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Graefes Arch Clin Exp Ophthalmol 2020 Jun 25. Epub 2020 Jun 25.

Department of Endocrinology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Str, no. 16, 700115, Iasi, Romania.

Aim: The purpose of this study is to share our experience on the use of different orbital decompression techniques, as well as the principles followed for deciding the most case-appropriate procedure that ensured the most favorable outcomes.

Methods: We reviewed the Graves' ophthalmopathy cases operated over the course of 14 years, regarding the presenting signs, the imaging evaluation, the degree of exophthalmos, the type of surgical orbital decompression performed, and the postoperative outcomes.

Results: All 42 patients identified presented with proptosis, with 92. Read More

Curr Eye Res 2020 Jun 21:1-17. Epub 2020 Jun 21.

Department of Centre of Advanced Research (CFAR), King George's Medical University (KGMU) , Lucknow, India.

Purpose: TAO is an organ specific autoimmune disease associated with thyroid, and inflammation of the orbit and periorbital tissues, which is different from systemic autoimmune diseases such as SLE. However, Grave's disease is a kind of systemic autoimmune syndrome which might involve the thyroid, the eye ball and the anterior tibial tissue. Considering the inexplicable understanding of TAO pathogenesis, the disease worsens for the patients. Read More

J Curr Ophthalmol 2020 Jan-Mar;32(1):1-13. Epub 2020 Mar 23.

Eye Research Center, Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: To review various treatment methods in thyroid eye disease (TED) related strabismus.

Methods: We searched in PubMed and Google Scholar and Ovid MEDLINE for keywords including TED-related strabismus, strabismus in thyroid-associated ophthalmopathy, Graves ophthalmopathy related strabismus or squint, and restrictive strabismus. Two expert strabismus specialists selected and evaluated the English articles that were related to our paper and had been published since 2000. Read More

Endocrine 2020 Jun 5. Epub 2020 Jun 5.

Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Purpose: We aimed to evaluate the performance of structural magnetic resonance imaging (MRI)-based quantitative measurements at extraocular muscle (EOM), orbital fat (OF), and especially lacrimal gland (LG) in predicting response to glucocorticoid (GC) in patients with active and moderate-severe thyroid-associated ophthalmopathy (TAO).

Methods: Forty-seven active and moderate-severe TAOs (responsive group, 29 patients and 58 eyes; unresponsive group, 18 patients and 36 eyes) were enrolled. Pretreatment MRI-based parameters of EOM, OF, and LG, and clinical factors were retrospectively collected and compared between two groups. Read More

Sci Rep 2020 Apr 30;10(1):7329. Epub 2020 Apr 30.

Department of Ophthalmology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Inflammation and remodelling of orbital tissue associated with enhanced adipogenesis commonly occur in Graves' ophthalmopathy (GO), however, the underlying mechanisms that link immune cells and adipocytes in orbital inflammation are not well-known. The primary aim of this study was to elucidate how a genetically determined shift in the T-cell repertoire toward self-reactive T-cells could drive orbital adipogenesis. To induce the T-cell-mediated autoimmune response, SKG mice were intraperitoneally injected with zymosan A once at 8 weeks of age. Read More

J Endocrinol Invest 2020 Apr 6. Epub 2020 Apr 6.

Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Gulou District, Nanjing, China.

Purpose: To explore the morphological and microstructural changes of grey and white matter in the patients of thyroid-associated ophthalmopathy (TAO).

Methods: Twenty-five TAO patients and 25 well-matched healthy controls were recruited. Structural T1- and diffusion-weighted magnetic resonance imaging data were analyzed using voxel-based morphometry and voxel-based analysis of diffusion tensor imaging. Read More

Clin Endocrinol (Oxf) 2020 Jun 5;92(6):536-544. Epub 2020 Mar 5.

Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Yonago, Japan.

