate of almost 80% and causes fewer adverse events than oral treatment. Zang S, et al. J Clin Endocrinol Metab 2011;96:
30 Despite evidence supporting the use of iv steroids for GO, there are a number of issues to consider before and during therapy. There is a morbidity and mortality rate associated with iv therapy for GO, of approximately 6.5% and 0.6%. 1 Before therapy, patients should be screened for recent hepatitis, liver dysfunction, cardiovascular morbidity, severe hypertension, inadequately managed diabetes and glaucoma. The cumulative dose should not exceed 8 Gray. 1. Zang S, et al. J Clin Endocrinol Metab 2011;96:
31 Medical management options for GO suggest that immunoglobulin is a good choice for active and severe disease, combining a good response rate with a low rate of side effects. 31
32 In vitro study of retro-orbital fibroblasts found that pentoxiphylline inhibited cytokine-induced HLA-DR expression and glycosaminoglycan (GAG) synthesis. This drug was then tested in 10 patients with moderately severe ophthalmopathy. Patients were examined after 12 weeks, when 8/10 patients had responded to the treatment with reductions in serum GAG and TNF alpha. Pentoxyphilline had a beneficial effect on the inflammatory symptoms of thyroid-associated ophthalmopathy. Balazs C et al. J Clin Endocrinol Metab 1997;82: Balazs C, et al. Horm Metab Res 1998;30:
33 In summary, treatment of patients with GO depends on whether disease is active or inactive. Key factors that help the symptoms of GO - normalise thyroid function and stop smoking. 33
CLINICAL ASSESSMENT OF PATIENTS WITH GRAVES ORBITOPATHY
44 MEDICINSKI GLASNIK / str. 44-48 Biljana Nedeljković-Beleslin 1 CLINICAL ASSESSMENT OF PATIENTS WITH GRAVES ORBITOPATHY Abstract: Clinical examination is the basis of a good assessment of a patient with
More informationSUMMARY OF RANDOMIZED CONTROLLED TRIALS COMPARING DIFFERENT ORBITAL RADIOTHERAPY REGIMENTS AND ORBITAL RADIOTHERAPY TO PLACEBO OR CORTICOSTEROIDS
TABLE e4. SUMMARY OF RANDOMIZED CONTROLLED TRIALS COMPARING DIFFERENT ORBITAL RADIOTHERAPY REGIMENTS AND ORBITAL RADIOTHERAPY TO PLACEBO OR CORTICOSTEROIDS Study Treatment Groups Primary Outcome Measure
More informationQUALITY OF LIFE IN GRAVES ORBITOPATHY
Jasmina Ćirić 1 QUALITY OF LIFE IN GRAVES ORBITOPATHY Abstract: The quality of life of patients with Graves orbitopathy (GO) may be seriously damaged due to the changes in appearance, working abilities
More informationEfficacy and safety of combined parenteral and oral steroid therapy in Graves orbitopathy
HORMONES 2014, 13(2):222-228 Research paper Efficacy and safety of combined parenteral and oral steroid therapy in Graves orbitopathy Biljana Nedeljkovic Beleslin, 1,2 Jasmina Ciric, 1,2 Milos Zarkovic,
More informationRisk Factors Associated with the Severity of Thyroid-Associated Orbitopathy in Korean Patients
pissn: 1011-8942 eissn: 2092-9382 Korean J Ophthalmol 2010;24(5):267-273 DOI: 10.3341/kjo.2010.24.5.267 Risk Factors Associated with the Severity of Thyroid-Associated Orbitopathy in Korean Patients Original
More informationSix Things That Changed How I Manage Graves Disease
Six Things That Changed How I Manage Graves Disease Anthony DeWilde, OD FAAO Kansas City VAMC 6 Things 1. Thyroid status 2. Pathogenesis 3. Ocular signs/symptoms 4. Labs 5. Smoking 6. Mental Health Graves
More informationWang et al. BMC Endocrine Disorders (2018) 18:13
Wang et al. BMC Endocrine Disorders (2018) 18:13 https://doi.org/10.1186/s12902-018-0240-8 RESEARCH ARTICLE Open Access A single-center retrospective study of factors related to the effects of intravenous
More informationGraves orbitopathy (GO), the main extrathyroidal
ORIGINAL ARTICLE Endocrine Care Prevalence and Natural History of Graves Orbitopathy in a Large Series of Patients With Newly Diagnosed Graves Hyperthyroidism Seen at a Single Center M. L. Tanda, E. Piantanida,
More informationSerum Interleukin Profile in Patients with Graves Orbithopathy
Acta Medica Marisiensis 2013;59(1):31-35 DOI: 10.2478/amma-2013-0007 RESEARCH ARTICLE Serum Interleukin Profile in Patients with Graves Orbithopathy Réti Zsuzsánna, Kun IZ, Radu Pop Corina Cristina University
More informationPatient information leaflet Thyroid Eye Disease
Patient information leaflet Thyroid Eye Disease What is Thyroid eye Disease? Thyroid Eye Disease (TED) is also known as Graves orbitopathy (GO), thyroid ophthalmopathy and thyroid-associated ophthalmopathy.
