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Graves eye disease

Zdeněk Fryšák, David Karásek, Milan Halenka
Endocrine orbitopathy (EO) must be understood mainly as a result of oxidative stress. The pathological process finally affects both the appearance and vision of the patient. In the case of inappropriate or late treatment or lack of patient cooperation, it significantly influences the quality of life of those affected. In spite of the sophisticated dia-gnostic algorithms, in some cases it is difficult to confirm the diagnosis of EO. The range of laboratory methods, the essential part of the diagnostic process, has only recently been extended by the possibility of quantification of specific, stimulating immunoglobulins (TSI)...
2016: Vnitr̆ní Lékar̆ství
Justyna Szczapa-Jagustyn, Anna Gotz-Więckowska, Jarosław Kocięcki
BACKGROUND: Risk of developing thyroid-associated ophthalmopathy (TAO) in children and adolescents is similar or may be even slightly higher than in adults. The aim of this article is to review and summarize current knowledge regarding diagnostic and therapeutic measures in pediatric TAO. CONTENT: MEDLINE and EMBASE papers were searched using the terms 'pediatric Graves' ophthalmopathy' 'pediatric Graves' orbitopathy', 'thyroid-associated ophthalmopathy in childhood and adolescence' from the year 1970 to December 2015...
October 1, 2016: Journal of Pediatric Endocrinology & Metabolism: JPEM
P Anagnostis, K Boboridis, F Adamidou, M Kita
BACKGROUND/AIMS: The natural course of Graves' orbitopathy (GO) has been poorly documented. The aim of this review is to provide current knowledge regarding the natural course of mild GO, trying to address the issue of whether and to what extent it constitutes a chronic remitting or transient disease. METHODS: We systematically searched PubMed for English language publications until August 2016 under the following terms: "Graves' orbitopathy" OR "Graves' ophthalmopathy" OR "thyroid eye disease" AND "natural course" OR "natural history"...
September 23, 2016: Journal of Endocrinological Investigation
Ilknur Tugal-Tutkun
PURPOSE OF REVIEW: The primary systemic vasculitides represent a spectrum of rare but life-threatening conditions that may also affect the eye in various forms. This article reviews recently published data on ocular manifestations of systemic vasculitis. RECENT FINDINGS: Early diagnosis and timely treatment has led to better visual outcomes in giant cell arteritis (GCA). Gene expression from orbital tissues could distinguish granulomatosis with polyangiitis (GPA) from sarcoidosis and Graves disease, but not from idiopathic orbital inflammation...
September 21, 2016: Current Opinion in Rheumatology
Jessica Hookham, Peter Truran, Amit Allahabadia, Sabapathy P Balasubramanian
BACKGROUND: Patients' perceptions and preferences influence the choice of radioiodine ablation (RIA) or surgery in the definitive management of Graves' disease. This study aimed to evaluate their concerns, experiences and satisfaction following definitive treatment. METHODS: A postal survey of patients who had treatment with surgery or RIA between January 2011 and June 2013 for Graves' disease was conducted. RESULTS: Of 214 patients, 136 (64%) responded...
September 20, 2016: Postgraduate Medical Journal
Ji Won Kim, Ka Hyun Lee, Young Jun Woo, Jinna Kim, Ki Chang Keum, Jin Sook Yoon
PURPOSE: To evaluate the effect of orbital radiation prior to surgery on the clinical course and extraocular muscle (EOM) radiologic volume changes after decompression in Graves' orbitopathy (GO). DESIGN: Retrospective, interventional case series METHODS: The medical records of patients treated with orbital decompression for GO and who underwent postoperative orbital computed tomography were reviewed. Only patients who underwent rehabilitative decompression in the inactive phase and who received systemic corticosteroids alone (ST group) or combined orbital radiation and systemic corticosteroids (SRT group) in the active inflammatory phase of the disease were selected...
August 16, 2016: American Journal of Ophthalmology
Flavia Magri, Francesca Zerbini, Margherita Gaiti, Valentina Capelli, Alberto Ragni, Mario Rotondi, Luca Chiovato
: Objective The outcome of anti-thyroid drugs (ATD) treatment for Graves' disease (GD) is difficult to be predicted. In this study we investigated whether male gender, besides other factors usually associated with a poor outcome of ATD treatment, may affect disease presentation and predict the response to medical treatment in subjects with GD. METHODS: We studied 294 patients with a first diagnosis of GD. In all patients, ATD treatment was started. Clinical features, thyroid volume and eye involvement were recorded at baseline...
