Update on thyroid eye disease: Regional variations in prevalence, diagnosis, and management

• Published in: Indian journal of ophthalmology Vol. 70; no. 7; pp. 2335 - 2345
• Main Authors: Yu, Caroline, Ford, Rebecca, Wester, Sara, Shriver, Erin
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.07.2022; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Decompression; Decompression, Surgical; Disease management; dysthyroid optic neuropathy; Edema; Eye diseases; Eyelid; Graves Ophthalmopathy - diagnosis; Graves Ophthalmopathy - epidemiology; Graves Ophthalmopathy - therapy; graves' ophthalmopathy; Humans; Inflammation; Insulin; Insulin-like growth factor I; Monoclonal antibodies; Oculomotor Muscles - surgery; oculoplastics; Optic neuropathy; orbital inflammation; Prevalence; Quality of Life; Radiation therapy; Review; Risk factors; strabismus; teprotumumab; Thyroid; thyroid eye disease; Thyroid gland; Variation; Vision; Vision Disorders - etiology; thyroid eye disease; oculoplastics; strabismus; Dysthyroid optic neuropathy; Graves' ophthalmopathy; orbital inflammation; teprotumumab
• ISSN: 0301-4738; 1998-3689; 1998-3689
• DOI: 10.4103/ijo.IJO_3217_21

Thyroid eye disease (TED) is a rare disease that can lead to decreased quality of life, permanent disfigurement, and vision loss. Clinically, TED presents with exophthalmos, periorbital edema, extraocular muscle dysfunction, and eyelid retraction, and can lead to vision-threatening complications such as exposure to keratopathy and dysthyroid optic neuropathy (DON). Over the last several years, significant advancements have been made in the understanding of its pathophysiology as well as optimal management. Ethnic variations in the prevalence, clinical presentation, and risk of vision-threatening complications of TED are summarized, and risk factors associated with TED are discussed. Additionally, significant advances have been made in the management of TED. The management of TED traditionally included anti-inflammatory medications, orbital radiation therapy, orbital surgical decompression, and biologic therapies. Most recently, targeted therapies such as teprotumumab, an insulin-like growth factor-1 receptor antagonist, have been studied in the context of TED, with promising initial data. In this review, updates in the understanding and management of TED are presented with a focus on the international variations in presentation and management.