Protocolo de diagnóstico y tratamiento de la oftalmopatía tiroidea
- Cayón, Manuel
- Torres Barea, I.
- Roca Rodríguez, Mª del Mar
- Aguilar Diosdado, Manuel
ISSN: 0304-5412
Year of publication: 2012
Issue Title: Enfermedades endocrinológicas y metabólicas: patología del tiroides
Series: 11
Issue: 14
Pages: 844-848
Type: Article
More publications in: Medicine: Programa de Formación Médica Continuada Acreditado
Abstract
Thyroid ophthalmopathy is the most frequent extrathyroidal manifestation of Graves' disease with autoimmune mechanism which is still incompletely understood. The severity and activity of ophthalmopathy should be evaluated reliably for planning subsequent therapy. When needed, complementary imaging techniques (orbital ultrasonography, computerized tomography or nuclear magnetic resonance) to confirm the diagnosis must be used. Management of Graves' ophthalmopathy is preferably done in a multidisciplinary setting. Management of orbitopathy can be either medical and surgical. AII subjects with this ophtalmopathy should benefit from euthyroidism restoration, smoking withdrawal and local measures. The medical therapy relies on the use of high dose systemic glucocorticoids or retro-orbital irradiation, either alone or in combination. Later on. surgery (orbital decompression, squint surgery, eyelid surgery, in this order) will eventually be needed for inactive disease.