More informationJames A. Garrity MD Department of Ophthalmology. Marius N. Stan MD Division of Endocrinology. Mayo Clinic Rochester, MN
James A. Garrity MD Department of Ophthalmology Marius N. Stan MD Division of Endocrinology Mayo Clinic Rochester, MN Epidemiologic and diagnostic considerations for Graves orbitopathy (GO) 1. How common?
More information10 Congresso Nazionale Associazione Italiana della Tiroide Cagliari, dicembre 2016 Orbitopa)a basedowiana acuta
10 Congresso Nazionale Associazione Italiana della Tiroide Cagliari, 15-17 dicembre 2016 Orbitopa)a basedowiana acuta Luigi Bartalena Università dell Insubria a Varese Prevalence of Graves orbitopathy
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Smith TJ, Kahaly GJ, Ezra DG, et al. Teprotumumab for thyroid-associated
More informationA questionnaire survey on the management of Graves orbitopathy in Europe
European Journal of Endocrinology (2006) 155 207 211 ISSN 0804-4643 CLINICAL STUDY A questionnaire survey on the management of Graves orbitopathy in Europe The European Group of Graves Orbitopathy: P Perros,
More informationAssessment of Quality of Life and Depression in Korean Patients with Graves Ophthalmopathy
pissn: 1011-8942 eissn: 2092-9382 Korean J Ophthalmol 2010;24(2):65-72 DOI: 10.3341/kjo.2010.24.2.65 Assessment of Quality of Life and Depression in Korean Patients with Graves Ophthalmopathy Original
More informationCase S.L. PMHx. Warning: Side-Effects May Include Upset-Stomach and Psychosis 7/12/12. ! CC: Upper and lower eyelids swollen
Warning: Side-Effects May Include Upset-Stomach and Psychosis Daniel R. Lefebvre, M.D. Case Presentation Case S.L.! CC: Upper and lower eyelids swollen! HPI: 51 y/o female! eye swelling left > right X
More informationPrevalence of Graves ophthalmopathy in patients with Graves disease presenting to a referral centre in north India
Indian J Med Res 139, January 2014, pp 99-104 Prevalence of Graves ophthalmopathy in patients with Graves disease presenting to a referral centre in north India Sagili Vijaya Bhaskar Reddy, Anu Jain *,
More informationThe patient experience of services for thyroid eye disease in the United Kingdom: results of a nationwide survey
European Journal of Endocrinology (2009) 161 483 487 ISSN 0804-4643 CLINICAL STUDY The patient experience of services for thyroid eye disease in the United Kingdom: results of a nationwide survey Stephanie
More informationGrave s orbitopathy an approach to clinical evaluation and management
Grave s orbitopathy an approach to clinical evaluation and management T W N Karunasena 1, M W S Niranjala 2 Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2012; 2: 106-110 Abstract Grave s
More informationThyroid orbitopathy. Thyroid orbitopathy (TO) is an organ. CLINICAL PRACTICE: Therapeutic review
CLINICAL PRACTICE: Therapeutic review Thyroid orbitopathy Shirley Fung, MBBS, is a research resident, Oculoplastic and Orbital Unit, Department of Ophthalmology, Royal Adelaide Hospital, University of
More informationRoshan S Prabhu 1,2*, Lang Liebman 4, Ted Wojno 3, Brent Hayek 3, William A Hall 1,2 and Ian Crocker 1,2
Prabhu et al. Radiation Oncology 2012, 7:95 RESEARCH Open Access Clinical outcomes of radiotherapy as initial local therapy for Graves ophthalmopathy and predictors of the need for post-radiotherapy decompressive
More informationThe treatment of thyroid-associated. High dose intravenous methylprednisolone pulse therapy versus oral prednisone for thyroidassociated
High dose intravenous methylprednisolone pulse therapy versus oral prednisone for thyroidassociated ophthalmopathy Ritva Kauppinen-Mäkelin 1, Anni Karma 2, Eeva Leinonen 1, Eliisa Löyttyniemi 3, Oili Salonen
More informationNOTE. Endocrinol. Japon. 1982, 29 (4), Abstract
Endocrinol. Japon. 1982, 29 (4), 495-501 NOTE Treatment of Graves' Ophthalmopathy by Steroid Therapy, Orbital Radiation Therapy, Plasmapheresis and Thyroxine Replacement KUNIHIRO YAMAMOTO, KOSHI SAITO,
More informationCLINICAL REVIEW. Thyroid eye disease. Petros Perros, 1 Christopher Neoh, 2 Jane Dickinson 2. For the full versions of these articles see bmj.
