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Thyroid associated orbitopathy

Marenza Leo, Teresa Mautone, Ilaria Ionni, Maria Antonietta Profilo, Elena Sabini, Francesca Menconi, Barbara Mazzi, Roberto Rocchi, Francesco Latrofa, Marco Nardi, Paolo Vitti, Claudio Marcocci, Michele Marinò
OBJECTIVE: Intravenous (iv) glucocorticoids (GC) (ivGC) are used for active Graves orbitopathy (GO), but factors affecting GO outcome are poorly understood. We performed a retrospective study to investigate the variables affecting GO after ivGC. METHODS: We evaluated 83 consecutive GO patients treated with ivGC but not orbital radiotherapy (ORT) and re-examined them after a median of 47 months. The endpoints were the relationships between GO outcome or additional treatments with age, sex, smoking habits, thyroid volume, thyroid treatment, time since thyroid treatment, antithyroid-stimulating hormone receptor antibodies (TRAb), GO duration, GO features, and follow-up time...
October 2016: Endocrine Practice
S L Hsu, P Y Lee, C H Chang, C H Chen
Thyroid orbitopathy (TO) is an autoimmune disease that is complicated by ocular surface disorders, leading to discomfort. Dry eye is very prevalent in patients with TO. Recent studies on the pathogenesis of dry eye have focused on the inflammatory process, and some supporting evidence has been discovered. Because TO is a disorder of autoimmune origin, we assumed that the association between TO and dry eye is related to inflammation. Inflammation of the ocular surface in TO-related dry eye has not been well studied...
August 30, 2016: Genetics and Molecular Research: GMR
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
Agata Czarnywojtek, Krzesisława Komar-Rychlicka, Małgorzata Zgorzalewicz-Stachowiak, Nadia Sawicka-Gutaj, Kosma Woliński, Paweł Gut, Maria Płazinska, Barbara Torlińska, Ewa Florek, Joanna Waligórska-Stachura, Marek Ruchała
INTRODUCTION    Graves' Orbitopathy (GO) is an autoimmune disease associated with Graves' disease. Therapy is largely dependent on the severity and activity of ocular changes. Particular attention should be given to radioiodine therapy (RIT). Although its application is a valuable method of the treatment of hyperthyroidism, it may be followed by worsening of GO. OBJECTIVES    The aim of the present article is to indicate how the severity of nicotine addiction influences the response for RAI treatment in GO patients...
August 18, 2016: Polskie Archiwum Medycyny Wewnętrznej
Douglas S Ross, Henry B Burch, David S Cooper, M Carol Greenlee, Peter Laurberg, Ana Luiza Maia, Scott A Rivkees, Mary Samuels, Julie Ann Sosa, Marius N Stan, Martin A Walter
BACKGROUND: Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This document describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspecialty physicians and others providing care for patients with this condition. METHODS: The American Thyroid Association (ATA) previously cosponsored guidelines for the management of thyrotoxicosis that were published in 2011...
October 2016: Thyroid: Official Journal of the American Thyroid Association
L Bartalena, E Masiello, F Magri, G Veronesi, E Bianconi, F Zerbini, M Gaiti, E Spreafico, D Gallo, P Premoli, E Piantanida, M L Tanda, M Ferrario, P Vitti, L Chiovato
OBJECTIVE: The Merseburg triad (hyperthyroidism, goiter, and orbitopathy) characterizes classical description of Graves' disease (GD). Aim of this observational, longitudinal study was to evaluate the current clinical features of newly diagnosed GD in Italy. MATERIALS AND METHODS: In two Northern Italy centers (Varese and Pavia), 283 consecutive patients (211 women, 72 men; mean age 47.4 years) with newly diagnosed GD were recruited in the years 2010-2014. Diagnosis was based on established criteria, and thyroid volume was assessed by ultrasonography...
July 27, 2016: Journal of Endocrinological Investigation
Y Kaichi, K Tanitame, H Itakura, H Ohno, M Yoneda, Y Takahashi, Y Akiyama, K Awai
BACKGROUND AND PURPOSE: The quantitative evaluation of orbital fat proliferation and edema and the assessment of extraocular muscles are useful for diagnosing and monitoring thyroid-associated orbitopathy. To evaluate therapy-induced quantitative changes in the orbital fat of patients with thyroid-associated orbitopathy, we performed volumetric and water fraction measurements by using T2-weighted FSE iterative decomposition of water and fat with echo asymmetry and least-squares estimation (FSE-IDEAL) imaging...