Objective: In Graves' ophthalmopathy (GO), fibrosis in extraocular muscles (EOMs) may be related to intravenous glucocorticoid (ivGC)-resistant diplopia. Signal intensity (SI) of magnetic resonance imaging (MRI) T1 mapping can quantify properties of EOM components, including fibrosis. We investigated EOM features of GO patients with diplopia using T1 mapping SI and the predictive value of T1 mapping SI in the response of diplopia to ivGCs. Read More

Acta Radiol 2020 Feb 13:284185120905032. Epub 2020 Feb 13.

Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China.

Medicine (Baltimore) 2020 Jan;99(5):e19026

Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing.

Introduction: Entropion and secondary trichiasis can lead to irritative symptoms and essential damage of ocular surface. There is no literature reporting the lower eyelid entropion related to thyroid-associated ophthalmopathy (TAO), let alone the treatment. Treatment based on etiology may yield effective and sustained results. Read More

N Engl J Med 2020 01;382(4):341-352

From Cedars-Sinai Medical Center, Los Angeles (R.S.D., A.P.); Johannes Gutenberg University Medical Center, Mainz (G.J.K.), and University Hospital Essen, Essen (A.E.) - both in Germany; Horizon Therapeutics, Lake Forest, IL (S.S., E.H.Z.T., R.P., J.W.S., T.V., R.J.H.); University of Tennessee Health Science Center, Memphis (J.C.F., B.T.F.); University of Pisa, Pisa (C.M., M.M., A.A.), and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (M.S.) - both in Italy; Oregon Health and Sciences University, Portland (R.D.); Medical College of Wisconsin Eye Institute, Milwaukee (G.J.H.); Eye Wellness Center-Neuro-Eye Clinical Trials, Houston (J.S., R.T.); Kellogg Eye Center-Michigan Medicine (C.N., T.J.S.) and University of Michigan Medical School (T.J.S.) - both in Ann Arbor; and Bascom Palmer Eye Institute, Miami (S.W.).

Background: Thyroid eye disease is a debilitating, disfiguring, and potentially blinding periocular condition for which no Food and Drug Administration-approved medical therapy is available. Strong evidence has implicated the insulin-like growth factor I receptor (IGF-IR) in the pathogenesis of this disease.

Methods: In a randomized, double-masked, placebo-controlled, phase 3 multicenter trial, we assigned patients with active thyroid eye disease in a 1:1 ratio to receive intravenous infusions of the IGF-IR inhibitor teprotumumab (10 mg per kilogram of body weight for the first infusion and 20 mg per kilogram for subsequent infusions) or placebo once every 3 weeks for 21 weeks; the last trial visit for this analysis was at week 24. Read More

Eur Radiol 2020 Apr 17;30(4):2138-2141. Epub 2020 Jan 17.

Section of Endocrinology - Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.

Background: Lacrimal gland (LG) involvement in patients with Graves ophthalmopathy (GO) has been considered as a potential cause of the associated GO symptoms and different studies demonstrated the LG involvement in patients with GO than healthy controls. The aim of this study was to evaluate LG involvement, through measurement of its herniation, using a magnetic resonance imaging (MRI) index, in patients with different GO activities.

Methods: Thirty-two consecutive Caucasian patients affected by GO were enrolled and grouped in group A (16 with inactive GO, CAS < 3) and B (16 with active GO, CAS ≥ 3) according to their GO activity. Read More

Front Endocrinol (Lausanne) 2019 17;10:707. Epub 2019 Oct 17.

Department of Radiology, National Institute of Geriatrics Rheumatology and Rehabilitation, Warsaw, Poland.

Despite unquestionable clinical usefulness of Clinical Activity Score, the evaluating system needs frequent supplementation. One of such diagnostic tools is Doppler imaging that is used for the analysis of flow in the retrobulbar vessels. The improvement of the reliability and sensibility of measurements could make Doppler imaging an everyday clinical tool and improve the efficacy of treatment in patients with active thyroid-associated orbitopathy. Read More

Korean J Ophthalmol 2019 Oct;33(5):436-445

Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Purpose: We sought to investigate the effects of Graves' orbitopathy (GO) and orbital decompression on lamina cribrosa depth (LCD) using spectral-domain optical coherence tomography.

