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Front Med (Lausanne) 2022 10;9:920716. Epub 2022 Jun 10.

Department of Ophthalmology, Changzheng Hospital, Naval Medical University, Shanghai, China.

Background: Thyroid-associated ophthalmopathy (TAO) is one of the most common orbital diseases that seriously threatens visual function and significantly affects patients' appearances, rendering them unable to work. This study established an intelligent diagnostic system for TAO based on facial images.

Methods: Patient images and data were obtained from medical records of patients with TAO who visited Shanghai Changzheng Hospital from 2013 to 2018. Read More

Brain Res 2022 Jun 20:147989. Epub 2022 Jun 20.

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing 100730, China. Electronic address:

Aim: To explore the morphological brain changes among active thyroid-associated ophthalmopathy (TAO) patients, inactive TAO patients and healthy controls and to investigate the neuropathological relationship of TAO using magnetic resonance imaging (MRI) data.

Methods: In this observational case-control study, we included 35 inactive TAO patients, 37 active TAO patients and 23 healthy controls. Voxel-based morphometry (VBM) analysis was conducted to evaluate the gray matter volume (GMV) changes among groups, and the correlations between GMV alterations and clinical parameters in active and inactive TAO groups were investigated. Read More

BMJ Open 2022 Jun 21;12(6):e050337. Epub 2022 Jun 21.

Department of Ophthalmology, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, Korea (the Republic of)

Objectives: The clinical course of thyroid eye disease (TED) is heterogeneous and predicting patients who may develop the severe sequelae of the disease is difficult. In this study, we evaluated the longitudinal association between changes in serum thyroid-stimulating hormone (TSH) receptor antibody (TRAb) levels and course of disease activity and severity over time.

Design: This was a multicentre, prospective, observational study. Read More

N Z Med J 2022 Feb 4;135(1549):43-49. Epub 2022 Feb 4.

FRACS, Breast, Endocrine, Laparoscopic and Melanoma Surgeon, Department of General Surgery, Waitematā DHB, Auckland.

Aim: To describe indications and outcomes of total thyroidectomy for Graves' disease in a large New Zealand endocrine surgery unit, and to compare these results to international studies.

Methods: We analysed a prospectively collected database to describe the indications and outcomes of surgery for Graves' disease between December 2001 and January 2021.

Results: Among 64 patients who underwent total thyroidectomy at our tertiary centre for Graves' hyperthyroidism, Graves' ophthalmopathy and patient preference/aversion to radioactive iodine were the most common indications for surgery. Read More

Cochrane Database Syst Rev 2022 06 16;6:CD009226. Epub 2022 Jun 16.

Moorfields and UCL Institute of Ophthalmology BMRC, Moorfields Eye Hospital NHS Foundation Trust, London, UK.

Background: Thyroid-associated ophthalmopathy (TAO) is the most frequent extrathyroidal manifestation of Graves' disease, affecting up to 50% of patients. It has a great impact on quality of life. Rituximab (RTX) is a human/murine chimeric monoclonal antibody that targets the CD20 receptor on B-lymphocytes. Read More

Front Endocrinol (Lausanne) 2022 30;13:900791. Epub 2022 May 30.

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

Periostin is a matricellular protein that is ubiquitously expressed in normal human tissues and is involved in pathologic mechanism of chronic inflammatory and fibrotic disease. In this study we investigate periostin in the pathogenesis of Graves' orbitopathy (GO) using human orbital adipose tissue obtained from surgery and primary cultured orbital fibroblasts . POSTN (gene encoding periostin) expression in Graves' orbital tissues and healthy control tissues was studied, and the role of periostin in GO pathologic mechanism was examined through small-interfering RNA (siRNA)-mediated silencing. Read More

Cureus 2022 May 12;14(5):e24954. Epub 2022 May 12.

Department of Internal Medicine, King Saud University Medical City, Riyadh, SAU.

Graves' ophthalmopathy (GO) is commonly associated with hyperthyroidism secondary to Graves' disease (GD). Although rare, there have been case reports of it occurring in patients who are hypothyroid with underlying Hashimoto's thyroiditis (HT), as well as in euthyroid patients. Below, we describe a case of GO developing in a patient who has hypothyroidism secondary to HT successfully treated with high-dose steroids. Read More

Eur J Med Res 2022 Jun 13;27(1):92. Epub 2022 Jun 13.

