Treatment of Graves' ophthalmopathy

Article Abstract:

Patients with Graves' disease experience seemingly unrelated health problems including pathological changes of the eye, particularly of the external muscles which move the eye, the extraocular muscles. At some time these patients usually experience episodes of increased thyroid functioning, hyperthyroidism, that result in an increase in circulating thyroid hormones. Accumulation of a fluid can also occur on the tibia (leg bone), and clubbing or other bony changes of the fingers can also occur, although the latter effects are rare. The disease process can be mysterious to the clinician because so little is known about this thyroid pathology and changes of the extraocular muscles, soft tissue, skin and bone. Approximately 40 percent of patients with Graves' disease develop a group of pathologies of the eye (ophthalmopathy) including exophthalmos (bulging of the eyes) and a large increase in the size of the muscles which move the eyeball (extrinsic eye muscles). The latter effect may limit the range of motion of the eyes. Two articles in this issue of the Journal discuss the treatment of Graves' disease as a means of improving ophthalmopathy. These papers describe the experience of patients following radioactive iodine treatments which are used to destroy thyroid tissue and decrease hyperthyroidism. The articles discuss various treatments used to arrest the ophthalmopathy of Graves' disease, including prednisone and cyclosporine, an immunosuppressive drug. The results show that current treatments are not uniformly effective, nor are they without significant side effects. Fortunately most patients do not require such aggressive treatments, but for those who do, the use of prednisone or surgery (orbital decompression, in which fat is removed from the eye socket) is recommended as treatment for ophthalmopathy of Graves' disease.

Care and treatment, Evaluation, Adrenocortical hormones, Eye diseases, Cyclosporine, Cyclosporins, Thyroid diseases, Hyperthyroidism, editorial

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Preventing Graves' ophthalmopathy

Article Abstract:

Graves' disease patients may be at lower risk of developing eye disorders when treated with drugs rather than radioactive iodine. Graves' disease is a type of hyperthyroidism in which some patients develop bulging of the eyes, eyelid swelling, and other changes, sometimes following treatment. The natural course of Graves'-associated eye problems is not fully understood, although genetic factors, smoking, and treatment with radioactive iodine may be related. Methimazole is an antithyroid drug that does not appear to promote eye problems, and may be better for high-risk patients.

Editorial, Prevention, Iodine, Iodine (Chemical element), Thyroid eye disease

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Similar abstracts:

• Abstracts: Prednisone and cyclosporine in the treatment of severe Graves' ophthalmopathy. part 2 Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

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