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Eur J Radiol 2021 Jun 8;141:109815. Epub 2021 Jun 8.

Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China. Electronic address:

Purpose: To explore radiological changes of the lacrimal gland (LG) in Graves' ophthalmopathy (GO) based on multi-parametric quantitative MRI and its clinical utility in LG diagnosis and activity in GO.

Methods: We enrolled 99 consecutive patients with GO (198 eyes) and 12 Graves' Disease (GD) patients (24 eyes) from July 2018 to June 2020. Clinical, laboratory, and MRI data were collected at the first visit. Read More

Case Rep Endocrinol 2021 22;2021:6669653. Epub 2021 May 22.

Pathology Department, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.

Graves' disease is the most common cause of hyperthyroidism, which is characterized by thyroid antibodies and the following clinical manifestations: goiter, ophthalmopathy, and pretibial myxedema. On the other hand, Henoch-Schönlein purpura is an IgA-mediated small-vessel vasculitis. Review of the literature showed a relationship between propylthiouracil overdose and the following Henoch-Schönlein purpura (IgA vasculitis) as a side effect. Read More

Korean J Ophthalmol 2021 Jun 4;35(3):198-206. Epub 2021 Jun 4.

Department of Endocrinology, Ondokuz Mayıs University, Samsun, Turkey.

Purpose: To investigate the diagnostic and prognostic significance of the blood-count derived systemic immunoinflammatory parameters in patients with thyroid-associated ophthalmopathy (TAO).

Methods: In this retrospective case-control study, the blood-count parameters and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio, and systemic immune-inflammatory index (SII), thyroid peroxidase antibody, and anti-thyroglobulin antibody were evaluated in 46 patients with TAO and 46 matched controls. The associations of the immunoinflammatory parameters with clinical outcomes were analyzed among TAO patients. Read More

Thyroid 2021 Jun 11. Epub 2021 Jun 11.

AV7 Limited, Cardiff, United Kingdom of Great Britain and Northern Ireland;

Background We report therapeutic use of K1-70™, a TSH receptor (TSHR) antagonist monoclonal antibody, in a patient with follicular thyroid cancer (FTC), Graves' disease (GD) and Graves' ophthalmopathy (GO). Methods A 51-year old female patient who smoked, presented in October 2014 with FTC complicated by GD, high levels of TSHR autoantibodies with high thyroid stimulating (TSAb) activity and severe GO. K1-70™ was administered at 3-weekly intervals with the dose adjusted to block TSAb activity. Read More

Am J Ophthalmol 2021 Jun 5. Epub 2021 Jun 5.

Department of Ophthalmology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China. Electronic address:

Purpose: To investigate the corneal endothelium damage in Graves ophthalmopathy (GO) and its role as a promising quantitative index to evaluate GO activity.

Design: Cross-sectional study.

Methods: This study included 128 eyes of 64 patients with GO. Read More

BMC Ophthalmol 2021 Jun 5;21(1):251. Epub 2021 Jun 5.

Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: To present the very rare comorbidity of developing non-specific orbital inflammation (NSOI) in two patients with histories of definite thyroid eye disease (TED).

Case Presentation: Both patients complained of new-onset progressive proptosis although their thyroid disease was controlled and computed tomography scan revealed an intraorbital inflammatory mass. The pathological assessment indicated that both patients had developed fibrosing NSOI. Read More

Exp Biol Med (Maywood) 2021 Jun 2:15353702211017292. Epub 2021 Jun 2.

Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.

Thyroid-associated ophthalmopathy is a typical autoimmune disease of orbital tissues. Alternative splicing significantly influences many diseases progression, including cancer, age-related macular degeneration, and multiple sclerosis, by modulating the expression of transcripts. However, its role in thyroid-associated ophthalmopathy is still unclear. Read More

Gene 2021 Aug 30;793:145750. Epub 2021 May 30.

