Recent advances in graves ophthalmopathy medical therapy: a comprehensive literature review

Li, Xueting; Li, Senmao; Fan, Wanlin; Rokohl, Alexander C.; Ju, Sitong; Ju, Xiaojun; Guo, Yang; Heindl, Ludwig M.

doi:10.1007/s10792-022-02537-6

Cited by 6 publications

(7 citation statements)

References 104 publications

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“…Teprotumumab was designated as a "breakthrough therapy" by the FDA because of its disease-modifying capabilities (Li et al, 2023). current data supports the use of intravenous corticosteroids to reduce CAS in individuals with moderate to severe GO.…”

Section: Discussionmentioning

confidence: 96%

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Occuli dextra proptosis in symptomatic hiperthyroidism with diffuse goitre in 45 year old woman: A case report with literature review

Timotius,

Putra,

Johansen

et al. 2023

jika

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Hyperthyroid is refers to increased of thyroid synthesis hormon production by the thyroid gland that cause an excessive amount thyroid homrone circulate in the blood and eventually cause protrusion of unilateral or both eyes at the anterior out of the orbit due to an increased orbital content within the rigid bony orbit. We report the case of 45 -year-old woman with major complaints of blurred vision on her right eye. Blurred vision on this patient is without a red eye but have a tension on his eye that feel like going out. On local examination of the neck area, there was visible mass during inspection, and on palpation there mass in the neck area. On laboratory examination, TSHs levels were 0.085 uIU/mL, FT4 levels were 12.8 pmol/L, creatinine was 0.9 mg/dL, Calcium was 1.23 mmol/L, Natrium 134 mmol/L, Kalium 3.30 mmol/L. On Colli ultrasound, multiple lymphadenopathy were found on the right and left Colli measuring 1.65 cm x 0.6 cm in the right Colli and 2.10 cm x 0.35 cm in the left Colli and on Head CT-scan with contrast orbita centration, Brain edema and proptosis on occuli dextra were found. The patient underwent oral therapy using propylthiouracil and intravenous methylprednisolone therapy. Administered intravenous methylprednisolone pulse therapy show a significant decrease on grave opthalmopathy severity.

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Section: Discussionmentioning

confidence: 96%

“…If GO is active, a small number of moderate GO patients may be recommended for low-dose immunomodulation. Patients with moderate-to-severe and active GO who have visible symptoms and active illness are mostly treated with medication or orbital irradiation treatment (Li et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

Occuli dextra proptosis in symptomatic hiperthyroidism with diffuse goitre in 45 year old woman: A case report with literature review

Timotius,

Putra,

Johansen

et al. 2023

jika

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“…(9) Studi Baixue Du (2020) pada populasi asia mendapatkan fakta bahwa 88,8% pasien berada pada fase inaktif dan 11,2% pasien berada pada aktif (atau plateau). (73) Mayoritas pasien orbitopati grave mengalami gejala berupa retraksi kelopak mata, paparan bola mata, peradangan pada otot ekstraokular yang menyebabkan terjadinya eksoftalmus, (74) dimana retraksi kelopak mata dapat dikatakan sebagai manifestasi tersering orbitopati grave, terjadi pada 90-98% pasien orbitopati…”

Section: Manifestasi Klinisunclassified

“…(73) Manifestasi klinis orbitopati grave juga dipengaruhi lokasi jaringan lunak orbital yang terkena. (74) Studi Baixue Dua (2020) mendapatkan bahwa sekitar 50% pasien orbitopati grave mengalami pembesaran otot extraokular, dengan otot yang terbanyak mengalami kelainan adalah m. rectus inferior (79,9%), diikuti m. rectus superior (55,6%), m. rectus medial (49,5%), dan m. rectus lateral (28,2%). Dalam analisa lebih lanjut didapatkan bahwa sebanyak 27,4% mata mengalami pembesaran hanya 1 otot ekstraokular, 20,1% mengalami pembesaran 2 otot ekstraokular, 20,3% mengalami pembesaran 3 otot ekstraokular, dan 21,0% mengalami pembesaran 4 otot ekstraokular.…”