Methods: Forty eyes that underwent orbital decompression to relieve compressive optic neuropathy or correct disfiguring exophthalmos in the context of GO were included. Subjects were imaged with spectral-domain optical coherence tomography before surgery and at 1 and 3 months after surgery, at which the examiner measured the LCD (distance from the anterior surface of the lamina cribrosa to the Bruch membrane opening line) and peripapillary retinal nerve fiber layer thickness. Read More

Int Ophthalmol Clin 2019 ;59(4):81-93

Probl Endokrinol (Mosk) 2019 09 12;65(3):174-183. Epub 2019 Sep 12.

Endocrinology Research Centre.

Confocal microscopy is a modern imaging method that provides ample opportunities for in vitro and in vivo research. The clinical part of the review focuses on well-established techniques, such as corneal confocal microscopy for the diagnosis of diabetic neuropathy or endocrine ophthalmopathy; new methods are briefly described (intraoperative evaluation of tissues obtained by removing pituitary adenomas, thyroid and parathyroid glands). In the part devoted to fundamental research, the use of confocal microscopy to characterize the colocalization of proteins, as well as three-dimensional intracellular structures and signaling pathways in vivo, is considered. Read More

J Pediatr Ophthalmol Strabismus 2019 Sep;56(5):319-326

Purpose: To assess the correlation between optical coherence tomography (OCT) and magnetic resonance imaging (MRI) measurements of extraocular rectus muscle thickness in patients with Graves' ophthalmopathy.

Methods: This was a cross-sectional observational study conducted in 62 eyes of 31 patients with Graves' ophthalmopathy. The disease phase was inactive in 20 patients and active in the remaining 11. Read More

J Pediatr Ophthalmol Strabismus 2019 09;56(5):281

Graefes Arch Clin Exp Ophthalmol 2019 Nov 23;257(11):2533-2540. Epub 2019 Aug 23.

Farabi Eye Hospital, Tehran University of Medical science, Qazvin Sq, Tehran, Iran.

Purpose: To compare macular and peripapillary vasculatures in active thyroid eye disease (TED), not active not compressive (NANC) TED, and control eyes.

Methods: Twenty-one eyes of 12 active TED patients, 77 eyes of 43 NANC patients, and 65 eyes of 35 healthy normal subjects were recruited in this observational study. The participants underwent optical coherence tomography (OCT) and OCT angiography (OCT-A) of the peripapillary and macular areas. Read More

Endocr Pract 2019 Dec 14;25(12):1268-1278. Epub 2019 Aug 14.

In thyroid-associated ophthalmopathy (TAO), long disease duration is negatively correlated with the response to immunosuppression treatment. The current treatment decision-making process does not involve magnetic resonance imaging (MRI); thus, we investigated the predictive value of MRI parameters for the immunosuppressive response in active moderate to severe TAO patients with different disease durations. We retrospectively analyzed the baseline MRI parameters of active TAO patients treated with guideline-recommended weekly glucocorticoid therapy in our center. Read More

Curr Opin Ophthalmol 2019 Sep;30(5):401-406

Thyroid Eye Disease Service, Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Purpose Of Review: To offer an update on advances and controversies in the assessment, investigation and treatment of thyroid eye disease (TED), a disfiguring orbital autoimmune disease, which can manifest with diplopia and threaten not only sight - but also life.

Recent Findings: Developments in biomarkers and imaging are helping to tailor the management of patients. Emerging therapies target different pathways in the disease and are informed by studies into TED pathogenesis: the last 2 years has, for example, seen the culmination of a two-decade long bench-to-bedside story in which an original focus on the IGF1 receptor has translated into an effective treatment for proptosis in thyroid eye disease. Read More

Folia Med (Plovdiv) 2019 Mar;61(1):90-96

Department of Diagnostic Imaging, Allergology and Physical Therapy, Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.