Applied Bioinformatics, German Cancer Research Center, Berliner Str. 41, 69120, Heidelberg, Germany.

Endocrine orbitopathy is typically treated by resecting orbital walls. This procedure reduces intraorbital pressure by releasing intraorbital tissue, effectively alleviating the symptoms. However, selection of an appropriate surgical plan for treatment of endocrine orbitopathy requires careful consideration because predicting the effects of one-, two-, or three-wall resections on the release of orbital tissues is difficult. Read More

Invest Ophthalmol Vis Sci 2022 06;63(6)

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

Purpose: We investigated a role of bone morphogenic protein 7 (BMP7), a member of the TGF-β superfamily on pathogenic mechanism of Graves' orbitopathy (GO). The therapeutic effects of BMP7 on inflammation and fibrosis were evaluated in cultured Graves' orbital fibroblasts.

Methods: Expression of BMP7 was compared in cultured orbital tissue explants from GO (n = 12) and normal control (n = 12) subjects using real-time PCR. Read More

Front Endocrinol (Lausanne) 2022 17;13:891922. Epub 2022 May 17.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China.

Graves' ophthalmopathy (GO) is a common orbital disease that threatens visual function and appearance. Orbital fibroblasts (OFs) are considered key target and effector cells in GO. In addition, hyaluronan (HA) production, inflammation, and orbital fibrosis are intimately linked to the pathogenesis of GO. Read More

Endocrinol Metab Clin North Am 2022 Jun 11;51(2):287-304. Epub 2022 May 11.

Division of Diabetes, Endocrinology and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 6707 Democracy Boulevard, Room 6054, Bethesda, MD 20892-5460, USA; Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA. Electronic address:

The management of hyperthyroidism and extrathyroidal manifestations of Graves disease remains complex. Considerations that include patient preference, age, comorbidity, pregnancy, tobacco smoking, and social determinants of health must all be weaved into a cohesive management plan. A multidisciplinary team is required to manage all aspects of Graves disease, particularly thyroid eye disease, for which new therapeutic options are now available. Read More

Zhonghua Yi Xue Za Zhi 2022 Jun;102(21):1579-1583

State key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.

To explore the analgesic efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) combined with medial canthus peribulbar block for postoperative pain in patients with thyroid-associated ophthalmopathy (TAO) after orbital decompression. This study was a single-center, single-blind, randomized controlled study. From June 2020 to December 2020, sixty TAO patients in Zhongshan Ophthalmic center, Sun Yat-sen University who were allocated to receive orbital decompression under general anesthesia, were randomly and equally divided into two groups (=30): the control group (group C) and the medial canthus peribulbar block group (group PB). Read More

Int J Mol Sci 2022 May 17;23(10). Epub 2022 May 17.

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

Orbital fibroblasts (OFs) in thyroid-associated ophthalmopathy (TAO) are differentiated from pre-adipocytes and mature adipocytes; increased lipid and fat expansion are the major characteristics of ophthalmic manifestations. Human placental mesenchymal stem cells (hPMSCs) were reported to immunomodulate pathogenesis and suppress adipogenesis in TAO OFs. Here, we prepared transforming growth factor β (TGFβ, 20 ng/mL)-treated hPMSCs (TGFβ-hPMSCs) in order to enhance anti-adipogenic effects in vitro and in TAO mice. Read More

J Curr Ophthalmol 2022 Jan-Mar;34(1):106-111. Epub 2022 Apr 16.

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

Purpose: To focus on clinical manifestations and epidemiology of thyroid eye disease (TED) in Central Iran's population.

Methods: In this retrospective case study, we analyzed all patients with TED who were referred to our oculoplastic clinic from 2015 to 2019. The patients' epidemiological characteristics and clinical presentation were compared between different thyroid disease groups and genders. Read More

Front Immunol 2022 10;13:849480. Epub 2022 May 10.

Department of Ophthalmology, Daping Hospital, Army Medical University, Chongqing, China.

Thyroid associated ophthalmopathy (TAO), characterized by T cell infiltration and orbital fibroblast activation, is an organ-specific autoimmune disease which is still short of effective and safety therapeutic drugs. The PD-1/PD-L1 pathway has been reported hindering the progression of Graves' disease to some extent by inhibiting T cell activity, and tumor therapy with a PD-1 inhibitor caused some adverse effects similar to the symptoms of TAO. These findings suggest that the PD-1/PD-L1 pathway may be associated with the pathogenesis of TAO. Read More

J Nepal Health Res Counc 2022 Mar 13;19(4):824-829. Epub 2022 Mar 13.