August 19, 2016: Endocrine Practice
Jessica Hookham, Emma E Collins, Amit Allahabadia, Sabapathy P Balasubramanian
BACKGROUND: Graves' disease can be treated with antithyroid drugs (ATDs), radioiodine or surgery. Use of definitive treatments (radioiodine or surgery) varies widely across centres. Specific clinical circumstances, local facilities, patient and clinician preferences and perceptions will affect the choice of treatment. Detailed understanding of UK clinicians' views and their rationale for different treatments is lacking. AIMS: To study the preferences and perceptions of UK clinicians on the role of surgery and radioiodine in the management of Graves' disease...
August 16, 2016: Postgraduate Medical Journal
Xiaozhen Ye, Xiaoyong Bo, Xiaohao Hu, Huanhuan Cui, Bin Lu, Jiaqing Shao, Jian Wang
CONTEXT: Graves' orbitopathy (GO) is a potentially sight-threatening disease for which currently available medical therapy is not reliably successful. Mycophenolate mofetil (MMF) is a selective immunosuppressant used widely in many autoimmune diseases. Preliminary studies have shown that MMF is effective in the treatment of active GO. OBJECTIVE: To evaluate the efficacy and safety of MMF in patients with active moderate-to-severe GO. PATIENTS: One hundred and 74 patients with active moderate-to-severe GO were randomized to receive either MMF or glucocorticoids (GC)...
August 3, 2016: Clinical Endocrinology
Ryan N Vogel, Drew B Davis, Brad H Kimura, Senthil Rathinavelu, Gabrielle S Graves, Aniko Szabo, Dennis P Han
PURPOSE: To describe visual outcome and prognostic indicators in neovascular age-related macular degeneration with advanced visual loss at the initiation of anti-vascular endothelial growth factor therapy. METHODS: A retrospective chart review was performed on a consecutive series of 1,410 patients with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor therapy at the Medical College of Wisconsin. Subjects were included if at the initiation of therapy they had 20/200 or worse visual acuity (VA) with no other visually limiting eye disease and a minimum follow-up of 6 months...
July 14, 2016: Retina
Sinan Çalışkan, Mutlu Acar, Canan Gürdal
PURPOSE: The purpose of the study is to compare choroidal thickness (CT) in patients with active and inactive Graves' ophthalmopathy (GO) and that in healthy subjects by using spectral domain optical coherence tomography (SD-OCT). METHODS: We conducted an observational, cross-sectional study of 28, 48, and 74 eyes of 14 patients with active GO (group 1), 24 patients with inactive GO (group 2), and 37 age-matched healthy subjects (group 3), respectively. Activity of GO was assessed by using initial clinical activity score (CAS)...
July 15, 2016: Current Eye Research
Caroline W Vargason, James G Chelnis, Behin I Barahimi, Louise A Mawn
Thyroid eye disease (TED) is an inflammatory, autoimmune orbitopathy with multifactorial etiology. Clinical presentation of TED spans a range from mild surface irritation to vision threatening compressive optic neuropathy. Potential vision loss underscores the importance of understanding genetic and environmental factors influencing the severity of TED presentation. This review will describe the classic risk factors for TED, outline treatments for Graves' disease (GD) and TED, and describe newer evidence of socioeconomic disparities in TED presentation...
2016: Seminars in Ophthalmology
B Wabbels
Botulinum toxin can be a useful tool for treating acute sixth nerve palsy and excessive eye deviations due to unstable Graves' disease, when surgery is not yet possible. The diagnostic injection for estimation of possible postoperative double vision also makes sense. In convergence spasms, periocular botulinum toxin injections can be a therapeutic option. Botulinum toxin is not a first line option in infantile esotropia without binocularity or in adult horizontal strabismus. Side effects include ptosis and vertical deviations...
July 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Jennifer S Graves, Hardeep Chohan, Benjamin Cedars, Samuel Arnow, Hao Yiu, Emmanuelle Waubant, Ari Green
OBJECTIVE: To assess retinal ganglion cell (RGC) injury and sex differences in axon loss in pediatric multiple sclerosis (MS). METHODS: This is a cross-sectional evaluation of consecutive pediatric MS subjects and controls. Eyes with acute optic neuritis (ON) within 6 months of visit were excluded. Spectral domain optical coherence tomography (OCT) included peripapillary ring and macular scans with post-acquisition segmentation of retinal layers using automated software (Heidelberg v1...