Aim: To establish the correlation between intraocular pressure (IOP) and thickness of extraocular muscles (EOM), the severity and activity of thyroid-associated orbitopathy (TAO).

Materials And Methods: 50 patients with TAO were included in the study. They all underwent a thorough ophthalmic examination, Goldmann tonometry (mm Hg) and computer tomography of the orbits, the muscle thickness sum (MTS) of each eye being measured in millimeters. Read More

PLoS One 2019 24;14(6):e0218701. Epub 2019 Jun 24.

Department of Gynecology, University Hospital Oldenburg, Oldenburg, Germany.

Purpose: Orbital decompression surgery is performed in patients with Graves' orbitopathy to treat dysthyroid optical neuropathy (DON) and reduce disfiguring proptosis. The intended proptosis reduction can deviate from the postoperative result and changes of motility with consecutive diplopia can occur. We performed a retrospective study to identify anatomical factors in computed tomography (CT), which influence the surgical effect and postoperative ocular motility and diplopia. Read More

Int Ophthalmol Clin 2019 ;59(3):113-124

Jpn J Radiol 2019 Aug 14;37(8):612-618. Epub 2019 Jun 14.

Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan.

Purpose: To evaluate the effectiveness of radiation therapy and steroids for Asian patients with Graves' ophthalmopathy using the clinical activity score (CAS), and changes in external ocular muscles and eye proptosis determined by magnetic resonance imaging (MRI).

Materials And Methods: We retrospectively reviewed 48 patients who received combined orbital radiation and systemic glucocorticoids in our hospital. MRI was performed both before and 1 month after treatment in all patients. Read More

Radiol Case Rep 2019 Aug 23;14(8):917-919. Epub 2019 May 23.

Department of Radiology, SUNY Downstate Medical Center, State University of New York Downstate Medical Center, MSC 1198, 450 Clarkson Ave, Brooklyn, NY 11203, USA.

Thyroid acropachy is a rare complication of autoimmune thyroid disease with characteristic imaging findings. Clinically, it presents as nail clubbing, swelling of digits and toes, almost always in association with thyroid ophthalmopathy and dermopathy. On radiographs, it manifests as prominent irregular and spiculated periosteal new bone formation in the hands and feet. Read More

Arch Soc Esp Oftalmol 2019 Aug 5;94(8):400-404. Epub 2019 Jun 5.

Instituto de Oftalmología, Fundación de Asistencia Privada Conde de Valenciana IAP, Ciudad de México, México.

The case concerns a 73 year-old female with a diagnosis of hyperthyroidism of 8 months onset. Since then, she has suffered hyperaemia and ocular proptosis. Bilateral exophthalmos was observed in the physical examination, along with mild conjunctival hyperaemia in the right eye associated with dilated episcleral vessels. Read More

Zhonghua Yan Ke Za Zhi 2019 May;55(5):361-368

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab., Beijing 100730, China.

To explore the imaging features of patients with special forms of strabismus and summarize the subtypes by using MRI imaging techniques. A retrospective case series study. Among the patients who visited the Beijing Tongren Hospital between 2006 and 2016, 1 113 patients were identified with special forms of strabismus after complete ophthalmic and orthoptic evaluations. Read More

Endocrinol Diabetes Metab Case Rep 2019 May 3;2019. Epub 2019 May 3.

Canberra Hospital, Woden, Canberra, Australian Capital Territory, Australia.

