Update on the Medical Treatment of Graves' Ophthalmopathy

Overview

Journal Int J Gen Med

Publisher Dove Medical Press

Specialty General Medicine

Date 2010 Apr 3

PMID 20360911

Citations 1

Authors

Gregory J Griepentrog

James A Garrity

Affiliations

Soon will be listed here.

Abstract

Purpose: To review recent advances in the understanding of Graves' ophthalmopathy (GO) pathogenesis as well as discuss current and future medical management strategies.

Design: Interpretive essay.

Methods: Literature review and interpretation.

Results: Medical treatment of GO has slowly evolved during the past few decades and has been hampered by a poor understanding of the disease at a cellular and molecular level. Current treatment recommendations and guidelines therefore focus on nonspecific immuno-suppression. Newer classes of treatment agents hold promise to more selectively target underlying cellular and molecular alterations in GO.

Conclusion: Cooperation between individual patients, physicians and between differing medical centers, together with a refined understanding of the pathogenesis of GO, will lead to newer more-effective treatments for the disease and improve patient quality of life.

Citing Articles

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Yang D, Gonzalez M, Durairaj V Saudi J Ophthalmol. 2013; 25(1):3-13.

PMID: 23960897 PMC: 3729509. DOI: 10.1016/j.sjopt.2010.10.001.

References

Prummel M, Wiersinga W, Mourits M, Koornneef L, Berghout A, van der Gaag R . Effect of abnormal thyroid function on the severity of Graves' ophthalmopathy. Arch Intern Med. 1990; 150(5):1098-101. View

Khalilzadeh O, Mojazi Amiri H, Tahvildari M, Anvari M, Esteghamati A, Mobarra Z . Pretibial myxedema is associated with polymorphism in exon 1 of CTLA-4 gene in patients with Graves' ophthalmopathy. Arch Dermatol Res. 2008; 301(10):719-23. DOI: 10.1007/s00403-008-0919-1. View

Mourits M, van Kempen-Harteveld M, Garcia M, Koppeschaar H, Tick L, Terwee C . Radiotherapy for Graves' orbitopathy: randomised placebo-controlled study. Lancet. 2000; 355(9214):1505-9. DOI: 10.1016/S0140-6736(00)02165-6. View

Bahn R, Heufelder A . Pathogenesis of Graves' ophthalmopathy. N Engl J Med. 1993; 329(20):1468-75. DOI: 10.1056/NEJM199311113292007. View

Prummel M, Wiersinga W . Smoking and risk of Graves' disease. JAMA. 1993; 269(4):479-82. View

Schneider H, Downey J, Smith A, Zinselmeyer B, Rush C, Brewer J . Reversal of the TCR stop signal by CTLA-4. Science. 2006; 313(5795):1972-5. DOI: 10.1126/science.1131078. View

Banga J, Nielsen C, Gilbert J, El Fassi D, Hegedus L . Application of new therapies in Graves' disease and thyroid-associated ophthalmopathy: animal models and translation to human clinical trials. Thyroid. 2008; 18(9):973-81. DOI: 10.1089/thy.2007.0406. View

Gopinath B, Musselman R, Beard N, El-Kaissi S, Tani J, Adams C . Antibodies targeting the calcium binding skeletal muscle protein calsequestrin are specific markers of ophthalmopathy and sensitive indicators of ocular myopathy in patients with Graves' disease. Clin Exp Immunol. 2006; 145(1):56-62. PMC: 1941994. DOI: 10.1111/j.1365-2249.2006.03110.x. View

Tani J, Wall J . Autoimmunity against eye-muscle antigens may explain thyroid-associated ophthalmopathy. CMAJ. 2006; 175(3):239. PMC: 1513432. DOI: 10.1503/cmaj.051680. View

10.

Kahaly G, Pitz S, Hommel G, Dittmar M . Randomized, single blind trial of intravenous versus oral steroid monotherapy in Graves' orbitopathy. J Clin Endocrinol Metab. 2005; 90(9):5234-40. DOI: 10.1210/jc.2005-0148. View

11.

Heufelder A, Dutton C, Sarkar G, Donovan K, Bahn R . Detection of TSH receptor RNA in cultured fibroblasts from patients with Graves' ophthalmopathy and pretibial dermopathy. Thyroid. 1993; 3(4):297-300. DOI: 10.1089/thy.1993.3.297. View

12.

Gorman C, Garrity J, Fatourechi V, Bahn R, Petersen I, Stafford S . A prospective, randomized, double-blind, placebo-controlled study of orbital radiotherapy for Graves' ophthalmopathy. Ophthalmology. 2001; 108(9):1523-34. DOI: 10.1016/s0161-6420(01)00632-7. View

13.

Marcocci C, Bartalena L, Panicucci M, Marconcini C, Cartei F, Cavallacci G . Orbital cobalt irradiation combined with retrobulbar or systemic corticosteroids for Graves' ophthalmopathy: a comparative study. Clin Endocrinol (Oxf). 1987; 27(1):33-42. DOI: 10.1111/j.1365-2265.1987.tb00836.x. View

14.

Wiersinga W . Perspective--Part III: retrobulbar irradiation in Graves orbitopathy: the Dutch experience. Ophthalmic Plast Reconstr Surg. 2002; 18(3):175-6. DOI: 10.1097/00002341-200205000-00004. View

15.

Salvi M, Vannucchi G, Campi I, Curro N, Dazzi D, Simonetta S . Treatment of Graves' disease and associated ophthalmopathy with the anti-CD20 monoclonal antibody rituximab: an open study. Eur J Endocrinol. 2007; 156(1):33-40. DOI: 10.1530/eje.1.02325. View

16.

Smith T, Hoa N . Immunoglobulins from patients with Graves' disease induce hyaluronan synthesis in their orbital fibroblasts through the self-antigen, insulin-like growth factor-I receptor. J Clin Endocrinol Metab. 2004; 89(10):5076-80. DOI: 10.1210/jc.2004-0716. View

17.

Paridaens D, van den Bosch W, van der Loos T, Krenning E, van Hagen P . The effect of etanercept on Graves' ophthalmopathy: a pilot study. Eye (Lond). 2004; 19(12):1286-9. DOI: 10.1038/sj.eye.6701768. View

18.

Bartalena L, Marcocci C, Bogazzi F, Manetti L, Tanda M, DellUnto E . Relation between therapy for hyperthyroidism and the course of Graves' ophthalmopathy. N Engl J Med. 1998; 338(2):73-8. DOI: 10.1056/NEJM199801083380201. View

19.

Gopinath B, Musselman R, Adams C, Tani J, Beard N, Wall J . Study of serum antibodies against three eye muscle antigens and the connective tissue antigen collagen XIII in patients with Graves' disease with and without ophthalmopathy: correlation with clinical features. Thyroid. 2006; 16(10):967-74. DOI: 10.1089/thy.2006.16.967. View

20.

Pfeilschifter J, Ziegler R . Smoking and endocrine ophthalmopathy: impact of smoking severity and current vs lifetime cigarette consumption. Clin Endocrinol (Oxf). 1996; 45(4):477-81. DOI: 10.1046/j.1365-2265.1996.8220832.x. View