B.P. Koirala Lions centre for ophthalmic studies, Institute of Medicine, Tribhuvan University, Kathmandu Nepal.

Background: Elevated intraocular pressure in thyroid associated orbitopathy may lead to development of secondary glaucoma in them. This study evaluated IOP in primary gaze correlation with clinical activity score in them.

Methods: A cross-sectional study was conducted from November 2020 to October 2021. Read More

Front Endocrinol (Lausanne) 2022 9;13:871009. Epub 2022 May 9.

Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland.

Objective: Management of Graves' orbitopathy remains a challenge. Our previous case report has shown promising results for rabbit antithymocyte globulin (rATG) in the treatment of Graves' orbitopathy.

Design: We present the response of 7 individuals with active moderate-to-severe steroid-resistant Graves' orbitopathy to rATG, representing preliminary results from a prospective single-center study. Read More

J Pak Med Assoc 2022 Apr;72(4):767-770

Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore (TN) -632004, India, and Non Communicable Disease Unit, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.

Graves' orbitopathy or thyroid associated orbitopathy (TAO) is a disquieting condition both for the patient and the clinician. While the mainstay of treatment of the orbitopathy is corticosteroids, its action is non-specific. The arguments against its use also include multiple side effects and recurrence on stopping it. Read More

Curr Neurol Neurosci Rep 2022 Jun 26;22(6):313-325. Epub 2022 May 26.

Department of Ophthalmology, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Court, Palo Alto, CA, 94303, USA.

Purpose Of Review: To review emerging treatments for thyroid eye disease (TED) associated extraocular muscle myopathy and dysthyroid optic neuropathy (DON).

Recent Findings: Emerging targeted biologic therapies may alter the disease course in TED. Teprotumumab, a type I insulin-like growth factor receptor inhibitor, is the most recent addition to the treatments available for TED-associated extraocular muscle myopathy causing diplopia. Read More

Curr Eye Res 2022 May 23:1-7. Epub 2022 May 23.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China.

Purpose: To perform orbital magnetic resonance imaging (MRI) three-dimensional (3D) reconstruction based on volume rendering and analyse changes in soft tissues in dysthyroid optic neuropathy (DON) patients.

Methods: Using MRI 3D reconstruction based on volume rendering, orbital model parameters were compared with measurements made by observers. The fat volume (FV) and extraocular rectus muscle volume (EOMV) of subjects were calculated via MRI 3D reconstruction. Read More

Front Endocrinol (Lausanne) 2022 3;13:851143. Epub 2022 May 3.

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

Objective: To evaluate the microstructural changes of the orbital optic nerve in thyroid-associated ophthalmopathy (TAO) patients with or without dysthyroid optic neuropathy (DON) using diffusion tensor imaging (DTI) and investigate whether DTI can be used to detect DON.

Materials And Methods: 59 bilateral TAO patients with (n= 23) and without DON (non-DON, n= 36) who underwent pretreatment DTI were included and 118 orbits were analyzed. The clinical features of all patients were collected. Read More

Front Endocrinol (Lausanne) 2022 29;13:902591. Epub 2022 Apr 29.

Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.

Molecules 2022 May 7;27(9). Epub 2022 May 7.

Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Nagyerdei Körút 98, 4032 Debrecen, Hungary.

Thyroid autoimmunity in Graves' disease (GD) is accompanied by Graves' orbitopathy (GO) in 40% of the cases. Orbital fibroblasts (OF) play a key role in the pathogenesis and cigarette smoking is a known deteriorating factor. Alongside conventional cigarettes (CC) new alternatives became available for smokers, including heated tobacco products (HTP) and E-cigarettes (ECIG). Read More

Int J Mol Sci 2022 May 9;23(9). Epub 2022 May 9.

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China.