Multinodular goitre is not associated with eye disease, unless in a rare case of Marine-Lenhart syndrome where it coexists with Grave's disease. Therefore, other causes of exophthalmos need to be ruled out when the eye disease is seen in a patient with multinodular goitre. Confusion can arise in patients with features suggestive of Graves' ophthalmopathy in the absence of thyroid-stimulating hormone receptor autoantibodies and no evidence of other causes of exophthalmos. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2019 Mar;44(3):322-328

Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008, China.

Objective: To investigate the values of orbital single photon emission computed tomography/computerized tomography (SPECT/CT) with 99mTc-diethylene triamine pentaacetic acid (99mTc-DTPA) on the evaluation of lacrimal gland inflammation in patients with thyroid associated ophthalmopathy (TAO).
 Methods: A total of 58 TAO patients were retrospectively recruited for this study, all of whom were categorized into all active group and all inactive group based on the clinical active score (CAS). Another 12 patients with the negative images on SPECT/CT served as a normal control group (NC). Read More

Ophthalmic Plast Reconstr Surg 2019 May/Jun;35(3):e64-e66

Department of Ophthalmology, University of California, San Francisco, San Francisco, California, U.S.A.

Intravenous tocilizumab has been demonstrated to be an effective disease modifying agent in the treatment of moderate to severe active thyroid eye disease. The authors describe 2 patients treated with tocilizumab using home subcutaneous administration over an accelerated, biweekly course. Both patients exhibited improvement in thyroid eye disease clinical activity and proptosis. Read More

Nucl Med Commun 2019 May;40(5):455-460

Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Temple University Health System.

Background: Radioactive iodine-131 (RAI) is an established treatment for patients with Graves' hyperthyroidism. RAI is reported to be associated with a 20-30% incidence of development or exacerbation of Graves' ophthalmopathy (GO). This study compares the progression of GO in patients who had evidence or no evidence of GO before RAI therapy. Read More

J Ultrason 2018 ;18(75):349-354

Imperial College NHS Trust, Western Eye Hospital , London , UK.

Pathological processes within the orbits are a heterogeneous group of diseases of various etiologies, clinical pictures and therapy models. Due to poor access to the orbits in a clinical examination, imaging plays a significant role in both diagnosis and treatment monitoring in patients with an orbital pathology. One of such imaging modalities is ultrasonography. Read More

Pol Arch Intern Med 2019 05 13;129(5):351-353. Epub 2019 Feb 13.

PLoS One 2019 7;14(2):e0211817. Epub 2019 Feb 7.

Department of Ophthalmology, University Medicine Greifswald, Greifswald, Mecklenburg-Western Pomerania, Germany.

Purpose: Exophthalmometry is a common examination in ophthalmology. For example it is relevant for diagnosis or follow-up of thyroid eye disease. However, exophthalmometry is affected by several factors such as ethnicity, sex and age. Read More

Arq Bras Oftalmol 2019 Mar-Apr;82(2):124-128. Epub 2019 Jan 10.

Ophthalmology Department, Ondokuz Mayis University, Samsun, Turkey.

Purpose: To compare the choroidal thickness in active and stable phases of thyroid eye disease.

Methods: Forty-seven eyes of 47 patients with thyroid eye disease were prospectively studied. Patients were evaluated on the basis of their clinical activity scores, with scores 33 defined as active disease. Read More

Med Sci Monit 2019 Feb 6;25:1024-1031. Epub 2019 Feb 6.

Department of Ophthalmology, Changzheng Hospital, Second Military Medical University, Shanghai, China (mainland).

BACKGROUND Thyroid-associated ophthalmopathy (TAO) is a common endocrine autoimmune disease. The present study explored corneal nerve changes in TAO patients. MATERIAL AND METHODS Thirty-eight Chinese TAO patients and 20 healthy individuals were included in the study. Read More

Eye (Lond) 2019 02 18;33(2):244-253. Epub 2019 Jan 18.

Trainee Ophthalmologist, Bristol Eye Hospital, Bristol, UK.

