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Revista ORL

On-line version ISSN 2444-7986

Abstract

GALINDO-FERREIRO, Alicia  and  MARQUES-FERNANDEZ, Victoria. Thyroid orbitopathy. Review of key points for diagnosis and treatment. Rev. ORL [online]. 2021, vol.12, n.4, pp.381-391.  Epub May 02, 2022. ISSN 2444-7986.  https://dx.doi.org/10.14201/orl.23829.

Introduction and objective:

Thyroid orbitopathy (TO) is an autoimmune disease of unknown etiology. It is a chronic and sometimes subacute or acute edematous and inflammatory disease, the main characteristics of which are eyelid edema, corneal ulcers, ocular hypertension, generally bilateral exophthalmos, restrictive strabismus, diplopia and optic neuropathy. To review and to update the current diagnostic and therapeutic approaches. To propose a practical, basic and precocious approach based in the knowledge of the TO.

Methods:

Literature review and exposition of our experience in the management of TO.

Results:

TO is an inflammatory orbital disease that probably has an autoimmune origin and most of the time is related to systemic disorders of the thyroid gland. Pathogenesis of the disease is not yet fully understood. Women are more likely to develop TO, and the disease is clearly affected by several factors such as smoking, age, sex and race. It is crucial to determine TO severity and activity for a correct management.

Conclusions:

Clinical knowledge is essential for the early diagnosis of this disorder, and it is the most important factor for the proper management of the disease. The medical treatment must be initiated promptly and should be aggressive and based in the current phase of the disease, in order to avoid the severe damage that follows TO. The surgical approach must be logical and sequential, but, on the other hand, must be rapid and aggressive in order to return the patient to his/her labour, social and familiar environment.

Keywords : orbit; thyroid; Graves' disease; ophthalmopathy; orbitopathy.

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