Fibrosis of extraocular muscles (EOMs) is a marker of end-stage in Graves' orbitopathy (GO). To determine the antifibrotic and anti-inflammatory therapeutic effects and the underlying molecular mechanisms of disulfiram (DSF) on perimysial orbital fibroblasts (pOFs) in a GO model in vitro, primary cultures of pOFs from eight patients with GO and six subjects without GO (NG) were established. CCK-8 and EdU assays, IF, qPCR, WB, three-dimensional collagen gel contraction assays, cell scratch experiments, and ELISAs were performed. Read More

Front Pharmacol 2022 26;13:785757. Epub 2022 Apr 26.

Department of Endocrinology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Intravenous glucocorticoid (GC) has been proposed to treat moderately severe Graves' orbitopathy (GO); however, the optimal regime remains debatable. We therefore performed this network meta-analysis to objectively determine the comparative efficacy and safety of different intravenous GC regimes, including daily, weekly, or monthly intravenous regimes, for the treatment of GO. We electronically searched Medline ( PubMed), EMBASE ( OVID), and the Cochrane Central Register of Controlled Trials (CENTRAL) ( OVID) to retrieve randomized controlled trials (RCTs) investigating the comparative efficacy and safety of different intravenous GC regimes in GO patients from the inception of each database to March 2021. Read More

Korean J Radiol 2022 Jun 26;23(6):664-673. Epub 2022 Apr 26.

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

Objective: To evaluate the performance of baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping of the extraocular muscles (EOMs) in the prediction of treatment response to intravenous glucocorticoid (IVGC) therapy for active and moderate-to-severe thyroid-associated ophthalmopathy (TAO) and to investigate the effect of fat-suppression (FS) in T2 mapping in this prediction.

Materials And Methods: A total of 79 patients clinically diagnosed with active, moderate-to-severe TAO (47 female, 32 male; mean age ± standard deviation, 46.1 ± 10 years), including 43 patients with a total of 86 orbits in the responsive group and 36 patients with a total of 72 orbits in the unresponsive group, were enrolled. Read More

Int Ophthalmol 2022 May 12. Epub 2022 May 12.

Faculty of Medicine, Ankara Bilkent City Hospital, Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Üniversiteler Mh., Bilkent Blv., 06800, Ankara, Turkey.

Purpose: Graves' orbitopathy (GO) is an inflammatory process that may involve the ocular surface, orbital fat, extraocular muscles, and optic nerves in patients with Graves' disease (GD). We aimed to compare thicknesses of retinal layers in patients with GD with and without GO.

Methods: One hundred seven patients with GD [23 with GO (Group 1), 84 without GO (Group 2)] and eighteen volunteers (Group 3) were enrolled. Read More

J Med Case Rep 2022 May 10;16(1):195. Epub 2022 May 10.

Southern California Eye Physicians and Surgeons, 1111 S. Fair Oaks Ave., Pasadena, CA, 91105, USA.

Background: Teprotumumab is a novel treatment that reduces inflammation and symptoms caused by thyroid eye disease. There are limited data on teprotumumab's effect on intraocular pressure.

Case Presentation: We report nine patients diagnosed with thyroid eye disease whose intraocular pressure decreased during teprotumumab treatment for 8 weeks: patient 1, a 67-year-old Hispanic woman; patient 2, an 86-year-old African-American man; patient 3, a 71-year-old Caucasian woman; patient 4, a 72-year-old Hispanic woman; patient 5, a 65-year-old Caucasian woman; patient 6, a 54-year-old Caucasian man; patient 7, a 54-year-old Asian man; patient 8, a 31-year-old Asian woman; patient 9, a 60-year-old Caucasian woman. Read More

Transl Vis Sci Technol 2022 05;11(5)

Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.

Purpose: To explore the safety and feasibility of robot-assisted orbital fat decompression surgery.

Methods: Ten prospectively enrolled patients (18 eyes) with Graves' ophthalmopathy underwent robot-assisted orbital fat decompression surgery with the da Vinci Xi surgical system. Intraoperative blood loss, operative time, and complications were recorded. Read More

Cureus 2022 Apr 6;14(4):e23890. Epub 2022 Apr 6.

Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.

Introduction Thyroid eye disease is a multifactorial disorder affecting the tear film and ocular surface, which leads to dry eye. The aim of the study is to evaluate the tear function test and ocular surface changes clinically and to correlate pathologically using impression cytology in recently diagnosed cases of thyroid dysfunction, including both hyperthyroid and hypothyroid patients, and to compare the results with healthy subjects. Methods This was a cross-sectional analytical study. Read More