Prevalence and Natural History of Graves' Orbitopathy in a Large Series of Patients With Newly Diagnosed Graves' Hyperthyroidism Seen at a Single Center

Abstract

Most patients with newly diagnosed Graves' disease have no ocular involvement. Moderate-to-severe and active GO or sight-threatening GO are rare at presentation and rarely develop during ATD treatment. Most patients (>80%) with no GO at baseline do not develop GO after an 18-month follow-up period. Remission of mild GO occurs in the majority of cases.

THERAPY OF ENDOCRINE DISEASE: Endocrine dilemma: management of Graves’ orbitopathy

“…Antithyroid drugs per se do not appear to negatively affect GO once euthyroidism has been restored. This is suggested by two prospective studies in which most patients during antithyroid drug treatment had stable GO (9,33), with only a few cases of progression or improvement compatible with the natural history of the disease. GO may improve with (34).…”

“…Although the pathogenesis of GO is not yet clarified, immunological cross-reactivity of thyroid and orbital antigens in muscular, connective, and adipose tissues is thought to play a key role (2). Different longitudinal studies confirm that spontaneous improvement or stabilization of eye symptoms and signs may occur when GO is mild (3,4,5,6,7,8,9). It is well known that GO has a self-limiting natural course, characterized by a phase of active inflammation of the orbital tissues, in which disease severity generally progresses, followed by a phase of stabilization and improvement of inflammation, as described by the 'Rundle curve' (10,11) (Fig.…”

Wcześniejsze leczenie choroby Gravesa lekami tyreostatycznymi lub radiojodem nie wpływa na skuteczność leczenia immunosupresyjnego orbitopatii tarczycowej

“…According to Tanda et al [4], some 20% of patients suffering from Graves' disease have inactive or mild GO, 6% have active and moderate-to-severe GO, and only 0.3% develop dysthyroid optic neuropathy (DON). The remaining 73.7% of Graves' patients are free of ocular symptoms.…”

“…The remaining 73.7% of Graves' patients are free of ocular symptoms. The prevalence of GO tends to decline over the years, perhaps due to the decrease in smoking habits or to earlier diagnosis [4][5][6][7]. As only limited groups of GO patients are available for randomised clinical trials (RCTs), precise GO pathogenesis and targeted treatment remain uncertain [2,8].…”

Cigarette smoking: number one enemy for Graves ophthalmopathy

“…Early diagnosis probably contributes substantially to the recent finding that many patients at diagnosis have no GO (75%) or mild GO (20%). 11 In addition, this may contribute to the secular trend Graves ophthalmopathy or orbitopathy (GO) is an autoimmune disorder involving the orbital tissue and characterized by increased orbital content, due to the expansion of the fibroadipose tissue and increased volume of the extraocular muscles. 1 The underlying pathophysiological process explains the clinical manifestations of GO, such as inflammation and edema of soft tissues, exophthalmos, extraocular muscle dysfunction causing diplopia, and, in rare cases, sight loss due to compression of the optic nerve.…”