For the full versions of these articles see bmj.com CLINICAL REVIEW Thyroid eye disease Petros Perros, 1 Christopher Neoh, 2 Jane Dickinson 2 1 Department of Endocrinology, Royal Victoria Infirmary, Newcastle
More informationProtocol. This trial protocol has been provided by the authors to give readers additional information about their work.
Protocol This trial protocol has been provided by the authors to give readers additional information about their work. Protocol for: Marcocci C, Kahaly GJ, Krassas GE, et al. Selenium and the course of
More informationResearch Article The Influence of Juvenile Graves Ophthalmopathy on Graves Disease Course
Hindawi Ophthalmology Volume 2017, Article ID 4853905, 5 pages https://doi.org/10.1155/2017/4853905 Research Article The Influence of Juvenile Graves Ophthalmopathy on Graves Disease Course Jurate Jankauskiene
More informationORIGINAL ARTICLE. CM Ng HKL Yuen KL Choi MK Chan KT Yuen YW Ng SC Tiu
Key words: Eye diseases; Graves disease; Orbit/radiation effects; Steroids; Treatment outcome "#$% =L=" CM Ng HKL Yuen KL Choi MK Chan KT Yuen YW Ng SC Tiu Hong Kong Med J 2005;11:322-30 Queen Elizabeth
More informationManagement of patients with Graves orbitopathy: initial assessment, management outside specialised centres and referral pathways
Clinical Medicine 2015 Vol 15, No 2: 173 8 CONCISE GUIDANCE Management of patients with Graves orbitopathy: initial assessment, management outside specialised centres and referral pathways Authors: Petros
More informationPsychological implications of Graves orbitopathy
European Journal of Endocrinology (2007) 157 127 131 ISSN 0804-4643 REVIEW Psychological implications of Graves orbitopathy I Coulter, S Frewin, G E Krassas 1 and P Perros Endocrine Unit, Level 6, Freeman
More informationSetting: The study was conducted at the University Hospital Thyroid-Eye Clinic.
ORIGINAL ARTICLE Double Vision Is a Major Manifestation in Moderate to Severe Graves Orbitopathy, but It Correlates Negatively With Inflammatory Signs and Proptosis Peter Laurberg, Dalia C. Berman, Inge
More informationManagement of Graves Orbitopathy
Management of Graves Orbitopathy Mario Salvi Graves Orbitopathy Center, Endocrinology Fondazione Ca Granda IRCCS, Milan, Dept. of Clinical and Community Sciences University of Milan, Italy Clinical course
More information! Women greater than men (4:1)» Typical of other autoimmune diseases
1 2 3 4 : Overview and Diagnosis Suzanne K. Freitag, M.D. Director, Ophthalmic Plastic Surgery Massachusetts Eye and Ear Infirmary Harvard Medical School! I have no financial disclosures. Learning Objectives!
