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International Ophthalmology

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01-10-2018 | Review

Advances in the management of thyroid eye diseases: An overview

Authors: Rashmi Kumari, Bhawesh Chandra Saha

Published in: International Ophthalmology | Issue 5/2018

Abstract

Introduction

Thyroid eye disease (TED) remains a notorious ailment for both patients and the treating ophthalmologists. Recent years have witnessed considerable research in the immunopathogenic mechanism of TED that has resulted in an expansion and modification of the available management options.

Aim

Purpose of this review is to summarise the advances in the management of thyroid ophthalmopathy.

Material and method

A thorough literature search and of the past 10 years web search with words Thyroid ophthalmopathy, recent, advances.

Results

Recent VISA classification and new serum markers seem to have potential to give diagnostic as well as therapeutic guidance, gauge treatment response and even identify risk of disease progression. Majority of TED patients can be managed conservatively due to its self-limiting nature but if indicated, still steroids are the preferable medical therapy; however, there is an increasing consensus towards the use of parenteral form as compared to the oral one on account of greater efficacy with lesser side effects. Steroid sparing medications, for example, rituximab, infliximab, etanercept, adalimumab, teprotumumab, tocilizumab, tanshinone, are showing encouraging results and form an area of active research.

Conclusion

Radiation therapy remains as an adjunctive modality in active diseases as a nonmedical treatment for TED with some promising data. Surgical intervention may be required in vision threatening conditions or to counteract the sequel of inflammatory phase. Advances in surgical techniques like stereotactic image-guided balanced orbital decompression with endoscopic approach ensure meticulous dissection with minimal trauma.

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Title: Advances in the management of thyroid eye diseases: An overview
Authors: Rashmi Kumari
Bhawesh Chandra Saha
Publication date: 01-10-2018
Publisher: Springer Netherlands
Published in: International Ophthalmology / Issue 5/2018
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-017-0694-0

At a glance: The STEP trials

Springer Medicine

Advances in the management of thyroid eye diseases: An overview

Abstract

Introduction

Aim

Material and method

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Aim

Material and method

Results

Conclusion

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