June 30, 2016: AJNR. American Journal of Neuroradiology
Marenza Leo, Teresa Mautone, Ilaria Ionni, Maria Antonietta Profilo, Elena Sabini, Francesca Menconi, Barbara Mazzi, Roberto Rocchi, Francesco Latrofa, Marco Nardi, Paolo Vitti, Claudio Marcocci, Michele Marinò
Objective Intravenous (iv) glucocorticoids (GC) (ivGC) are used for active Graves' orbitopathy (GO), but factors affecting GO outcome are poorly known. Here we performed a retrospective study aimed at investigating the variables affecting GO after ivGC. Methods We evaluated 83 consecutive GO patients treated with ivGC, but not with orbital radiotherapy, and re-examined them after a median period of 47 months. The end-points were the relation between GO outcome or additional treatments with age, gender, smoking, thyroid volume, thyroid treatment, time since thyroid treatment, TRAb, GO duration, GO features and follow-up time...
June 30, 2016: Endocrine Practice
Jwu Jin Khong, Kathryn P Burdon, Yi Lu, Lefta Leonardos, Kate J Laurie, John P Walsh, Adam D Gajdatsy, Peter R Ebeling, Alan A McNab, Thomas G Hardy, Richard J Stawell, Garry J Davis, Dinesh Selva, Angelo Tsirbas, Grant W Montgomery, Stuart Macgregor, Jamie E Craig
PURPOSE: Thyroid-associated orbitopathy (TO) is an autoimmune-mediated orbital inflammation that can lead to disfigurement and blindness. Multiple genetic loci have been associated with Graves' disease, but the genetic basis for TO is largely unknown. This study aimed to identify loci associated with TO in individuals with Graves' disease, using a genome-wide association scan (GWAS) for the first time to our knowledge in TO. METHODS: Genome-wide association scan was performed on pooled DNA from an Australian Caucasian discovery cohort of 265 participants with Graves' disease and TO (cases) and 147 patients with Graves' disease without TO (controls)...
June 1, 2016: Investigative Ophthalmology & Visual Science
Mustafa Sahin, Rifat Emral
No abstract text is available yet for this article.
June 2016: Journal of Clinical Endocrinology and Metabolism
Zofia Pniakowska, Anna Klysik, Roman Gos, Piotr Jurowski
AIM: To determine the relevance of the objective parameters addressing the altered biomechanical properties of cornea for glaucoma monitoring in patients with mild or moderate thyroid associated orbitopathy (TAO), and in healthy individuals. METHODS: Twenty-five patients with TAO (group 1) and 25 healthy adults (group 2) were included to the study. Both groups were of a similar age and the ratio women:man. For each patient, the following parameters of both eyes were measured with ocular response analyzer (ORA): corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann correlated intraocular pressure (IOPg) and corneal compensated intraocular pressure (IOPcc)...
2016: International Journal of Ophthalmology
Joëlle Antoun, Cherif Titah, Isabelle Cochereau
PURPOSE OF REVIEW: Checkpoint inhibitors have been increasingly considered as new targets for cancer therapies. Patients receiving checkpoint inhibitors develop many immune-related adverse events (IRAEs). However, ophthalmic IRAEs are rare and have been reported in less than 1% of patients. To date, few case reports evaluating the ophthalmological side-effects of checkpoint inhibitors have been published. In this review, we plan to report the different ocular and orbital side-effects of the checkpoint inhibitors, and to help guide ophthalmologists and oncologists in their management...
July 2016: Current Opinion in Oncology
Luigi Bartalena, Lelio Baldeschi, Kostas Boboridis, Anja Eckstein, George J Kahaly, Claudio Marcocci, Petros Perros, Mario Salvi, Wilmar M Wiersinga
Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease, though severe forms are rare. Management of GO is often suboptimal, largely because available treatments do not target pathogenic mechanisms of the disease. Treatment should rely on a thorough assessment of the activity and severity of GO and its impact on the patient's quality of life. Local measures (artificial tears, ointments and dark glasses) and control of risk factors for progression (smoking and thyroid dysfunction) are recommended for all patients...
March 2016: European Thyroid Journal
Sviatlana Zhyzhneuskaya, Caroline Addison, Vasileios Tsatlidis, Jolanta U Weaver, Salman Razvi
BACKGROUND: There is little information regarding the natural history of subclinical hyperthyroidism (SH) due to Graves' disease (GD). METHODS: A prospective analysis was conducted of patients with SH due to GD between 2007 and 2013 with at least 12 months of follow-up. SH was diagnosed if serum thyrotropin (TSH) was below the laboratory reference range (0.4-4.0 mIU/L) and when thyroid hormones were normal. GD was confirmed by either a raised TSH receptor antibody (TRAb) level or uniform uptake on Technetium scan...