More informationGraves Ophthalmopathy: The Role of Thyroid Cross Reacting Autoantigens and The Effect of Thyroid Ablation
Int J Endocrinol Metab 2006; 4: 47-51 Graves Ophthalmopathy: The Role of Thyroid Cross Reacting Autoantigens and The Effect of Thyroid Ablation Latrofa F, Marino M, Marcocci C, Pinchera A. Department of
More informationEffectiveness of Somatostatin Analogs versus Placebo for Graves Ophthalmopathy: A Meta-Analysis
Review Articles Chin J Evid-based Med 2013, 13(1): 106-111 * 430030 Graves GO PubMed EMbase The Cochrane Library WanFang Data CNKI VIP CBM Graves RCT 2012 3 2 RevMan 5.0 Meta 5 RCT 210 Meta GO MD=0.58
More informationOriginal 2016, 63 (2), Ito Hospital, Tokyo, Japan 2) Olympia Eye Hospital, Tokyo, Japan
2016, 63 (2), 151-157 Original TSH receptor antibody titers measured with a third-generation assay did not reflect the activity of Graves ophthalmopathy in untreated Japanese Graves disease patients Koji
More informationClinical Study The Influence of Prior Hyperthyroidism on Euthyroid Graves Ophthalmopathy
Ophthalmology, Article ID 426898, 6 pages http://dx.doi.org/10.1155/2014/426898 Clinical Study The Influence of Prior Hyperthyroidism on Euthyroid Graves Ophthalmopathy Karolien Termote, 1 Brigitte Decallonne,
More informationTreatment of Graves' ophthalmopathy with an in house Phosphorus 32 source: Initial clinical observations
EXPERIMENTAL AND THERAPEUTIC MEDICINE 14: 2795-2800, 2017 Treatment of Graves' ophthalmopathy with an in house Phosphorus source: Initial clinical observations HAI TAO HAO 1, YUJUN WANG 2, XUFU WANG 3,
More informationLids and Orbits A Patient s Perspective. Dr. Paul Cauchi Consultant Ophthalmologist Southern General and Gartnavel General Hospitals, Glasgow
Lids and Orbits A Patient s Perspective Dr. Paul Cauchi Consultant Ophthalmologist Southern General and Gartnavel General Hospitals, Glasgow Overview Pathophsiology. Symptoms. Signs. Management. Pathophysiology
More informationClinical Profile and Visual Outcomes after Treatment in Patients with Dysthyroid Optic Neuropathy
pissn: 1011-8942 eissn: 2092-9382 Korean J Ophthalmol 2012;26(2):73-79 http://dx.doi.org/10.3341/kjo.2012.26.2.73 Clinical Profile and Visual Outcomes after Treatment in Patients with Dysthyroid Optic
More informationTHYROID EYE DISEASE. A General Overview
JAMES R. PATRINELY, MD, FACS CHARLES N.S. SOPARKAR, MD, PHD, FACS 3730 KIRBY DRIVE, SUITE 900, HOUSTON, TX 77098 TELEPHONE (713) 795-0705 FAX (713) 807-0630 THYROID EYE DISEASE A General Overview INTRODUCTION,
More informationOrbital and Ocular Adnexal Disorders with Red Eyes
Orbital and Ocular Adnexal Disorders with Red Eyes Jason Lee Associate Consultant Department of Ophthalmology and Visual Sciences Practical Ophthalmology for the Family Physician 21 Jan 2017 No financial
More information7 Case reports Case series. 2 open label studies 131, Case reports
TABLE e5. ALTERNATIVE TREATMENTS FOR ACTIVE THYROID EYE DISEASE (TED) Pharmacological Agent/Intervention Classification of Treatment/Mechanism of Action Study Design(s) Results of Randomized Study (if
More informationThyroid Eye Disease. A Patient s Guide
Sashank Prasad, MD www.brighamandwomens.org/neuro-ophthalmology A Patient s Guide Symptoms Diagnosis Treatment www.ishaol.com Prognosis What are the symptoms of Thyroid Eye Disease? Patients with Thyroid
More informationTHE STIR SEQUENCE MRI IN THE ASSESSMENT OF EXTRAOCULAR MUSCLES IN THYROID EYE DISEASE
THE STR SEQUENCE MR N THE ASSESSMENT OF EXTRAOCULAR MUSCLES N THYROD EYE DSEASE H. B. HOH! R. D. LATT 2 C. WAKELEy2 J. KABALA2 P. GODDARD 2 M. J. POTTS! and R. A. HARRAD! Bristol SUMMARY Nineteen patients
More informationThyroid eye disease: a review
CLINICAL AND EXPERIMENTAL REVIEW Thyroid eye disease: a review Clin Exp Optom 2017; 100: 20 25 Danielle L Weiler* OD FAAO *Optometry Section, Southern Arizona Veterans Affairs Health Care System, Tucson,
More informationGraves ophthalmopathy: a preventable disease?
