The treatment of a patient with euthyroid Graves' ophthalmopathy is described. A poor response was obtained from large doses of prednisone whereas a combination of orbital irradiation and low dose cyclophosphamide induced a dramatic resolution. As there is no fully satisfactory treatment for this condition, this combined therapy deserves further investigation.

Thyroid eye disease (also known as Graves' ophthalmopathy) is a complex orbital inflammatory disease, which can be sight threatening, debilitating and disfiguring. This overview discusses the epidemiology, risk factors, pathogenesis, presentation, ophthalmic clinical features, investigations and treatment of thyroid eye disease.

BACKGROUND Graves ophthalmopathy is a chronic, multisystem, autoimmune disorder characterized by increased volume of intraorbital fat and hypertrophic extraocular muscles. Proptosis, impaired ocular motility, diplopia, lid retraction, and impaired visual acuity are treated with orbit decompression and fat reduction. The authors present the addition of skeletal augmentation to further improve pe...

Background: Mild eye signs, especially itchiness and grittiness of the eyelids and upper eyelid retraction (UER), are found in about 25% of patients with Hashimoto’s thyroiditis (HT) in whom antibodies against calsequestrin and flavoprotein (Fp) are often detected. The role of T lymphocyte reactivity against eye muscle antigens in patients with thyroiditis has not been investigated. Methods: We...

A 46-year-old womanwith hypothyroid Graves' disease (EMOsyndrome) is reported. The patient had bilateral exophthalmos, conjunctival chemosis, periorbital edema and limitation of lateral gaze. Laboratory examination revealed the presence of primary hypothyroidism with positive thyroid-stimulating hormone (TSH) binding inhibitory immunoglobulin and thyroid stimulation antibody. These fiindings in...

PURPOSE To evaluate the reduction in proptosis, incidence of postoperative diplopia, and postoperative globe symmetry after transcaruncular medial wall decompression in patients with unilateral Graves ophthalmopathy. METHODS Retrospective review of 16 consecutive patients who underwent unilateral transcaruncular medial wall orbital decompression from 1995 to 2007. The diagnosis of Graves opht...

OBJECTIVE To determine whether clinical and biochemical features of Graves' disease at presentation predict response to medical and radioiodine treatment. METHODS We carried out a retrospective 10-year study of 194 consecutive Saudi subjects with Graves' disease who were treated with antithyroid drugs, radioiodine therapy, or both, between January 1995 and December 2004 at King Khalid Univers...

The serum concentration of hyaluronan (HA) was measured by radiometric assay in patients with pretibial myxedema (PTM) and Graves' ophthalmopathy (GO). The mean HA concentration in the patients (n = 8) was 21.2 +/- 15.3 (mean +/- SD) microgram/l, while that of Graves' disease without skin or eye involvement (n = 7) was 23.5 +/- 11.0 (mean +/- SD) microgram/l and that of the control (n = 8) was ...