School of Basic Medical Sciences, Special Key Laboratory of Ocular Diseases of Guizhou Province, Zunyi Medical University, Guizhou 563000, China. Electronic address:

Objective: Graves' disease (GD) is a common autoimmune disease manifesting with diffuse symmetric thyroid gland enlargement, pretibial myxedema, and Graves' ophthalmopathy (GO). Recently, the vitamin D receptor (VDR) gene has been linked to various autoimmune diseases. This study aimed to investigate the association of VDR gene polymorphisms with susceptibility to GD and GO in the Southwest Chinese Han population. Read More

Endocr Connect 2021 Jun 1. Epub 2021 Jun 1.

H Chen, Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Purpose: To evaluate the value of magnetic resonance imaging (MRI)-based texture analysis of extraocular muscle (EOM) and orbital fat (OF) in monitoring and predicting the response to glucocorticoid (GC) therapy in patients with thyroid-associated ophthalmopathy (TAO).

Methods: Thirty-seven active and moderate-to-severe TAO patients (responders, n=23; unresponders, n=14) were retrospectively enrolled. MRI-based texture parameters (entropy, uniformity, skewness and kurtosis) of EOM and OF were measured before and after GC therapy, and compared between groups. Read More

Stem Cell Res Ther 2021 May 29;12(1):304. Epub 2021 May 29.

Department of Ophthalmology, Bundang CHA Medical Center, CHA University, Seongnam, Gyeonggi-do, 13496, Republic of Korea.

Background: Graves' ophthalmopathy (GO) is a disorder, in which orbital connective tissues get in inflammation and increase in volume. Stimulants such as thyroid-stimulating hormone (TSH), insulin-like growth factor 1(IGF-1), IL-1, interferon γ, and platelet-derived growth factor cause differentiation into adipocytes of orbital fibroblasts (OFs) in the orbital fat and extraocular muscles. Human placental mesenchymal stem cells (hPMSCs) are known to have immune modulation effects on disease pathogenesis. Read More

Clin Nucl Med 2021 May 12. Epub 2021 May 12.

From the Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University; Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province; and Academician (Expert) Workstation of Sichuan Province, Luzhou, Sichuan, China.

Abstract: 68Ga-FAPI PET/CT has been used in the assessment of a variety of malignancies. In addition, FAPI uptake in nonmalignant diseases has also been reported. Herein, we present a case of Graves ophthalmopathy detected by 68Ga-FAPI PET/CT. Read More

J Coll Physicians Surg Pak 2021 May;30(5):599-601

Department of Radiology, Mayo Hospital, Lahore, Pakistan.

The aim of the study was to determine the result of conservative management of Graves ophthalmopathy in a multi-disciplinary setting by a team of ophthalmologists and endocrinologists. Twenty-seven patients of thyroid eye disease were included in the study who underwent complete ocular examination and complete thyroid biochemical profile. Each patient was advised lubrication with artificial tears, cool compresses, sleeping with elevated head at bed, taping of the eyelids while sleeping and avoidance of smoking. Read More

Front Endocrinol (Lausanne) 2021 7;12:669871. Epub 2021 May 7.

Imperial College School of Medicine, Imperial College London, London, United Kingdom.

Background/aims: There is no universal consensus on the practical implementation and evaluation of the Amsterdam Declaration on Graves Orbitopathy in a Multidisciplinary Thyroid Eye Disease (MDTED) pathway. Recent recommendations from the UK TEAMeD-5 and BOPSS initiative highlight the importance of prevention, screening, and prompt referral of patients with moderate to severe and sight-threatening thyroid eye disease to multidisciplinary (MDTED) clinics and recommends annual auditing. We propose a practical service evaluation model with Key Performance Indicators (KPI) that are achievable and could be implemented across most TED pathways. Read More

Int Ophthalmol 2021 May 21. Epub 2021 May 21.

University of Health Sciences, Ulucanlar Eye Education and Research Hospital, 06250, Altındağ, Ankara, Turkey.

Objective: The aim of this study was to evaluate the smoking effect on peripapillary and macular microvascular structure in patients with inactive Graves' ophthalmopathy (GO) and to compare these structures with those of healthy control subjects.