European Journal of Endocrinology (2002) 146 457 461 ISSN 0804-4643 MINI REVIEW Graves ophthalmopathy: a preventable disease? Luigi Bartalena, Claudio Marcocci 1 and Aldo Pinchera 1 Cattedra di Endocrinologia,
More informationQuality of Life in Patients with Thyroid Eye Disease
Quality of Life in Patients with Thyroid Eye Disease Mohsen Bahmani-Kashkouli, MD; Farzad Pakdel, MD; Arezoo Astaraki, MD Masih Hashemi, MD; Yasamin Honarbakhsh, MD; Bahareh Mirarmandehi, MD; Sara Jam,
More informationWhat was going on. Thyroid Related Orbitopathy. Pathophysiology. Definition GALLO EYE AND FACIAL PLASTIC SURGERY 3/16/2017
GALLO EYE AND FACIAL PLASTIC SURGERY What was going on A. She found out the increase to her Premium and Deductible for employee health care next year B. She is getting an over agressive Physical Exam by
More informationLong-term effects of Graves ophthalmopathy on health-related quality of life
European Journal of Endocrinology (2002) 146 751 757 ISSN 0804-4643 CLINICAL STUDY Long-term effects of Graves ophthalmopathy on health-related quality of life Caroline Terwee 1,4, Iris Wakelkamp 2, Stevie
More informationThyroid Associated Orbitopathy (TAO): Effects of Medical And Surgical Treatments
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 7 Ver. I (July. 2017), PP 33-38 www.iosrjournals.org Thyroid Associated Orbitopathy (TAO):
More informationClinical Study Methotrexate for the Treatment of Thyroid Eye Disease
Ophthalmology, Article ID 128903, 5 pages http://dx.doi.org/10.1155/2014/128903 Clinical Study Methotrexate for the Treatment of Thyroid Eye Disease Diego Strianese, 1 Adriana Iuliano, 1 Mariantonia Ferrara,
More informationTHYROID EYE DISEASE ORBITAL DECOMPRESSION SURGERY
THYROID EYE DISEASE ORBITAL DECOMPRESSION SURGERY What is thyroid eye disease (TED)? TED is an autoimmune condition where the body s own immune system attacks the tissues of the thyroid gland and the eye
More informationExtraocular muscle repositioning as the last therapeutic option for a patient with a severe course of Graves Ophthalmopathy: a case report
Rau et al. BMC Ophthalmology (2018) 18:56 https://doi.org/10.1186/s12886-018-0718-1 CASE REPORT Open Access Extraocular muscle repositioning as the last therapeutic option for a patient with a severe course
More informationDisclosures. Learning objectives. Case 1A. Autoimmune Thyroid Disease: Medical and Surgical Issues. I have nothing to disclose.
Disclosures Autoimmune Thyroid Disease: Medical and Surgical Issues I have nothing to disclose. Chrysoula Dosiou, MD, MS Clinical Assistant Professor Division of Endocrinology Stanford University School
More informationDepartment of Nuclear Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
C A S E REPORT pissn: 2384-3799 eissn: 2466-1899 Int J Thyroidol 2017 November 10(2): 102-106 https://doi.org/10.11106/ijt.2017.10.2.102 Development of Graves Ophthalmopathy after Radioactive Iodine Ablation
More informationEUGOGO INITIAL ASSESSMENT
EUGOGO INITIAL ASSESSMENT Please complete non-italicised boxes except where indicated, plus relevant italicised ones. 1. Date of inclusion Year of birth Sex male female dd mm yyyy Race Caucasian Black
More informationMagnetic resonance imaging determination of extraocular eye muscle volume in patients with thyroid-associated ophthalmopathy and proptosis
ACTA OPHTHALMOLOGICA SCANDINAVICA 26 Magnetic resonance imaging determination of extraocular eye muscle volume in patients with thyroid-associated ophthalmopathy and proptosis Jan Kvetny, 1 Katriina Bøcker
More informationCOMBINED RADIOTHERAPY AND MEDICAL IMMUNOSUPPRESSION IN THE MANAGEMENT OF THYROID EYE DISEASE
COMBNED RADOTHERAPY AND MEDCAL MMUNOSUPPRESSON N THE MANAGEMENT OF THYROD EYE DSEASE K. G. CLARDGEt, R. GHABRAL\ G. DAVS\ M. TOMLNSON2, S. GOODMAN2, R. A. HARRAD and M. J. POTTS1 Bristol SUMMARY Although
