Thyroid-associated orbitopathy (TAO) is an autoimmune disorder that affects multiple periocular tissues. In TAO, an active immunologic inflammatory phase is typically followed by a cicatrizing recovery phase. Management in the inflammatory phase is supportive, and surgical rehabilitation should generally be deferred until the patient is stable. We review current treatment concepts, with a focus on the timing and sequence of surgical procedures to address proptosis, motility restriction, and eyelid malposition in patients with TAO. A stepwise surgical approach maximizes the predictability of surgical outcomes and minimizes reoperations.
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http://dx.doi.org/10.1016/j.jaapos.2017.12.002 | DOI Listing |
PeerJ
December 2024
Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou, China.
Background: Plasma from patients with active thyroid-associated orbitopathy (TAO-A) could cause inflammation to fibroblasts, and such a mechanism was explored in the context of melanoma.
Methods: Plasma samples collected from TAO-A patients and healthy control (HC) were primarily co-cultured with the melanoma-associated fibroblasts (MAFs) derived from melanoma patients. The survival and inflammation of the co-cultured MAFs were measured after confirming the levels of pro-inflammatory cytokines.
Sci Rep
November 2024
Department of Ophthalmology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea.
The purpose of this study was to evaluate the clinical feasibility and reliability of a neural network (NN)-based automated proptosis measurement system using computed tomography (CT) images. An automated proptosis measurement system was developed using the CT images of 200 eyes from 100 patients diagnosed with thyroid-associated orbitopathy. We compared the proptosis value obtained from the proposed automated system with the values obtained from the Hertel exophthalmometer and manual measurements of CT slices.
View Article and Find Full Text PDFEur Thyroid J
December 2024
Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy.
Insights Imaging
August 2024
Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
Objectives: The clinical activity score (CAS) and European severity scale (ESS) are established clinical tools to assess thyroid eye disease (TED) but are limited in terms of subjectivity and their reliability in non-Caucasian individuals, and can underestimate significant disease in the posterior orbit. Preliminary data from pilot studies have shown that diffusion-weighted imaging (DWI) using extraocular muscle (EOM) apparent diffusion coefficient (ADC) measurements may provide complementary information in TED. This study expands on previous research to assess for correlations between clinical scores and EOM-ADCs in stratifying disease activity and severity in a large patient cohort from an ethnically diverse population.
View Article and Find Full Text PDFOrbit
August 2024
Department of Ophthalmology, CUO Maisonneuve-Rosemont Hospital, Université de Montréal, Montreal, QC, Canada.
The authors describe a case of bilateral diffuse paraneoplastic orbital myositis induced by a stage IA left testicular pure seminoma. The patient presented with findings typical of thyroid-associated orbitopathy (TAO) and was thought to have TAO until discovery of the malignancy. Treatment included an urgent orchiectomy, as well as 7 weeks of therapeutic plasma exchange.
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