Management of Graves' ophthalmopathy: reality and perspectives.

摘要: Graves’ ophthalmopathy is an debilitating disease impairing the quality of life affected individuals. Despite recent progress in understanding its pathogenesis, treatment often not satisfactory. In mild cases, local therapeutic measures (artificial tears and ointments, sunglasses, nocturnal taping eyes, prisms) can control symptoms signs. severe forms (3‐5%), aggressive are required. If active, high-dose glucocorticoids and/or orbital radiotherapy, or decompression represent mainstay treatment. but inactive, preferred. Novel treatments such as somatostatin analogs intravenous immunoglobulins under evaluation. Rehabilitative (extraocular muscle eyelid) surgery needed after inactivation eye disease. Correction both hyper- hypothyroidism crucial for ophthalmopathy. Antithyroid drugs thyroidectomy do influence course ophthalmopathy, whereas radioiodine may cause progression preexisting especially smokers. The exacerbation, however, prevented by glucocorticoids. addition, thyroid ablation prove beneficial view pathogenetic model relating to autoimmune reactions directed against antigens shared orbit. (Endocrine Reviews 21: 168 ‐199, 2000)