The clinical features of thyroid eye disease are dictated by the orbit's compartmentalisation; particularly, the muscle cone, which is delimited by the rectus muscles, their inter-muscular septa and the posterior sclera. The cone is anchored to the orbit apex and contains the posterior globe, the muscle bellies, a fat pad, and the blood circulation, optic nerve, and CSF sheath. It is surrounded by mobile extraconal fat, retained by the orbital septum. Read More

BMC Endocr Disord 2019 Jan 18;19(1):10. Epub 2019 Jan 18.

Department of Nuclear Medicine, Medical University of Bialystok, M. Skłodowskiej-Curie St. 24A, 15-276, Bialystok, Poland.

Background: The most frequently used methods of assessing Graves' orbithopathy (GO) include: Clinical Activity Score (CAS), ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI). There exists another, slightly forgotten, imaging method: single-photon emission computed tomography (SPECT) with the use of diethylenetriaminepentaacetic acid tagged with Tc (Tc-DTPA). These days it is possible to conduct a SPECT examination fused with a CT scan (SPECT/CT), which increases the diagnostic value of the investigation. Read More

Orbit 2019 Dec 10;38(6):440-445. Epub 2019 Jan 10.

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.

: To evaluate alterations in orbital color Doppler imaging (CDI) parameters and their correlation to disease activity and severity in patients with thyroid eye disease (TED). : Seventy-six orbits of 45 TED patients and 40 orbits of 40 normal controls were enrolled in this cross-sectional study. According to clinical activity score (CAS), patients were categorized to active (CAS ≥ 3) or inactive disease (CAS < 3). Read More

BMC Ophthalmol 2019 Jan 8;19(1). Epub 2019 Jan 8.

Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland.

Background: Thyroid-associated orbitopathy (TAO) constitutes an immune-mediated inflammation of the orbital tissues of unclear etiopathogenesis. TAO is most prevalent in hyperthyroid patients with Graves' disease (GD); however, severe cases of orbitopathy associated with Hashimoto's thyroiditis (HT) have rarely been described.

Case Presentation: Herewith we report an unusual case of a middle-aged clinically and biochemically euthyroid woman with a stable HT, who developed a severe unilateral left-sided TAO. Read More

Acta Ophthalmol 2019 Aug 28;97(5):e800-e806. Epub 2018 Dec 28.

Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.

Purpose: To compare the structure and function of the Meibomian gland and eyelid blinking patterns between thyroid eye disease (TED) patients with dry eye and nonthyroidal dry eye (DE) patients.

Methods: This was a prospective, cross-sectional and observational study. Clinical measurements were performed as follows: (1) external examination, (2) Lipiview Interferometer (lipid layer thickness, incomplete blinking rate and meibography) and (3) slit-lamp biomicroscopy (corneal staining, tear break-up time (TBUT), meibum expression). Read More

Eye (Lond) 2019 02 11;33(2):235-243. Epub 2018 Dec 11.

Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK.

Imaging in thyroid eye disease (TED) is used to exclude other diagnoses, assess for apical crowding and plan surgery. But to quantify TED activity objectively, subjective clinical scoring assessments remain the norm. Magnetic resonance imaging (MRI) T2-relaxation times correlate with extra-ocular muscle (EOM) inflammation, but are confounded by signal from fat. Read More

Endocrine 2019 05 1;64(2):308-315. Epub 2018 Dec 1.

Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland.

Purpose: To evaluate the influence of intravenous methylprednisolone (IVMP) pulse administration on bone mineral density (BMD) of the lumbar spine and the femoral neck in patients with moderate-to-severe Graves' orbitopathy (GO).

Methods: Thirty-five patients with GO in euthyreosis were treated with 12 IVMP pulses (6 × 0.5 g, 6 × 0. Read More

Orbit 2019 Dec 4;38(6):433-439. Epub 2018 Dec 4.

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen , Essen , Germany.