Methods: A total of 34 healthy participants (control group), 22 inactive GO patients with smoking (smoker group) and 19 inactive GO patients with non-smoking (non-smoker group) were recruited in this prospective study. After detailed ophthalmological examination, vessel densities (VD) of the superficial capillary plexus (SCP), deep capillary plexus (DCP), retinal peripapillary capillary (RPC) and foveal avascular zone (FAZ) area, and acircularity index (AI) of the FAZ were analysed with optical coherence tomography angiography (OCTA) for each eye. Read More

Sichuan Da Xue Xue Bao Yi Xue Ban 2021 May;52(3):510-515

Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China.

Objective: To explore the clinical features of thyroid-associated ophthalmopathy (TAO) with extraocular muscle involvement.

Methods: The data of 2170 TAO patients who were seen at the Orbital Disease Clinic, West China Hospital, Sichuan University from September, 2009 to January, 2020 were collected retrospectively. The extraocular muscle involvement of these patients was confirmed by CT or MRI. Read More

Int J Endocrinol 2021 30;2021:5513008. Epub 2021 Apr 30.

Private Practice, Ankara, Turkey.

Background: Graves' ophthalmopathy is the most common extrathyroidal manifestation of Graves' disease. The objective of this study was to investigate the clinical ophthalmological and MRI findings in newly diagnosed Graves' ophthalmopathy.

Methods: This study included 36 newly diagnosed Graves' disease patients and 23 control participants. Read More

Ophthalmic Plast Reconstr Surg 2021 May-Jun 01;37(3):296

Ophthalmic Plast Reconstr Surg 2021 May-Jun 01;37(3):296

Eur Radiol 2021 May 15. Epub 2021 May 15.

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.

Objectives: To evaluate the optic nerve and CSF in the optic nerve sheath as imaging markers of dysthyroid optic neuropathy (DON).

Methods: In this single-centre retrospective study, orbital images of 30 consecutive participants (54 orbits) with DON, 30 patients (60 orbits) with thyroid-associated ophthalmopathy (TAO) without DON, and 19 healthy controls (HCs; 38 orbits) were analysed. The diameter and cross-sectional area of the optic nerve and its sheath, water fraction of the optic nerve, and volume of the fluid in the optic nerve sheath were measured and compared. Read More

J Cell Mol Med 2021 Jun 14;25(12):5799-5810. Epub 2021 May 14.

Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Thyroid-associated ophthalmopathy (TAO), the most common and severe manifestation of Graves' disease (GD), is a disfiguring and potentially blinding autoimmune disease. The high relapse rate (up to 20%) and substantial side effects of glucocorticoid treatment further decrease the life quality of TAO patients. To develop novel therapies, we amid to explore the immunopathogenesis of TAO. Read More

BMJ Case Rep 2021 May 10;14(5). Epub 2021 May 10.

Endocrinology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

Teprotumumab (Tepezza), an insulin-like growth factor type 1 receptor antagonist, was approved for treatment of thyroid eye disease in 2020. Teprotumumab is administered intravenously every 3 weeks for a total of eight doses. Common side effects include nausea, diarrhoea, muscle spasms, hearing impairment, dysgeusia, headaches, dry skin, infusion reactions and hyperglycaemia. Read More

J Endocr Soc 2021 May 17;5(5):bvab034. Epub 2021 Mar 17.

Department of Ophthalmology, Stanford University School of Medicine, Stanford, California 94305, USA.

Thyroid eye disease (TED) is a complex inflammatory disease that can have a long clinical course with sight-threatening and debilitating ocular sequelae. Until recently, there were limited therapeutic options available. In the last decade we have gained a deeper understanding of the underlying pathophysiology, which has led to the development of novel effective targeted therapies. Read More

Thyroid 2021 May 5. Epub 2021 May 5.

Samsung Medical Center, 36626, Division of Endocrinology and Metabolism, Department of Medicine, Gangnam-gu, Seoul, Korea (the Republic of).

Background: The actions of thyrotropin-binding inhibitory immunoglobulins (TBIIs) against thyrotropin receptors in thyroid follicular cells have been studied as important etiological factors in Graves' disease (GD). The purpose of this study was to investigate changes in the TBII levels of patients undergoing total thyroidectomy (TTx) or radioactive iodine (RAI) therapy for GD refractory to antithyroid drugs (ATD).

