Rezumat. Oftalmopatia tiroidiana sau boala oculară tiroidiană este o patologie inflamatorie a orbitei asociată cu boala tiroidiană autoimună
care determină hipertrofia și fibroza țesutului adipos al orbitei și a mușchilor striați. Patologia prezintă morbiditate
crescută cu defect estetic și funcțional. Boala Graves este cea mai frecventă patologie autoimună, iar circa 50% dintre pacienți
pot dezvolta orbitopatia tiroidiană.
Actuality. Thyroid ophthalmopathy or thyroid
eye disease (TED) is an orbital inflammatory condition
associated with autoimmune thyroid disorders,
which determine hypertrophy and fibrosis of orbital
fat and striated muscle, presenting increased
morbidity: aesthetically and functionally. Graves’
disease is the most common autoimmune disorder.
Approximately 50% of patients with Graves’ disease
may develop thyroid orbitopathy. The orbital target
of the immune response is probably the pluripotent
orbital fibrocyte. The diagnosis of TED is established
based on three aspects of the disease: clinical findings,
thyroid function and antibody tests, imaging
characteristics. The most important clinical features
of orbitopathy are lid retraction, proptosis, divergent
visual axis and dystyroid optic neuropathy. Inflammatory
phase is managed by conservative medical
treatment and chronic fibrotic phase by surgical.
Objectives. To present the epidemiology of
TED and possible risk factors; the pathophysiological
mechanism and clinical manifestations of thyroid
ophthalmopathy; to elucidate the stages and
the criteria of diagnosis; selection of treatments;
clinical case presentation. Materials and Methods. This study is a case
report, based on a retrospective analysis of a patient,
using different diagnostic methods presented
in the article.
Discussion and conclusion. Thyroid ophthalmopathy
is an orbital inflammatory condition,
which is associated with autoimmune thyroid disease
that causes hypertrophy and cicatrizing of
orbital fat and striated muscles. Although it is selflimiting,
it can significantly disrupt the aesthetic aspect,
vision and quality of life of patient. TED has a
biphasic course, with a progressive („active”) phase
that lasts 6-18 months, followed by a stable („inactive”)
phase. These phases are classified as „clinical
activity”. Immunomodulatory medication and radiotherapy
used in the temporary active phase may
limit the destructive consequences of the immune
cascade. TED management is ideally performed using
a multidisciplinary team (endocrinologist, ophthalmologist,
rheumatologist, oncologist), each
having an area for expertise.