June 2016: Thyroid: Official Journal of the American Thyroid Association
Mohammad Reza Akbari, Ahmad Ameri, Ali Reza Keshtkar Jaafari, Arash Mirmohammadsadeghi
PURPOSE: To evaluate the rate of and predictive factors for successful treatment of restrictive myopathy in thyroid-associated orbitopathy (TAO) using botulinum toxin injection. METHODS: Twenty patients with restrictive myopathy of TAO were enrolled in the study. Abnormal thyroid function test results were not a prerequisite for inclusion. In each extraocular muscle 25 units of botulinum toxinA were injected. The success rate, calculated at 2 years or last follow-up before surgery, was defined as proportion of the cases with esotropia of <10(Δ), vertical deviation of <5(Δ), and no diplopia in primary position and downgaze for at least 1 year...
April 2016: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Jwu Jin Khong, Sue Finch, Chamika De Silva, Stacey Rylander, Jamie E Craig, Dinesh Selva, Peter R Ebeling
CONTEXT: Previous association studies suggest the development of Graves' orbitopathy (GO) is variably influenced by environmental risk factors. OBJECTIVE: To determine the risk factors and predict odds for developing GO in Graves' hyperthyroidism (GH). DESIGN: Case-control study. SETTING: Multi-centre Australian Thyroid-associated Orbitopathy Research group consisting of tertiary endocrinology and ophthalmology outpatients and related private practices...
July 2016: Journal of Clinical Endocrinology and Metabolism
George J Kahaly, Tanja Diana, Jennifer Glang, Michael Kanitz, Susanne Pitz, Jochem König
CONTEXT: Thyroid-associated orbitopathy (TAO) rarely occurs in patients with Hashimoto's thyroiditis (HT). OBJECTIVE: There is evidence that TSH receptor stimulating antibodies (TSAb) play a role in the pathogenesis of TAO. In this report, the prevalence of TSAb in HT patients with and without TAO was studied. DESIGN: This is a longitudinal observational study. SETTING: The study took place in an academic joint thyroid-eye clinic...
May 2016: Journal of Clinical Endocrinology and Metabolism
Jae Hoon Jeong, Jeong Kyu Lee, Dong Ik Lee, Yeoun Sook Chun, Bo Youn Cho
OBJECTIVE: To report the physiological monitoring of intraocular pressure (IOP) during the postoperative periods after orbital decompression surgery and ascertain the correlation between the clinical factors and IOP changes. METHODS: The medical records of 113 orbits from 60 patients who underwent orbital decompression surgery were reviewed retrospectively. IOP measurement during the postoperative periods was classified based on the postoperative day: week 1 (1-7 days), month 1 (8-41 days), month 2 (42-70 days), month 3 (71-97 days), month 4 (98-126 days), and final (after 127 days)...
2016: Clinical Ophthalmology
Dorota Walasik-Szemplińska, Magdalena Pauk-Domańska, Urszula Sanocka, Iwona Sudoł-Szopińska
Patients with symptoms of thyroid-associated orbitopathy are classified on the basis of the clinical activity score (CAS) proposed by Mourits in 1989. Despite its undoubted clinical usefulness, it has several limitations which can decide about the success or failure of the implemented treatment. Numerous reports mention the presence of hemodynamic changes in orbital and bulbar vessels in the course of an orbitopathy called Graves' disease. The usage of Doppler sonography in the diagnosis of numerous ophthalmologic vascular diseases suggests that changes in thyroid-associated orbitopathy can correlate with the activity and severity of the disease...
December 2015: Journal of Ultrasonography
A Imburgia, G Elia, F Franco, P Perri, E Franco, M Galiè, L C Clauser
Endocrine orbitopathy (EO) can have important consequences, such as exophthalmos and restrictive strabismus. A retrospective study was performed of 35 patients with EO who underwent orbital decompression surgery and restrictive strabismus correction. Two surgical techniques for orbital decompression were analyzed: fat decompression by Olivari technique and three-wall bony expansion with fat decompression. Strabismus surgery was performed using adjustable or non-adjustable sutures under topical anaesthesia. Patients were divided into two groups according to the type of intra-orbital decompression performed, and the postoperative values resulting from the different fat decompression techniques were recorded...
June 2016: International Journal of Oral and Maxillofacial Surgery
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