Section: Manifestasi Klinisunclassified

Unveiling Modern Strategies for Diagnosing and Treating Grave Orbitopathy

Ujianto,

Sari,

Rakhman

2024

JK-RISK

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Graves' Orbitopathy (GO), also known as thyroid eye disease or thyroid-associated orbitopathy is characterized by inflammation, ocular muscle hypertrophy, adipogenesis, and oedema (due to glycosaminoglycan accumulation). This condition leads to remodeling, tissue expansion, and/or fibrosis within the fibroadipose tissue or extraocular muscles of the orbit. GO manifests as an extrathyroidal aspect of autoimmune thyroid diseases in both Grave's disease (GD) and Hashimoto's thyroiditis. The pathophysiological foundation of GO entails the infiltration of B cells, T cells, and CD34+ fibroblasts in the orbit. B cells generate IGF (insulin-like growth factor), wherein IGF and TRab (Thyroid-Receptor antibodies) stimulate the IGF receptor complex and thyrotropin receptor (respectively) on the surface of CD34+ cells which triggers orbital tissue expansion, orbital protrusion, optic nerve compression, and eyeball displacement, resulting in exophthalmos. GO progress through an active phase (characterized by inflammation with visible manifestations), followed by a plateau phase (stabilization of GO manifestations), and a gradual resolution of distinctive residual signs and symptoms (inactive phase). This entire process spans between 18-24 months in untreated patients, where disease manifestations significantly depend on the phase during which the disease is identified. GO therapy is intended to shorten the active phase and supress its residual eye manifestations during the inactive phase. In general, GO therapy is categorized into general and disease severity-specific approaches. GO therapy often falls short of providing satisfactory results, prompting need of surgery to address lingering clinical manifestations. This review presents the latest insights into the pathogenesis and treatment of GO for better management and outcomes.

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“…Graves’ orbitopathy (GO), also called Graves’ ophthalmopathy, thyroid-associated ophthalmopathy (TAO), or thyroid eye disease (TED), is an autoimmune disorder of the orbit and retrobulbar tissues, representing the major extrathyroidal manifestation of Graves’ disease (GD) [ 1 – 3 ]. Although GO is most frequently associated with hyperthyroidism, it may rarely occur in euthyroid or hypothyroid patients [ 3 , 4 ]. App.…”

Section: Introductionmentioning

confidence: 99%

Safety of non-standard regimen of systemic steroid therapy in patients with Graves’ orbitopathy: a single-centre experience

Sawicka-Gutaj,

Gruszczyński,

Zawalna

et al. 2024

Pharmacol. Rep

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Background Graves’ orbitopathy (GO) is an autoimmune disorder of the orbit and retro-ocular tissues and the primary extrathyroidal manifestation of Graves’ disease. In moderate-to-severe and active GO iv glucocorticoids (GCs) are recommended as first-line treatment. The aim was to assess the safety profile of methylprednisolone administered intravenously for three consecutive days at 1 g in patients with active, moderate-to-severe or sight-threatening Graves’ orbitopathy. Methods We retrospectively evaluated 161 medical records of patients with GO treated with high-dose systemic GCs in the Department of Endocrinology, Metabolic Disorders, and Internal Medicine in Poznań between 2014 and 2021. Clinical data included age, gender, laboratory results, activity and severity of GO, smoking status, disease duration, and presented side effects. Results The presence of mild side effects was observed during 114 (71%) hospitalizations. The most common complications were hyperglycemia (n = 95) and elevated aminotransferases (n = 31). Increased levels of aminotransferases were more likely observed in smokers and GO duration above 12 months. Based on the multivariate logistic regression, higher TRAb and CAS values were significantly associated with lower odds of hyperglycemia. In turn, the increased odds of elevated aminotransferases were significantly correlated with higher initial ALT levels, female gender, and GO duration above 12 months. In addition, the multidimensional correspondence analysis (MPA) showed that GO patients who declared smoking and had not l-ornithine l-aspartate applied demonstrated a higher probability of elevated aminotransferases. Conclusions Active GO treatment with high-dose systemic GCs is not associated with serious side effects. Hyperglycemia is the most common steroid-induced complication.

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Recent advances in graves ophthalmopathy medical therapy: a comprehensive literature review

Cited by 6 publications

References 104 publications

Occuli dextra proptosis in symptomatic hiperthyroidism with diffuse goitre in 45 year old woman: A case report with literature review

Occuli dextra proptosis in symptomatic hiperthyroidism with diffuse goitre in 45 year old woman: A case report with literature review

Unveiling Modern Strategies for Diagnosing and Treating Grave Orbitopathy

Safety of non-standard regimen of systemic steroid therapy in patients with Graves’ orbitopathy: a single-centre experience

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