Thyroid orbitopathy

Thyroid orbitopathy is the fisrt cause of orbital diseases. It is also known by the name of Graves ‘ophthalmopathy by its association with Graves’ disease, considered the most frequent extrathyroidal manifestation of this disease. Thyroid orbitopathy 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. The disease has a variable clinical presentation and it may cause severe damage in vision and orbital architecture, therefore, producing a decrease in the patient?s quality of life and may also alter significantly the personal behavior. Pathogenesis of the disease is not yet fully understood, but it is widely held that there is a common autoantigen shared between the thyroid gland and the orbital adipogenic fibroblasts. Women are more likely to develop thyroid orbitopathy, and the disease is clearly affected by several factors such as smoking, age, sex and race. The most common symptoms are the eyelid retraction, exophthalmos, motility restriction, Involvement of the lacrimal gland, ocular surface changes, and alterations of the optic nerve.

Ultrasonography, CT and MRI show the anatomical structures of the orbit through the analysis of the different densities of orbital tissue. Patients with active orbitopathy should be treated with anti-inflammatory medication (steroids), radiotherapy or immunosuppressive. Patients with non-active orbitopathy should be treated surgically especially with endoscopic orbital decompression.