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Thyroid eye disease: current and potential medical management

Abstract

Introduction

Thyroid eye disease (TED) is the most frequent extra-thyroid manifestation of Graves’ disease and it is more frequent in middle age and in female gender. Nowadays, the causal mechanisms of this disease are not completely understood, but the current available studies suggest that the main causative factor is the thyroid stimulating hormone receptor.

Materials and methods

To collect reports on TED medical management, a thorough literature search was performed in PubMed database. An additional search was made in Google Scholar to complete the collected items.

Results

Among the indentified risk factors, tobacco habit is the most relevant. The main criteria to choose a suitable treatment are the activity and severity of the disease. Support measures can be used to improve the patient’s symptoms in any phase of the disease. There is a large number of drugs proposed to manage TED, although with different reported rates of success.

Conclusions

Currently, the drugs of choice are corticosteroids in moderate-to-severe and in sight-threatening forms. The main problem of corticosteroids is their spectrum of side effects. Therefore, other alternatives are being suggested for medical management of this disease. The efficacy of these alternatives remains unclear.

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Acknowledgements

This work has received financial support from ISCIII (RD16/0008/0003) cofounded by European Regional Development Fund (FEDER), and Consellería de Cultura, Educación e Ordenación Universitaria, Xunta de Galicia (Centro Singular de Investigación de Galicia Acreditación 2016–2019, ED431G/05).

Funding

This study was funded by ISCIII (RD16/0008/0003) cofounded by European Regional Development Fund (FEDER), and Consellería de Cultura, Educación e Ordenación Universitaria, Xunta de Galicia (Centro Singular de Investigación de Galicia Acreditación 2016–2019, ED431G/05).

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Correspondence to Jessica M. Pouso-Diz.

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Pouso-Diz, J.M., Abalo-Lojo, J.M. & Gonzalez, F. Thyroid eye disease: current and potential medical management. Int Ophthalmol (2020). https://doi.org/10.1007/s10792-019-01258-7

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Keywords

  • Thyroid eye disease
  • Graves’ disease
  • TSHR
  • Corticosteroids