An evidence-based approach to the treatment of Graves' ophthalmopathy

A recent survey demonstrated considerable controversy about the therapeutic approach to a patient with Graves' ophthalmopathy. Among various reasons for this disagreement is the lack of an accepted way to assess the outcome of a given therapeutic intervention. An evidence-based approach requires an objective and meaningful assessment of therapeutic outcomes in prospective, randomized studies in which confounding factors (e.g., smoking, disease activity, and state of the thyroid) are accounted for and controlled. On the basis of the available studies, a treatment approach can be selected.