Int J Thyroidol.  2019 Nov;12(2):91-96. 10.11106/ijt.2019.12.2.91.

Treatment of Graves' Ophthalmopathy

• Lee JK

• KMID: 2465061
• DOI: http://doi.org/10.11106/ijt.2019.12.2.91

Abstract

Graves' ophthalmopathy (GO) is an autoimmune disease associated with orbital inflammation and fibrosis which can result in lid retraction, soft tissue swelling, and proptosis. Treatment should rely on a thorough assessment of the activity and severity of GO. Control of risk factors for GO progression and topical treatments for dry eye are recommended for all patients. In mild GO, a careful observation is usually sufficient. In moderate-to-severe and active GO, high-dose intravenous glucocorticoids can be considered an initial treatment. The most common schedule for intravenous glucocorticoids is a cumulative dose of 4.5 g of methylprednisolone, divided into 12 weekly infusions (6 weekly infusions of 0.5 g, followed by 6 weekly infusions of 0.25 g). Orbital radiation has been shown to be an effective secondary treatment in patients with active GO unresponsive to intravenous glucocorticoids. Rehabilitative surgery is needed in patients with GO when the disease is associated with a significant impact on quality of life or visual function after the disease has been inactive for at least 6 months.

Keyword

Graves' ophthalmopathy; Activity; Severity; Steroid; Orbital decompression

MeSH Terms

Appointments and Schedules
Autoimmune Diseases
Exophthalmos
Fibrosis
Glucocorticoids
Humans
Inflammation
Methylprednisolone
Orbit
Quality of Life
Risk Factors
Glucocorticoids
Methylprednisolone

Figure

• 

  Fig. 1. Management of Graves’ ophthalmopathy based on recommendation of European Group on Graves’ Orbitopathy (EUGOGO).

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