More informationSelenium and the Course of Mild Graves Orbitopathy
T h e n e w e ngl a nd j o u r na l o f m e dic i n e original article and the Course of Mild Graves Orbitopathy Claudio Marcocci, M.D., George J. Kahaly, M.D., Gerasimos E. Krassas, M.D., Luigi Bartalena,
More informationUvA-DARE (Digital Academic Repository)
UvA-DARE (Digital Academic Repository) Clinical activity score as a guide in the management of patients with Graves' ophthalmopathy Mourits, M.P.; Prummel, M.F.; Wiersinga, W.M.; Koornneef, L. Published
More informationEUGOGO FOLLOW-UP assessment
EUGOGO FOLLOW-UP assessment Please complete non-italicized boxes except where indicated, plus relevant italicized ones. F1. Date follow-up (dd mm yyyy) Visit # Year of birth ( yyyy ) Randomization code
More informationSlide notes: This presentation provides information on Graves disease, a systemic autoimmune disease. Epidemiology, pathology, complications,
1 This presentation provides information on Graves disease, a systemic autoimmune disease. Epidemiology, pathology, complications, including ophthalmic complications, treatments (both permanent solutions
More informationGraves Ophthalmopathy Overview. Graves Disease Hyperthyroidism TSIgs (anti-tsh-receptor-abs) Graves Disease 10/22/2010
Graves Disease Robert Graves Graves Ophthalmopathy Overview Robert C. Kersten Dept. of Ophthalmology UCSF Triad Hyperthyroidism Eye findings Pretibial Myxedema (phalangeal acropachy-1%) Most common auto-immune
More informationWiersinga WM, Kahaly GJ (eds): Graves Orbitopathy: A Multidisciplinary Approach Questions and Answers. Basel, Karger, 2010, pp 33 39
Diagnosis and Pathogenesis Wiersinga WM, Kahaly GJ (eds): Graves Orbitopathy: A Multidisciplinary Approach Questions and Answers. Basel, Karger, 2010, pp 33 39 Epidemiology C. Daumerie Department of Endocrinology,
More informationAzienda Ospedaliera-Universitaria Mater Domini, Catanzaro, Italy
Article 1 Subclinical Visual Field Alterations are Commonly Present in Patients with Graves Orbitopathy and are Mainly Related to the Clinical Activity of the Disease Authors A. F. L a bo nia 1, G. C.
More informationGRAVES OPHTHALMOPAthy
CLINICAL SCIENCES Oxidative Stress Change by Systemic Corticosteroid Among Patients Having Active Graves Ophthalmopathy Chieh-Chih Tsai, MD; Shu-Ching Kao, MD; Ching-Yu Cheng, MD, MPH; Hui-Chuan Kau, MD,
More informationResearch Article Corticosteroids for Graves Ophthalmopathy: Systematic Review and Meta-Analysis
BioMed Research International, Article ID 4845894, 9 pages https://doi.org/10.1155/2018/4845894 Research Article Corticosteroids for Graves Ophthalmopathy: Systematic Review and Meta-Analysis Xiaofang
More informationResearch Article Determinants of Extraocular Muscle Volume in Patients with Graves Disease
Thyroid Research Volume 2012, Article ID 368536, 4 pages doi:10.1155/2012/368536 Research Article Determinants of Extraocular Muscle Volume in Patients with Graves Disease Samer El-Kaissi 1 and Jack R.
More informationASSOCIATION BETWEEN THYROID-STIMULATING IMMUNOGLOBULIN LEVELS AND OCULAR FINDINGS IN PEDIATRIC PATIENTS WITH GRAVES DISEASE
ASSOCIATION BETWEEN THYROID-STIMULATING IMMUNOGLOBULIN LEVELS AND OCULAR FINDINGS IN PEDIATRIC PATIENTS WITH GRAVES DISEASE BY Olga M. Acuna MD, Ioanna Athannassaki MD, AND Evelyn A. Paysse MD * ABSTRACT
More informationMisdiagnosed Vogt-Koyanagi-Harada (VKH) disease and atypical central serous chorioretinopathy (CSC)
HPTER 12 Misdiagnosed Vogt-Koyanagi-Harada (VKH) disease and atypical central serous chorioretinopathy (S) linical Features VKH disease is a bilateral granulomatous panuveitis often associated with exudative
More informationSystemic Management of Graves Disease. Robert James Graves, M.D., FRCS ( ) Graves Disease: Endocrinopathy or Ophthalmopathy?