: Different minimally invasive surgical approaches to the orbit allow individualized bone resection to reduce proptosis and decompress the optic nerve in patients with Graves' orbitopathy (GO). This study aims to compare piezosurgery to an oscillating saw used to resect bone from the lateral orbital wall. : In a retrospective study, we analyzed balanced orbital decompressions performed on 174 patients (318 cases) with GO. Read More

Eye (Lond) 2019 02 29;33(2):223-229. Epub 2018 Nov 29.

Thyroid Eye Disease Service, Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Alemtuzumab-a monoclonal antibody targeting the CD52 glycoprotein expressed by most mature leucocytes-effectively decreases relapse rate and disability progression in early, relapsing-remitting multiple sclerosis (MS). However, secondary autoimmune disorders complicate therapy in nearly 50% of treated patients, with Graves' disease being the most common. Rarely, thyroid eye disease (TED) ensues; only seven such cases have been reported. Read More

Graefes Arch Clin Exp Ophthalmol 2019 Feb 28;257(2):405-411. Epub 2018 Nov 28.

Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan.

Purpose: To examine the clinicopathological characteristics of patients with thyroid eye disease (TED) who showed asymmetric lacrimal gland enlargement.

Methods: Sixteen patients were included in this retrospective, observational case series. The following data were collected: sex, age, laterality, past medical history, laboratory results for thyroid function and other autoimmune disorders, pathological results, other systemic lesions related to lacrimal gland pathology, and the clinical course after treatment. Read More

Acta Clin Croat 2018 Jun;57(2):301-306

Department of Ophthalmology, Rijeka University Hospital Center, Rijeka, Croatia.

Thyroid-associated orbitopathy (TAO) is a common manifestation of Graves' disease. The aim of the study was to assess the six percent of patients with TAO that develop dysthyroid optic neuropathy (DON), which is the most serious complication of TAO. As DON can cause perma-nent damage, it is essential to detect DON early when visual loss is still reversible. Read More

Clin Endocrinol (Oxf) 2019 02 27;90(2):328-333. Epub 2018 Nov 27.

The Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK.

Objective: Patients with hyperthyroidism lacking autoimmune features but showing diffuse uptake on thyroid scintigram can have either Graves' disease or germline activating TSH receptor (TSHR) mutation. It is important to identify patients with activating TSHR mutation due to treatment implication, but the overlapping clinical features with Graves' disease make it difficult to discriminate these two conditions without genetic testing. Our study aimed to assess the potential of systematic TSHR mutation screening in adults with hyperthyroidism, showing diffuse uptake on thyroid scintigraphy but absence of TSH receptor antibodies (TRAb) and clinical signs of autoimmunity. Read More

Orbit 2019 Oct 18;38(5):347-352. Epub 2018 Oct 18.

Ophthalmic Plastic and Reconstructive Surgery Department, University of Health Sciences, Istanbul Beyoglu Eye Research and Training Hospital , Istanbul , Turkey.

: The aim of this study was to evaluate whether orbital changes induced by thyroid eye disease affect the ocular pulse amplitude and choroidal perfusion. : A total of 38 eyes of 38 patients with thyroid eye disease (Group 1) and 38 eyes of 38 control individuals (Group 2) with normal intraocular pressure were enrolled in this study. Thyroid eye disease activity was defined using clinical activity score. Read More

Clin Physiol Funct Imaging 2019 Mar 16;39(2):135-142. Epub 2018 Oct 16.

Faculdade de Medicina, Pós-graduacão em Endocrinologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

It has been suggested that technetium-99m (99mTc)-anti-tumour necrosis factor alpha (TNF-α) scintigraphy (SCI) may be a useful diagnostic tool in Graves' ophthalmopathy (GO). This study evaluated whether orbit total radioactivity uptake on SCI could be used to predict corticosteroid therapy (CorT) responses in active-GO patients. A longitudinal study of patients with active GO defined by Clinical Active Score (CAS) >3/7 was done. Read More