Methods: We enrolled patients who underwent TTx or RAI for GD with previous ATD use between January 2011 and December 2017 at the Samsung Seoul Hospital in Seoul, Korea. Read More

Clin Endocrinol (Oxf) 2021 May 3. Epub 2021 May 3.

Department of Endocrinology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, P.R. China.

Objective: Previous studies suggested IgG4 levels were associated with the development of Graves' ophthalmopathy (GO). The present study investigated the role of IgG4 levels in glucocorticoid (GC) treatment in GO patients.

Methods: Sixty-nine GO patients were enrolled. Read More

Front Endocrinol (Lausanne) 2021 16;12:654473. Epub 2021 Apr 16.

Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy.

Graves' disease (GD) is an organ-specific autoimmune disorder of the thyroid, which is characterized by circulating TSH-receptor (TSH-R) stimulating antibodies (TSAb), leading to hyperthyroidism. Graves' ophthalmopathy (GO) is one of GD extra-thyroidal manifestations associated with the presence of TSAb, and insulin-like growth factor-1 receptor (IGF-1R) autoantibodies, that interact with orbital fibroblasts. Cytokines are elevated in autoimmune (i. Read More

FEBS Open Bio 2021 May 2. Epub 2021 May 2.

Department of Ophthalmology, The Second People's Hospital of Yunnan Province, The Fourth Affiliated Hospital of Kunming Medical University, China.

Graves' ophthalmopathy, also known as thyroid-associated orbitopathy (TAO), is the most common inflammatory eye disease in adults. The most common etiology for TAO is Graves' disease (GD); however, proteomic research focusing on differences between GD and TAO is limited. This study aimed to identify differentially expressed proteins between thyroid-associated orbitopathy (TAO) and GD. Read More

Ophthalmology 2021 Apr 28. Epub 2021 Apr 28.

Department of Ophthalmology, University of California, San Francisco, San Francisco, California.

Teprotumumab, a monoclonal antibody targeted against the insulin-like growth factor 1 (IGF-1) receptor, was recently approved by the United States Food and Drug Administration for the treatment of thyroid eye disease (TED). Phase 1 studies of teprotumumab for the treatment of malignancies demonstrated an acceptable safety profile but limited effectiveness. Basic research implicating the IGF-1 receptor on the CD-34+ orbital fibrocyte in the pathogenesis of TED renewed interest in the drug. Read More

Eye Vis (Lond) 2021 Apr 30;8(1):18. Epub 2021 Apr 30.

Department of Surgical, Ophthalmology Unit, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Savi, 10, 56126, Pisa, Italy.

Background: Hemodynamic changes have been observed in patients with Graves' disease. The aim of our study was to evaluate choroidal vascular change using the choroidal vascularity index (CVI) in patients with thyroid-associated ophthalmopathy (TAO).

Methods: In this cross-sectional observational study, 40 patients affected by TAO were recruited. Read More

Eye Vis (Lond) 2021 Apr 28;8(1):19. Epub 2021 Apr 28.

The Eye Hospital of Wenzhou Medical University, No. 270 Xueyuan Xi Road, Wenzhou, Zhejiang, 325027, P. R. China.

Background: To describe the surgical technique and assess the clinical efficacy and safety of modified endoscopic transnasal orbital apex decompression in the treatment of dysthyroid optic neuropathy.

Methods: In this retrospective research, forty-two subjects (74 orbits) who underwent modified endoscopic transnasal orbital apex decompression for the treatment of dysthyroid optic neuropathy were enrolled. Preoperative and postoperative best-corrected visual acuity (BCVA), visual field mean deviation (MD), Hertel exophthalmometry, and new onset diplopia were assessed before and after the intervention. Read More

PLoS One 2021 22;16(4):e0249988. Epub 2021 Apr 22.

Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Purpose: We investigated the effect of octreotide, a long-acting somatostatin (SST) analogue, on IGF-1 secretion and its possible mechanism of action in orbital fibroblasts (OFs) from patients with thyroid-associated ophthalmopathy (TAO).

Materials And Methods: OFs were isolated from the orbital fat of patients with TAO or healthy individuals. The expression level of insulin-like growth factor (IGF)-1, at the protein and mRNA level, was determined with ELISA and quantitative RT-PCR, respectively. Read More