Systemic Management of Graves Disease Rona Z. Silkiss, M.D., FACS Associate Clinical Professor, UCSF Chief, Division of Ophthalmic Plastic and Orbital Surgery California Pacific Medical Center No financial
More informationClinical Study Efficacy of Subantimicrobial Dose Doxycycline for Moderate-to-Severe and Active Graves Orbitopathy
International Endocrinology Volume 2015, Article ID 285698, 8 pages http://dx.doi.org/10.1155/2015/285698 Clinical Study Efficacy of Subantimicrobial Dose Doxycycline for Moderate-to-Severe and Active
More informationValidation of VISA classification for Thyroid Associated Orbitopathy
25 Original Article Validation of VISA classification for Thyroid Associated Orbitopathy Dr M. Subrahmanyam 1, Dr P. Modini 2, Dr K.J. Sivacharan 3, Dr B. Kavya 4 Abstract Aim : To Validate the VISA classification
More informationHigh-Dose Intravenous Steroid Pulse Therapy in Thyroid-Associated Ophthalmopathy
Endocrine Journal 1996, 43 (6), 689-699 High-Dose Intravenous Steroid Pulse Therapy in Thyroid-Associated Ophthalmopathy TETSUYA TAGAMI, KIYosHI TANAKA, HIDEO SUGAWA*, HIROTOSHI NAKAMURA**, Yoji MIYOSHI,
More informationDouble-Blind, Placebo-Controlled Trial of Octreotide Long-Acting Repeatable (LAR) in Thyroid-Associated Ophthalmopathy
0021-972X/04/$15.00/0 The Journal of Clinical Endocrinology & Metabolism 89(12):5910 5915 Printed in U.S.A. Copyright 2004 by The Endocrine Society doi: 10.1210/jc.2004-0697 Double-Blind, Placebo-Controlled
More informationCitation for published version (APA): Jellema, H. M. (2016). Surgical treatment of diplopia in Graves' Orbitopathy patients
UvA-DARE (Digital Academic Repository) Surgical treatment of diplopia in Graves' Orbitopathy patients Jellema, H.M. Link to publication Citation for published version (APA): Jellema, H. M. (2016). Surgical
More informationElevated serum concentrations of metalloproteinases (MMP-2, MMP-9) and their inhibitors (TIMP-1, TIMP-2) in patients with Graves orbitopathy
Original papers Elevated serum concentratio of metalloproteinases (MMP-2, ) and their inhibitors (TIMP-1, TIMP-2) in patients with Graves orbitopathy Katarzyna Kapelko-Słowik 1, A F, Mirosław Słowik 2,
More informationDiagnostic accuracy of short-time inversion recovery sequence in Graves ophthalmopathy before and after prednisone treatment
Neuroradiology (2014) 56:353 361 DOI 10.1007/s00234-014-1332-4 DIAGNOSTIC NEURORADIOLOGY Diagnostic accuracy of short-time inversion recovery sequence in Graves ophthalmopathy before and after prednisone
More informationAntithyroid drugs in Graves disease: Are we stretching it too far?
Original Article Antithyroid drugs in Graves disease: Are we stretching it too far? Muthukrishnan Jayaraman, Anil Kumar Pawah, C. S. Narayanan 1 Department of Internal Medicine, Armed Forces Medical College,
More informationOxidative stress markers in tears of patients with Graves orbitopathy and their correlation with clinical activity score
Choi et al. BMC Ophthalmology (2018) 18:303 https://doi.org/10.1186/s12886-018-0969-x RESEARCH ARTICLE Open Access Oxidative stress markers in tears of patients with Graves orbitopathy and their correlation
More informationThe role of Tc-99m polyclonal human immunoglobulin G scintigraphy in Graves ophthalmopathy
ORIGINAL ARTICLE Annals of Nuclear Medicine Vol. 16, No. 7, 461 465, 2002 The role of Tc-99m polyclonal human immunoglobulin G scintigraphy in Graves ophthalmopathy Hulya ORTAPAMUK,* Banu HOSAL** ç and
More information*Please see amendment for Pennsylvania Medicaid at the
1 of 28 Number: 0419 Policy *Please see amendment for Pennsylvania Medicaid at the end of this CPB. I. Aetna considers orbital decompression surgery, and eye muscle surgery or eyelid surgery (e.g., marginal
More informationRisk Factors for Graves Orbitopathy; the Australian Thyroid-Associated Orbitopathy Research (ATOR) Study
ORIGINAL ARTICLE Risk Factors for Graves Orbitopathy; the Australian Thyroid-Associated Orbitopathy Research (ATOR) Study Jwu Jin Khong, Sue Finch, Chamika De Silva, Stacey Rylander, Jamie E. Craig, Dinesh
More informationEuthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical Graves ophthalmopathy
1 Department of Ophthalmology, University of Essen, Essen, Germany; 2 Institute for Medical Informatics, Biometry and Epidemiology University of Essen, Essen, Germany; 3 Department of Medicine, Division
More informationThyroid Eye Disease. Patient & Family Guide
Patient & Family Guide Thyroid Eye Disease 2018 Register using a self check-in kiosk in the main entrance of the Centennial or Dickson building, Victoria General site. Next, go to the Eye Care Centre in
More informationPrevalence and Severity of Ophthalmic Manifestations of Graves Disease in Mashhad. University Endocrine Clinics
Prevalence and Severity of Ophthalmic Manifestations of Graves Disease in Mashhad University Endocrine Clinics Mohammad Etezad-Razavi, MD, 1 Robabeh-Beygom Aboutorabi, MD 2 Siamak Zarei-Ghanavati, MD,
More informationAnatomy: There are 6 muscles that move your eye.