June 15, 2016: Multiple Sclerosis: Clinical and Laboratory Research
Arshiya Tabasum, Ishrat Khan, Peter Taylor, Gautam Das, Onyebuchi E Okosieme
UNLABELLED: TSH receptor antibodies (TRAbs) are the pathological hallmark of Graves' disease, present in nearly all patients with the disease. Euthyroid Graves' ophthalmopathy (EGO) is a well-recognized clinical entity, but its occurrence in patients with negative TRAbs is a potential source of diagnostic confusion. A 66-year-old female presented to our endocrinology clinic with right eye pain and diplopia in the absence of thyroid dysfunction. TRAbs were negative, as measured with a highly sensitive third(-)generation thyrotropin-binding inhibitory immunoglobulin (TBII) ELISA assay...
2016: Endocrinology, Diabetes & Metabolism Case Reports
Cecilie Aass, Ingrid Norheim, Erik Fink Eriksen, Ellen Charlotte Børnick, Per M Thorsby, Milaim Pepaj
BACKGROUND: Graves' orbitopathy (GO) is a severe organ-specific autoimmune inflammatory ocular complication most often associated with Graves' disease (GD). Besides the cosmetic problems these patients develop, GO may also cause severe, sight-threateningcomplications. Additionally, GO complicates the treatment of patients with GD, making the identification of Graves patients at risk for eye disease before they develop symptoms a critical step in the clinical management and quality of life of these patients...
June 3, 2016: Clinical Endocrinology
Anna Ginter, Michael E Migliori
Graves' Disease is an autoimmune disease where circulating antibodies bind to the thyrotropin receptors on the thyroid gland. These bound antibodies mimic thyroid stimulating hormone without the normal feedback from the anterior pituitary, causing hyperthyroidism and thyrotoxicosis. These antibodies also interact with orbital tissues and cause the characteristic orbital findings of thyroid eye disease (TED). It is not clearly understood why anatomically and physiologically distinct tissues like the thyroid gland and orbit are affected selectively, or why the orbital disease tends to be self-limited...
2016: Rhode Island Medical Journal
Jing Yu, Ai-Juan Tian, Xin Yuan, Xiao-Xin Cheng
OBJECTIVES: Although it is well accepted that there is a close relationship between hypothyroidism and depression, previous studies provided inconsistent or even opposite results in whether subclinical hypothyroidism (SCH) increased the risk of depression. One possible reason is that the etiology of SCH in these studies was not clearly distinguished. We therefore investigated the relationship between SCH resulting from 131I treatment of Graves' disease and depression. DESIGN AND METHODS: The incidence of depression among 95 patients with SCH and 121 euthyroid patients following 131I treatment of Graves' disease was studied...
2016: PloS One
Nora Dehina, Peter Josef Hofmann, Thomas Behrends, Anja Eckstein, Lutz Schomburg
BACKGROUND: Selenium (Se) is of importance for regular functioning of the immune system and thyroid gland, and may have a health effect in mild Graves' ophthalmopathy (GO). OBJECTIVE: As the Se status declines in inflammation, we analyzed whether GO activity or severity affects the Se status of patients. METHODS: Serum Se and selenoprotein P (SePP) concentrations were retrospectively determined in 84 consecutive GO patients before treatment and compared to their clinical activity score (CAS) and severity of eye changes (NOSPECS) status, and to the concentrations of autoantibodies targeting the TSH receptor (TRAK) or the IGF1 receptor (IGF1R-aAB)...
March 2016: European Thyroid Journal
A Eckstein, D Dekowski, D Führer-Sakel, U Berchner-Pfannschmidt, J Esser
Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease and the full clinical picture can impair the quality of life of the patients considerably. Active inflammation can often be effectively treated by intravenous steroids/immunosuppression, however does not lead to full remission, since inflammation rather quickly results in irreversible fibrosis and increase of orbital fat. Very important is the control of risk factors (smoking cessation, good control of thyroid function, selenium supplementation) to prevent progression to severe stages...
April 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
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