MLO 605 Cover Story.indd

raves’ ophthalmopathy (GO) is an inflammatory process that affects tissues of the orbit in patients with Graves’ disease (GD) and, more rarely, with Hashimoto’s thyroiditis. It is the most frequent extrathyroidal manifestation of Graves’ disease. GO is a disfi guring disease that impairs, even in its milder forms, the quality of life of affected patients. It is clinically signifi cant in 50% of patients and severe in 3% to 5%. Approximately 50% of patients with GD do not have clinically relevant ocular involvement, although sub-clinical abnormalities can be shown in many of them by computed tomography scan or magnetic resonance imaging (MRI), or by measurement of intraocular pressure.1,2 In approximately 90% of cases, GO is bilateral, and in 5% to 15% can be monolateral. The natural history of GO is not well understood. Spontaneous disease regression occurred in approximately 66% of patients, whereas eye manifestation remained stable in more than 20% and worsened in 14%. Due to the relative rarity of the disease and the fact that diagnosis and treatment involve physicians of different specialties, GO requires a highly specialized and multidisciplinary approach.1,2