Thyroid Ophtalmopathy. Case report

Abstract

Thyroid ophthalmopathy or thyroid eye disease (TED) is an orbital inflammatory condition associated with autoimmune thyroid disorders, which determine hypertrophy and fibrosis of orbital fat and striated muscle, presenting increased morbidity: aesthetically and functionally. Graves’ disease is the most common autoimmune disorder. Approximately 50% of patients with Graves’ disease may develop thyroid orbitopathy. The orbital target of the immune response is probably the pluripotent orbital fibrocyte. The diagnosis of TED is established based on three aspects of the disease: clinical findings, thyroid function and antibody tests, imaging characteristics. The most important clinical features of orbitopathy are lid retraction, proptosis, divergent visual axis and dystyroid optic neuropathy. Inflammatory phase is managed by conservative medical treatment and chronic fibrotic phase by surgical.

Objectives. To present the epidemiology of TED and possible risk factors; the pathophysiological mechanism and clinical manifestations of thyroid ophthalmopathy; to elucidate the stages and the criteria of diagnosis; selection of treatments; clinical case presentation.