Therapy In Practice

Drugs

, Volume 66, Issue 13, pp 1685-1700

Pharmacological Treatments for Thyroid Eye Disease

  • Sara P. ModjtahediAffiliated withDivision of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye InstituteDepartment of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at University of California
  • , Bobeck S. ModjtahediAffiliated withDivision of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye InstituteDepartment of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at University of California
  • , Ahmad M. MansuryAffiliated withDivision of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye InstituteDepartment of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at University of California
  • , Dinesh SelvaAffiliated withOculoplastic and Orbital Division, Department of Ophthalmology and Visual Sciences, Royal Adelaide Hospital, University of AdelaideDepartment of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at University of California
  • , Raymond S. DouglasAffiliated withDivision of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye InstituteDepartment of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at University of California
  • , Robert A. GoldbergAffiliated withDivision of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye InstituteDepartment of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at University of California
  • , Igal LeibovitchAffiliated withDivision of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye InstituteDepartment of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at University of California Email author 

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Abstract

Thyroid eye disease (TED), which affects the majority of patients with Grave’s disease, is associated with significant ophthalmic morbidity. In patients with mild disease, supportive treatment with lubricating medication can be sufficient. However, in patients with severe TED and disfiguring proptosis or sight-threatening neuropathy, more aggressive medical or surgical interventions are necessary. Corticosteroids remain the preferred pharmacological treatment modality in the majority of patients with an active inflammatory component. Other immunosuppressive drugs in combination with corticosteroids may be helpful in patients with corticosteroid-resistant TED. Newer agents such as somatostatin analogues have not shown to be of significant clinical benefit; however, initial studies on the use of antioxidants and cytokine antagonists are encouraging.