Thyroid Eye Disease Your doctor thinks you have thyroid orbitopathy. This is an autoimmune condition where your body's immune system is producing factors that stimulate enlargement of the muscles that
More informationGraves Disease. What is Graves disease?
Graves Disease What is Graves disease? The thyroid gland s production of thyroid hormones (T 3 and T 4 ) is triggered by thyroidstimulating hormone (TSH), which is made by the pituitary gland. Graves disease,
More informationPrevalence and Risk Factors for Thyroid Eye Disease among Korean Dysthyroid Patients
pissn: 1011-8942 eissn: 2092-9382 Korean J Ophthalmol 2013;27(6):397-404 http://dx.doi.org/10.3341/kjo.2013.27.6.397 Original Article Prevalence and Risk Factors for Thyroid Eye Disease among Korean Dysthyroid
More informationTrust Protocol for the Administration of Intravenous Methylprednisolone for Thyroid Eye Disease A Protocol. The Clinical Investigation Unit (CIU)
A Protocol For Use in: By: For: Division responsible for document: Key words: Name of document author: Job title of document author: Name and job title of document author s Line Manager: Supported by:
More informationNeuro-imaging for the Ophthalmologist. Karl C. Golnik, MD, MEd University of Cincinnati & The Cincinnati Eye Institute
Neuro-imaging for the Ophthalmologist Karl C. Golnik, MD, MEd University of Cincinnati & The Cincinnati Eye Institute Neuro-ophthalmology is that subspecialty where the diagnosis is made upon reinterpretation
More informationSomatotroph Pituitary Adenomas (Acromegaly) The Diagnostic Pathway (11-2K-234)
Somatotroph Pituitary Adenomas (Acromegaly) The Diagnostic Pathway (11-2K-234) Common presenting symptoms/clinical assessment: Pituitary adenomas are benign neoplasms of the pituitary gland. In patients
More informationColour Doppler Imaging of Superior Ophthalmic Vein in Thyroid-Associated Eye Disease
Colour Doppler Imaging of Superior Ophthalmic Vein in Thyroid-Associated Eye Disease Deniz Somer*, Seyhan Bahar Özkan*, Hakan Özdemir, Serhan Atilla, Meltem Fatma Söylev* and Sunay Duman* *Department of
More informationGraves Ophthalmopathy Advances in Diagnosis and Treatment CONSTANCE L. FRY, MD ASSOCIATE PROFESSOR OF OPHTHALMOLOGY UT HEALTH SAN ANTONIO
Graves Ophthalmopathy Advances in Diagnosis and Treatment CONSTANCE L. FRY, MD ASSOCIATE PROFESSOR OF OPHTHALMOLOGY UT HEALTH SAN ANTONIO Ophthalmic Manifestations GO is the #1 cause of unilateral and
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,100 116,000 120M Open access books available International authors and editors Downloads Our
More informationEvaluation of Extraocular Muscle Enlargement in Dysthyroid Ophthalmopathy
Evaluation of Extraocular Muscle Enlargement in Dysthyroid Ophthalmopathy Yoko Murakami*,, Takashi Kanamoto*,, Toshikazu Tuboi*,, Toshine Maeda* and Yoichi Inoue* *Olympia Eye Hospital, Tokyo, Japan; Department
More informationResearch Article Predictors of the Dose-Effect Relationship regarding Unilateral Inferior Rectus Muscle Recession in Patients with Thyroid Eye Disease
International Endocrinology Volume 2015, Article ID 703671, 5 pages http://dx.doi.org/10.1155/2015/703671 Research Article Predictors of the Dose-Effect Relationship regarding Unilateral Inferior Rectus
More informationGraves' disease (GD) is the most common cause
Thyroid peroxidase antibody positivity and triiodothyronine levels are associated with pediatric Graves' ophthalmopathy Jung Hyun Lee, So Hyun Park, Dae Gyun Koh, Byung Kyu Suh Gyeonggi-do, Korea Background:
More informationCombined Infliximab and Rituximab in Necrotising Scleritis
This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License (www.karger.com/oa-license), applicable to the online version of the article
More information